Toasted skin syndrome, also known as erythema ab igne, remains a skin reaction caused by chronic exposure to infrared radiation in the form of heat. Tanning syndrome was once common in older people who stood or sat near open fires or electric heaters. Although introducing central heating has reduce burnt skin syndrome, it is still found in people expose to heat from other sources.
Limited exposure to heat, insufficient to cause a direct burn, causes a transient mild red rash resembling lace or fishnet tan skin syndrome. Prolonged and repeated contact causes marked redness and discolouration of the skin (hyper- or hypopigmentation). The skin and underlying tissues may become thinner (atrophy), and in rare cases, sores may develop. Some patients may complain of mild itching and burning sensation.
What Causes Toasted Skin Syndrome?
Various modern objects can cause toasted skin syndrome, but it’s been around longer than you think.
When the syndrome was first discover, wood stoves and working with hot coals were the triggers for these skin irritations.
Coal miners and cooks exposed to such heat sources for a long time have often developed burnt skin syndrome on the face.
Modern causes of brown skin syndrome are somewhat different. The current common reasons are:
- Protracted use of a laptop on the thighs: This can usually be seen on the left thigh, as most laptop batteries and ports are on the left side of the device. The recent rise in remote work is likely to become more common.
- Heated seats in the car: Cases have been report in people using their heated seats for 2 to 4 hours at a time.
- Heating pads or hot water bottles: Although helpful in relieving abdominal pain, burnt skin syndrome has been reporting after prolonged use.
- Space heater: In the past, scalded skin syndrome was found in older people who spent much of their time in front of radiators or heaters.
Signs and Symptoms of Toaster Skin Syndrome
Toasted Skin Syndrome (erythema ab igne) begins by appearing as a lacy or web-like (reticular) skin discolouration. It may be a transient pink or red at first but will eventually change to a grey or brown discolouration as heat exposure continues.
The localized lesions observed today reflect the different sources of heat to which people may be expose. Examples include:
- Repeated application of hot water bottles or heating pads to treat chronic pain, e.g. chronic back pain
- Repeated contact with car radiators or furniture with built-in heaters
- Occupational risks for goldsmiths and jewellers (face exposed to heat), bakers and cooks (arms).
Toasted Skin Syndrome Diagnosis
A history of excessive heat exposure in the patient’s starting area helps in the clinical diagnosis of tan skin syndrome). The duration of repeated exposure required to cause skin changes varies from a few months to several years, and the damage appears to be cumulative.) Typically, patients with scalded skin syndrome report mild itching and burning. Your doctor will make a 3- or 4-mm core biopsy if the diagnosis of burned skin syndrome is uncertain.
Microscopic changes in tan skin syndrome depend on the type of heat, duration of exposure, and the area of the body affected
Histologically, toasted skin syndrome resembles actinic keratoses, with the epidermis showing squamous atypia). Early tan skin syndrome shows atrophy of the squamous epithelium and increased epidermal and upper dermal melanin with dermal vasodilation). Advanced cases show epidermal vacuolization, focal hyperkeratosis, and dyskeratosis). Epidermal dysplasia may also be seen in abnormal elastic tissue). Early lesions of burned skin syndrome result in epidermal atrophy with loss of the interpapillary ridges. Some patients present with focal or confluent hyperkeratosis, dyskeratosis, keratinocyte atypia, and occasionally melanocytic atypia. Hyperpigmentation with focal degenerative changes in basal keratinocytes is seen. Similar changes can be seen in chronic actinic skin lesions.
Melanotic incontinence occurs with melanophages present in the upper dermis). Degeneration of collagen and a relative increase in dermal elastic tissue are observe. Unlike solar elastosis, it is not basophilic in samples stain with hematoxylin and eosin. Telangiectasias in the papillary dermis and occasionally hemosiderin may be seen more frequently on the legs in patients with tan skin syndrome). Apparent functional activation of melanocytes with the numerical increase in dendritic processes is also observe). Abundant melanophages and also, occasional changes in elastic fibres are appreciate, similar to actinic elastosis. No changes consistent with preneoplastic skin diseases are kept).
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Who are in Danger of Developing Toasted Skin Syndrome?
Grilled skin syndrome often occurs in people exposed to high temperatures at work. You understand:
- Factory workers (those who work in iron and coal factories)
Other people at risk of developing fried skin syndrome include:
- People spend long hours in front of the fire.
- Middle-aged and older adults are more likely to spend their time in front of stoves, fireplaces, or heaters
- Individuals receiving medical treatment for conditions that require exposure to heat and radiation, such as malignancies, musculoskeletal disorders, chronic pancreatitis, IBD (inflammatory bowel disease)
- Young people and corporate workers who spend much of their time with laptops resting on their thighs
- goldsmiths and jewellers
- Repeated use of furniture with built-in heaters.
- Dentists or surgeons who work with intense light
Treating and Managing Toasted Skin Syndrome
Remove Heat Source
Avoid proximity to radiators. Do not work with your laptop latent on your lap. Keep a safe distance and also, avoid constant contact with fireplaces, infrared lamps and other heating strategies. Also, remain careful when using a hot water bottle: do not place it on bare skin. Use lukewarm water instead of hot water and wrap it with a cloth to minimize damage.
Dependent on the severity of your disorder, the doctor will prescribe topical medications. You can prescribe:
- 5-Fluorouracil for chronic cases of brown skin syndrome
- Topical tretinoin to minimize hyperpigmentation
- Topical ointments containing hydroquinone or other bleaching agents to control pigment changes
The doctor may also prescribe therapies such as:
- Laser treatment with ruby, alexandrite, or Q-switched Nd: YAG lasers to reduce pigmentation.
- Photodynamic therapy to rejuvenate the skin and decrease hyperpigmentation. However, its effectiveness in treating this condition is still being studied.
In some people with erythema ab igne, the rash can develop into fluid-filled blisters. It is rare but usually indicates lichen planus (an inflammatory disease of the mucous membranes) in the area. Grilled skin syndrome is a harmless condition. However, if not treated correctly, it can lead to severe complications.
How is Toasted Skin Syndrome Treated?
Although there is no specific treatment for scalded skin syndrome, there are things you can do to relieve symptoms. These include:
- Distance from the heat source: This is the best way to avoid further irritation. Once the heat source is remove, the discolouration will likely fade, and any offence will go away. If the cause is a laptop, reflect putting a laptop sleeve over your computer or moving your workspace.
- Topical medications: Topical medications, such as retinoids, can help relieve the symptoms of fried skin syndrome. A dermatologist can recommend which one is best for your particular situation.
Toasted skin syndrome is cause by prolonged exposure to heat to the skin, usually from heat sources such as laptop batteries, radiators, or heating pads. These heat sources can damage the cells and also, fibres of the skin, leading to skin discolouration. Sometimes these changes in skin cells can lead to cancer. Treatment involves removing the source of heat causing the irritation and applying medication to the skin to relieve the itch.
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