Doctors have issued a warning following an increase in cases of erythema ab igne (EAI), commonly known as toasted skin syndrome, among children. This condition, characterised by a net-like rash caused by prolonged exposure to low-level heat, has traditionally been seen in adults using heat sources like hot water bottles or heating pads. However, the rise in electronic device use among youngsters, particularly during home schooling, has brought new attention to the risk factors for children.
A recent case involved a pre-teen boy who was diagnosed with EAI after resting his laptop on his stomach for up to eight hours each day, often while it was charging. Initially, the boy visited a children’s emergency department presenting with unexplained bruising. Neither he nor his parents were aware of any cause. He showed no signs of illness such as fever or weight loss, and initial blood tests and scans were normal, resulting in his discharge.
However, two weeks later, the rash had worsened, becoming tender with areas of peeling skin, prompting a return visit to hospital. Further questioning revealed the boy’s routine use of his laptop directly on his skin during home schooling sessions. This detail led to the diagnosis of erythema ab igne.
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Dr Mara Znagoveanu of University Hospitals of Leicester NHS Trust highlighted that while EAI is more commonly reported in adults, it may be overlooked in children-especially when the heat source is less obvious than traditional items. She stressed that increasing electronic device use is a new and under-recognised cause of EAI in paediatric patients.
Dr Znagoveanu warned that misdiagnosis of EAI in children might lead to unwarranted investigations such as unnecessary blood tests or scans. She added that the condition is generally reversible, with skin improvements noted over weeks to months once the heat source is removed. Some cases may see persistent pigmentation changes, but in the boy’s case, the rash had completely resolved several months later, as confirmed through a follow-up telephone consultation.
Currently, there are no formal paediatric guidelines for diagnosing EAI, and detection relies on clinical history and distinctive skin patterns. Dr Znagoveanu emphasised the importance of considering EAI in children who present with reticulated rashes, particularly with increasing electronic device use. Early recognition and targeted questioning can prevent misdiagnosis and reduce unnecessary medical testing.