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Images/Instrument in Dermatology/Dermatosurgery
2024
:4;
39
doi:
10.25259/CSDM_18_2024

Mottled rash on the dorsal feet of an adolescent girl

Department of Telemedicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Corresponding author: Priyadarshini Sahu, Department of Telemedicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. priyadarshinis2142@gmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Vashisht KR, Sahu P, Gupta R. Mottled rash on the dorsal feet of an adolescent girl. CosmoDerma. 2024;4:39. doi: 10.25259/CSDM_18_2024

An 18-year-old girl from a semi-urban area sought remote consultation through teledermatology for a “winter season” rash on her feet. On examination, distinct mottled hyperpigmentation in a reticulate, mesh-like pattern on the dorsal aspect of both feet, with the left side showing more prominence, was observed [Figures 1 and 2]. Further, probing revealed that she had been spending prolonged hours studying next to a heater with the bare left foot positioned directly next to the appliance. A diagnosis of “Erythema ab igne” was established, and she was counseled to avoid the proximity of the bare area to the heat source.

Figure 1:
Mottled, reticulate hyperpigmentation on dorsum of left foot; (placed directly next to heat source).
Figure 2:
Similar, faint rash on dorsal aspect of right foot; (placed relatively further from heat source).

Erythema ab igne or “toasted skin syndrome” results from repeated and prolonged exposure to low levels of infrared radiation, such as from a heating appliance, insufficient to cause a burn. This exposure causes degeneration of elastic fibers and basal cells leading to the release of melanin and dark lacy discoloration.[1] The rash initially manifests as transient, mottled erythema and progresses to fixed, reticulate hyperpigmentation.[2] The condition, less common in youth, may be misdiagnosed as livedo reticularis leading to unnecessary immunological investigations, but may be distinguished by its pigmentary rather than telangiectatic changes.[1]

Ethical approval

The Institutional Review Board approval is not required.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

References

  1. , , . Erythema ab igne. CMAJ. 2010;182:E228.
    [CrossRef] [PubMed] [Google Scholar]
  2. , . Clinical features and etiology of patients with erythema ab igne: A retrospective multicenter study. J Cosmet Dermatol. 2020;19:1774-9.
    [CrossRef] [PubMed] [Google Scholar]

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