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QUESTION: A 59-year-old man is seen because of a netlike rash in the sacral area. The rash began 2 months ago and was neither pruritic nor painful. The patient has a long history of arthritis and back pain. On physical examination, a hyperpigmented reticulated rash is seen on the sacral area (figure).
What additional history would help to make this diagnosis?
ANSWER: Additional history revealed that the patient started using a heating pad to soothe his back pain about the same time the reticulated rash began to appear.
The patient has erythema ab igne ("red from fire"), also known as toasted-skin syndrome, heat-induced circum-scribed dermal melanosis, fire stains, ephelis ignealis, or livedo reticularis e calore.
Erythema ab igne is a cutaneous disorder caused by absorption of infrared radiation. Women are affected more often than men. 1 Patients have a history of repeated exposures to heat at a lower level than that which causes a thermal burn. The skin is often...