Doctors have issued warnings about a rise in cases of erythema ab igne (EAI), known as toasted skin syndrome, among children. This condition is a patchy, net-like rash resulting from prolonged exposure to low-level heat, often caused by resting electronic devices directly on the skin.
A recent case involved a pre-teen boy who developed EAI after placing his laptop on his stomach for up to eight hours daily, particularly while the device was charging. Initially, the boy attended a children’s emergency department due to what appeared to be spontaneous bruising. Neither he nor his parents could identify the cause of the rash. His general health was good, with no trauma, fever, or weight loss noted. Blood tests and scans found no abnormalities, and he was discharged.
Two weeks later, the rash worsened, becoming tender and accompanied by peeling skin. Further inquiry revealed the boy was being home-schooled and used his laptop extensively, often resting it on his abdomen.
Dr Mara Znagoveanu from University Hospitals of Leicester NHS Trust highlighted that while EAI has traditionally been observed in adults using heat sources like hot water bottles or heating pads, the rise in children’s use of electronic devices, especially during home schooling, is an emerging cause. She emphasised that EAI in children may be overlooked due to the less obvious heat exposure compared to traditional sources.
Misdiagnosis can lead to unnecessary investigations, including blood tests and imaging. In contrast, EAI is generally reversible once the heat source is removed, with the rash healing over weeks to months. Persistent skin pigmentation changes can occur in some cases.
Follow-up via telephone revealed the boy’s rash had resolved months after the diagnosis. Dr Znagoveanu noted the absence of formal paediatric guidelines for diagnosing EAI and stressed the importance of clinical diagnosis through careful history-taking.
This case underscores the need for awareness among healthcare professionals to consider EAI in children presenting with characteristic skin rashes, particularly given the increasing use of electronic devices. Early recognition can prevent unnecessary medical procedures and support timely management.