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ORIGINAL CONTRIBUTIONS
Year : 1990  |  Volume : 56  |  Issue : 2  |  Page : 119-120

Erythema ab igne




Correspondence Address:
Kumar Anil Gaikwad


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  Abstract 

Fifteen females cooking in front of 'Chulha' developed erythema ab igne on the legs and hands. the patients were exposed to the heat for variable periods. Clinical and histo-pathological regression was seen after protective covering with clothes in two patients.


Keywords: Erythema ab igne, Housewives, `Chulha′


How to cite this article:
Gaikwad KA, Khedker M Y, Ban A P. Erythema ab igne. Indian J Dermatol Venereol Leprol 1990;56:119-20

How to cite this URL:
Gaikwad KA, Khedker M Y, Ban A P. Erythema ab igne. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2020 Aug 5];56:119-20. Available from: http://www.ijdvl.com/text.asp?1990/56/2/119/3497


Erythema ab igne is caused by repeated and prolonged exposures to infra-red radiation insufficient to produce a burn.[1] It is also termed as' ephelis ignealis, erythema a calore and ephelis ab igne.[2] The disease is commonly seen in places with a cold climate like America and England where people have to resort to various heating devices to protect themselves from cold.[3],[4],[5],[6] It has occasionally been reported from some parts of India with similar climatic condi­tionss[6],[7] or with a psychiatric disorder.[8] We are reporting erythema ab igne in females who were repeatedly exposed to heat from a `Chulha' during cooking.


  Materials and Methods Top


Female patients having erythematous reticular lesions on the legs and hands, with a history of cooking in front of the `Chulha' were included in the study. The duration and mode of exposure to heat were recorded. General and systemic examination was carried out to look for any internal disease. Hemogram, urinalysis, serum cholesterol, serum proteins, liver function tests, X-ray chest and electrocardiogram were done in all cases. Skin biopsies from the lesions were stained with hematoxylin and eosin and Prussian blue stains. House visit was paid by one of the authors to study the exact mode of exposure to the heat. The right leg was uncovered and continuously exposed to the source of heat ('Chulha'). The distance of the leg from the heat source was about 30 to 40 cm. The right hand was brought near the 'Chulha' inter­mittently while roasting the bread (Shaker). The patients were instructed to cover the exposed part with the saree to avoid direct exposure to heat. Seven patients visited the hospital only twice in two years, and they did not follow the instructions, five patients did it intermittently. Three patients followed the instructions strictly for one year. Repeat histopathological examina­tion was permitted by two of them.


  Results Top


Out of 15 cases, 9 were in the age group of 21 to 25 years, the period of exposure to heat in them was 7 to 8 years and the daily exposure was more than 6 hours. Four patients were in the age group of 16 to 20 years, the period of exposure was 5 to 7 years, and the daily average exposure was 4 hours. Two patients were below the age of 15 years, the period of exposure was 1 to 2 years, the daily average exposure being 1 to 2 hours. Our youngest patient was 13 years and the eldest was 30-year­old. Clinical examination and investigations revealed no other abnormality. Histopatholo­gically, the epidermis was thinned, collagen fibres were fragmented and there was lymphocy­tic infiltration in the dermis. A variable amount of brownish pigment due to hemosiderin was evident with the Prussian blue stain. There were no abnormal cells to suggest malignancy. In 8 patients who followed the instructions about avoidance of direct heat, the burning sensation subsided at the end of 6 months to 1 year. The lesions became faint. Amongst the 3 patients who strictly followed the instructions for 1 year, repeat histopathological examination was permitted by two, which revealed regression of the changes. The lymphocytic infiltration was less and the Prussian blue reaction was milder. There was no change in the epidermis.


  Comments Top


Erythema ab igne is becoming less common in America and England due to central heating. In our region, `Chuiha' is still commonly used for cooking. It is cheap, and suits the earnings of the low socio-economic population. The exposure of heat from the `Chuiha' is almost unavoidable in the females who cook, but to the best of our knowledge, erythema ab igne has not been reported in this group. Erythema ab igne is generally asymptomatic but may be associated with slight discomfort like burning and itching.[5],[6],[7],[9] The initial burning and hyperpigmentation was probably neglected by our patients.

Erythema ab igne has been commonly reported in association with malnutrition, cirrhosis of liver, Hansen disease, anemia and malignancy,[6],[7] hypothyroidism[1],[9] and psychia­tric disorder.[8] There is no satisfactory treatment for erythema ab igne but the patient should be instructed for proper clothings and efforts should be made to improve the microcircula­tion.[1] Our two cases suggest that reversibility is possible with advice regarding clothings.

 
  References Top

1.Wilkinson DS : C taneous reaction to mechanical and thermal injury, in : Text book of Dermatology, Editors, Rook A, Wilkinson DS and Ebling FJG Vol III, Blackwell Scientific Publication, Oxford, 1979; p 485-508.  Back to cited text no. 1    
2.Finlayson GR, Sams WM Jr and Smith JG Jr Erythema ab igne, J Invest Dermatol, 1966; 46 104-108.  Back to cited text no. 2    
3.Johnson WC and Butterworth T : Erythema ab igne elastosis, Arch Dermatol, 1971; 104 :.128-131.  Back to cited text no. 3    
4.Peterkin GAG : Malignant changes in erythema ab igne, Brit J Dermatol, 1955; 2 : 1599-1602.  Back to cited text no. 4    
5.Sharad S and Mark R : The wages of warmth, changes in erythema ab igne, Brit J Dermatol, 1977; 97 : 179-186.  Back to cited text no. 5    
6.Bedi BMS : Erythema ab igne, Ind J Dermatol­Venereol, 1969; 35 : 200-201.  Back to cited text no. 6    
7.Bedi BMS : Erythema ab igne, Ind J Dermatol Venereol, 1971; 37 : 69-71.  Back to cited text no. 7    
8.Pavithran K : Erythema ab igne, schizophrenia and thermophilia, Ind J Dermatol Venereol Leprol, 1987; 53 : 81-82.  Back to cited text no. 8    
9.Sneddon IB : Winter ailments of the skin, Practi­tioner, 1968; 201 : 886-891.  Back to cited text no. 9    




 

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