Cases and Research Letters
Erythema Ab Igne Caused by Laptop Computer Use
Eritema ab igne provocado por el ordenador portátil
T. Fernández-Portilla, B. Escutia-Muñoz
, M. Navarro-Mira, C. Pujol-Marco
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Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain
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Fernández-Portilla, B. Escutia-Muñoz, M. Navarro-Mira, C. Pujol-Marco" "autores" => array:4 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Fernández-Portilla" ] 1 => array:4 [ "nombre" => "B." "apellidos" => "Escutia-Muñoz" "email" => array:1 [ 0 => "bescutia@aedv.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Navarro-Mira" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Pujol-Marco" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eritema <span class="elsevierStyleItalic">ab igne</span> provocado por el ordenador portátil" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 951 "Tamanyo" => 115215 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Reticulated hyperpigmented macules with ill-defined borders on the anterior aspect of the left thigh of the first patient.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Erythema <span class="elsevierStyleItalic">ab igne</span> results from the repeated exposure of skin to heat levels below the threshold required to cause a thermal burn. It is characterized by the appearance of a transient reticulated erythematous macule progressing to a persistent hyperpigmented macule with the same pattern. The extent and morphology of the lesions are usually determined by the shape of the heat source; the lesions tend to be asymptomatic or involve a burning sensation. This skin condition was once common in the elderly and was related to the use of braziers and other heating appliances. The pretibial area of the legs and the lower back were the more commonly reported locations.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Currently, it is associated with the use of electrical devices that provide heat for therapeutic use (electric blankets, heating pads, heaters, electric seats) and recently has also been associated with the long-term use of laptop computers.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–8</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We describe 2 cases and illustrate their similarities. The characteristics of this disorder, both in its location and the age of the patients, make it easily recognizable and differentiate it from classic cases of erythema <span class="elsevierStyleItalic">ab igne.</span> We draw attention to the possible long-term complications caused by the increasingly common practice of positioning laptop computers on the thighs.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The first patient was a 24-year-old male computer science student with a 4-month history of a reticulated hyperpigmented macule with ill-defined borders located on the anterior aspect of the left thigh (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There was clinical suspicion of erythema <span class="elsevierStyleItalic">ab igne</span>; a medical history taken in order to identify the heat source suggested the use of a laptop computer as the most likely cause.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The second patient was a 20-year-old woman with a 3-month history of a reticulated hyperpigmented macule with poorly defined borders located on the anterior aspect of the left thigh, apparently unrelated to any exogenous cause (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Her medical history included a sedentary lifestyle, smoking, and the use of oral contraceptives. The lesion was initially thought to be livedo racemosa. Additional tests were ordered including a complete blood count, blood biochemistry, and basic coagulation profile. The results were within the normal reference range. Hepatitis serology, cryoglobulin test, and antinuclear antibody, extractable nuclear antigen antibodies, antineutrophil cytoplasmic antibodies, and antiphospholipid panels were negative. Skin biopsy only revealed a nonspecific perivascular lymphocytic inflammatory infiltrate. Following the tests, the patient was again questioned about the use of heat-emitting devices, and she replied that she used a laptop computer on her thighs for several hours a day. This suggested a diagnosis of erythema <span class="elsevierStyleItalic">ab igne</span> caused by placing the laptop in close proximity to the skin.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The first case of erythema <span class="elsevierStyleItalic">ab igne</span> induced by a laptop computer was described in 2004. Since then, 13 cases have been reported, all having the same clinical characteristics.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> It most often affects young men and women, is located on the anterior aspect of the thigh, and is almost always restricted to just one thigh, depending on the position of the computer's heat source. It appears between 2 weeks and several months following prolonged use and resolves without treatment if contact is avoided.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4–8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Classically, when a patient presents with erythema <span class="elsevierStyleItalic">ab igne</span>, the first recommendation is to avoid close exposure of the skin to heat because, even though it may not cause a burn, this skin disorder has been associated in the long term with squamous cell carcinoma, Merkel cell carcinoma (although less often), or both. A case has recently been described of cutaneous marginal zone B-cell lymphoma.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> However, if heat therapy has been applied for pain relief, the second recommendation is to ascertain the underlying cause. In addition, motivated by these new patterns of erythema <span class="elsevierStyleItalic">ab igne</span>, recent studies have shown that supporting laptop computers on the thighs raises scrotal temperature by up to 2.8<span class="elsevierStyleHsp" style=""></span>°C. This increase in temperature is produced by posture-related effects and exposure to the heat dissipated by the laptop computer. It has also been shown that an increase of 1<span class="elsevierStyleHsp" style=""></span>°C alone may have a negative impact on spermatogenesis, possibly leading to sterility if the transient increase in scrotal temperature is repeated over a prolonged period.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Thus, since the use of laptops is increasingly common among young people, we must add the risk of male infertility as a possible complication to the list of those already known. In fact, some authors recommend that manufacturers should warn of the risk of premalignant skin lesions<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> due to placing laptop computers in contact with the skin and of sterility in men if they are positioned close to the genital area.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: T. Fernández-Portilla, B. Escutia-Muñoz, M. Navarro-Mira, C. Pujol-Marco. Eritema <span class="elsevierStyleItalic">ag igne</span> provocado por el ordenador portátil. Actas Dermosifiliogr. 2012;103:559-60.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 951 "Tamanyo" => 115215 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Reticulated hyperpigmented macules with ill-defined borders on the anterior aspect of the left thigh of the first patient.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 709 "Ancho" => 951 "Tamanyo" => 88680 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Macule with the same features and location in the second patient.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Environmental and sports-related skin diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. 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Sheehan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2009.08.005" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2010" "volumen" => "62" "paginaInicial" => "1080" "paginaFinal" => "1081" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20466192" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increase in scrotal temperature in laptop computer users" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y. Sheynkin" 1 => "M. Jung" 2 => "P. Yoo" 3 => "D. Schulsinger" 4 => "E. Komaroff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/humrep/deh616" "Revista" => array:6 [ "tituloSerie" => "Hum Reprod" "fecha" => "2005" "volumen" => "20" "paginaInicial" => "452" "paginaFinal" => "455" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15591087" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000006/v1_201304241313/S1578219012002065/v1_201304241313/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010300000006/v1_201304241313/S1578219012002065/v1_201304241313/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012002065?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 10 | 21 | 31 |
| 2024 Octubre | 91 | 41 | 132 |
| 2024 Septiembre | 79 | 24 | 103 |
| 2024 Agosto | 105 | 47 | 152 |
| 2024 Julio | 96 | 33 | 129 |
| 2024 Junio | 125 | 31 | 156 |
| 2024 Mayo | 117 | 31 | 148 |
| 2024 Abril | 122 | 17 | 139 |
| 2024 Marzo | 126 | 44 | 170 |
| 2024 Febrero | 101 | 22 | 123 |
| 2024 Enero | 100 | 33 | 133 |
| 2023 Diciembre | 106 | 33 | 139 |
| 2023 Noviembre | 105 | 49 | 154 |
| 2023 Octubre | 118 | 34 | 152 |
| 2023 Septiembre | 115 | 31 | 146 |
| 2023 Agosto | 84 | 16 | 100 |
| 2023 Julio | 113 | 36 | 149 |
| 2023 Junio | 129 | 19 | 148 |
| 2023 Mayo | 110 | 25 | 135 |
| 2023 Abril | 108 | 25 | 133 |
| 2023 Marzo | 116 | 22 | 138 |
| 2023 Febrero | 163 | 15 | 178 |
| 2023 Enero | 93 | 34 | 127 |
| 2022 Diciembre | 104 | 47 | 151 |
| 2022 Noviembre | 71 | 17 | 88 |
| 2022 Octubre | 82 | 25 | 107 |
| 2022 Septiembre | 96 | 37 | 133 |
| 2022 Agosto | 86 | 35 | 121 |
| 2022 Julio | 51 | 33 | 84 |
| 2022 Junio | 38 | 27 | 65 |
| 2022 Mayo | 110 | 36 | 146 |
| 2022 Abril | 119 | 30 | 149 |
| 2022 Marzo | 147 | 47 | 194 |
| 2022 Febrero | 120 | 28 | 148 |
| 2022 Enero | 137 | 31 | 168 |
| 2021 Diciembre | 72 | 54 | 126 |
| 2021 Noviembre | 89 | 46 | 135 |
| 2021 Octubre | 82 | 54 | 136 |
| 2021 Septiembre | 90 | 32 | 122 |
| 2021 Agosto | 79 | 25 | 104 |
| 2021 Julio | 102 | 28 | 130 |
| 2021 Junio | 105 | 25 | 130 |
| 2021 Mayo | 136 | 33 | 169 |
| 2021 Abril | 383 | 53 | 436 |
| 2021 Marzo | 170 | 23 | 193 |
| 2021 Febrero | 117 | 34 | 151 |
| 2021 Enero | 102 | 17 | 119 |
| 2020 Diciembre | 94 | 15 | 109 |
| 2020 Noviembre | 73 | 10 | 83 |
| 2020 Octubre | 62 | 19 | 81 |
| 2020 Septiembre | 51 | 11 | 62 |
| 2020 Agosto | 59 | 12 | 71 |
| 2020 Julio | 55 | 19 | 74 |
| 2020 Junio | 69 | 26 | 95 |
| 2020 Mayo | 64 | 17 | 81 |
| 2020 Abril | 38 | 18 | 56 |
| 2020 Marzo | 44 | 22 | 66 |
| 2020 Febrero | 1 | 1 | 2 |
| 2019 Diciembre | 4 | 3 | 7 |
| 2019 Octubre | 0 | 1 | 1 |
| 2019 Septiembre | 4 | 0 | 4 |
| 2019 Agosto | 0 | 2 | 2 |
| 2019 Julio | 0 | 1 | 1 |
| 2019 Junio | 0 | 10 | 10 |
| 2019 Mayo | 2 | 18 | 20 |
| 2019 Abril | 0 | 1 | 1 |
| 2019 Marzo | 2 | 8 | 10 |
| 2018 Diciembre | 2 | 0 | 2 |
| 2018 Octubre | 3 | 0 | 3 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Julio | 1 | 0 | 1 |
| 2018 Mayo | 1 | 0 | 1 |
| 2018 Marzo | 4 | 0 | 4 |
| 2018 Febrero | 87 | 8 | 95 |
| 2018 Enero | 117 | 7 | 124 |
| 2017 Diciembre | 87 | 7 | 94 |
| 2017 Noviembre | 89 | 4 | 93 |
| 2017 Octubre | 81 | 3 | 84 |
| 2017 Septiembre | 59 | 11 | 70 |
| 2017 Agosto | 68 | 8 | 76 |
| 2017 Julio | 68 | 10 | 78 |
| 2017 Junio | 76 | 8 | 84 |
| 2017 Mayo | 103 | 9 | 112 |
| 2017 Abril | 64 | 16 | 80 |
| 2017 Marzo | 114 | 10 | 124 |
| 2017 Febrero | 168 | 5 | 173 |
| 2017 Enero | 50 | 8 | 58 |
| 2016 Diciembre | 61 | 13 | 74 |
| 2016 Noviembre | 107 | 12 | 119 |
| 2016 Octubre | 118 | 23 | 141 |
| 2016 Septiembre | 190 | 9 | 199 |
| 2016 Agosto | 93 | 11 | 104 |
| 2016 Julio | 50 | 21 | 71 |
| 2016 Junio | 11 | 0 | 11 |
| 2016 Mayo | 5 | 16 | 21 |
| 2016 Abril | 4 | 3 | 7 |
| 2016 Marzo | 8 | 1 | 9 |
| 2016 Febrero | 3 | 4 | 7 |
| 2016 Enero | 8 | 2 | 10 |
| 2015 Diciembre | 14 | 0 | 14 |
| 2015 Noviembre | 25 | 6 | 31 |
| 2015 Octubre | 23 | 2 | 25 |
| 2015 Septiembre | 13 | 6 | 19 |
| 2015 Agosto | 12 | 4 | 16 |
| 2015 Julio | 195 | 12 | 207 |
| 2015 Junio | 163 | 6 | 169 |
| 2015 Mayo | 125 | 8 | 133 |
| 2015 Abril | 141 | 7 | 148 |
| 2015 Marzo | 170 | 7 | 177 |
| 2015 Febrero | 173 | 9 | 182 |
| 2015 Enero | 114 | 11 | 125 |
| 2014 Diciembre | 96 | 6 | 102 |
| 2014 Noviembre | 80 | 9 | 89 |
| 2014 Octubre | 106 | 15 | 121 |
| 2014 Septiembre | 93 | 8 | 101 |
| 2014 Agosto | 105 | 9 | 114 |
| 2014 Julio | 123 | 13 | 136 |
| 2014 Junio | 64 | 3 | 67 |
| 2014 Mayo | 93 | 5 | 98 |
| 2014 Abril | 104 | 1 | 105 |
| 2014 Marzo | 76 | 8 | 84 |
| 2014 Febrero | 66 | 11 | 77 |
| 2014 Enero | 48 | 5 | 53 |
| 2013 Diciembre | 52 | 4 | 56 |
| 2013 Noviembre | 58 | 16 | 74 |
| 2013 Octubre | 36 | 4 | 40 |
| 2013 Septiembre | 46 | 7 | 53 |
| 2013 Agosto | 28 | 10 | 38 |
| 2013 Julio | 10 | 13 | 23 |
| 2013 Junio | 18 | 22 | 40 |
| 2013 Mayo | 12 | 18 | 30 |
| 2013 Abril | 21 | 12 | 33 |
| 2013 Marzo | 23 | 18 | 41 |
| 2013 Febrero | 38 | 3 | 41 |
| 2013 Enero | 81 | 6 | 87 |
| 2012 Diciembre | 50 | 16 | 66 |
| 2012 Noviembre | 2 | 0 | 2 |
| 2012 Octubre | 1 | 0 | 1 |
| 2012 Septiembre | 0 | 2 | 2 |
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