Erythema ab igne – rash from your laptop or space heater?

These days, erythema ab igne is often caused by laptop users placing the laptops on their thighs. The rash then shows up on the thighs.
These days, erythema ab igne is often caused by laptop users placing the laptops on their thighs. The rash then shows up on the thighs.

Erythema ab igne, aka fire stains, toasted skin syndrome, or hot water bottle rash, is a rash that occurs after exposure to heat.  A reddish, purplish, or brownish discoloration appears in a lacy pattern.  The rash is caused by repeated exposure to a heat source.

Some examples of these heat sources include:

– laptops – The rash occurs on the thighs where people rest their laptops.

– space heaters, infrared heaters – These direct heat to a confined area.

– hot water soaks – For example, frequent soaking of the feet in hot water.

– heating pads

– hot compresses

This patient had erythema ab igne on the belly from using heat to relieve belly pain. Photo by Dr. James Heilman.
This patient had erythema ab igne on the belly from using heat to relieve belly pain. Photo by Dr. James Heilman.

– hot water bottles

– chair heaters, car seat heaters

– fire/fireplace

– hot stove

In most cases, the pigmentation from erythema ab igne eventually goes away. However, in some longstanding cases, the pigmentation does not resolve.  In these longstanding cases, the skin may have a different texture as well.  If you are diagnosed with erythema ab igne, your doctor will likely advise you to avoid continued use of the focal heat source that you are being exposed to.

October is Eczema Awareness Month!

October is Eczema Awareness month. Check out the National Eczema Associattion website: for more information
October is Eczema Awareness month. Check out the National Eczema Associattion website: for more information

October is upon us and so is eczema! October is eczema awareness month. For many people, the nippier drier weather of the fall leads to flares of eczema. Indeed, I’ve been seeing a lot more folks in clinic coming in with dry skin and eczema flares.

Sometimes it’s helpful to hear from a community of other eczema patients as well as caregivers with expertise in eczema. Check out the National Eczema Association’s webpage at and also their Facebook page.

In coming posts, we’ll talk about issues related to eczema.

Cheyletiella: your pet’s walking dandruff can make you itch

Cheyletiella mite. Photo from Wikipedia user Joelmills
Cheyletiella mite. Photo from Wikipedia user Joelmills

Man/Woman’s best friends can sometimes lead to annoying & itchy skin conditions.  Take the Cheyletiella mite which can live on your dog, cat or rabbit.  This little mite can appear as a little white fleck on your pet, and it can look like your pet has “walking dandruff.”  You may notice your pet grooming itself or scratching more than usual.  Unfortunately, this mite can get on your skin as well and lead to itching and a rash.  The good thing however, is that even if these mites get on you, they can’t live on your skin for long (no more than 3 weeks really).  They don’t burrow into your skin the way other mites can (e.g.  the scabies or Sarcoptes mite). You should bring your pet to the vet though, where your vet can treat your pet with an anti-mite medication.

PUPPP = Pruritic Urticarial Papules and Plaques of Pregnancy = Itchy bumps during pregnancy!

It’s been a while since we’ve talked about pregnancy and the skin!  We already know from our previous posts that pregnancy can cause many changes in your skin, including acne.  Several rashes are associated with pregnancy as well.

One of these rashes associated with pregnancy has an acronym PUPPP which stands for “Pruritic Urticarial Papules and Plaques of Pregnancy” [translation: pruritic = itchy, urticarial = hive-like, papules = bumps, plaques = plaques].  PUPPP is one of the more common rashes to occur in pregnancy and usually happens in the late third trimester.

Who gets PUPPP?  Well, a pregnant woman.  Risk factors for getting PUPPP include being in one’s 1st pregnancy, having twins (or more), and obesity.

What does PUPPP look like and present as?  This rash presents with very itchy pink to red bumps, often within the stretch marks.  Sometimes blistering or “bulls-eye” looking spots can be present.

Is there any effect on the baby if the mother has PUPPP?  To our knowledge, no.

So what should you do if you develop an itchy rash during pregnancy?  See your obstetrician and/or dermatologist.  This is a fairly common rash in pregnancy.  Various medications can be used to help relieve the itching — otherwise, it can be really hard to get a good night’s rest.  The rash usually goes away 1 week after delivering.

Do babies get acne?

Image courtesy of Sage Ross.

The answer is yes! Babies get acne too! “Neonatal acne” or “neonatal cephalic pustulosis” is a common condition that crops up in the first few weeks or month of your baby’s life as little pimples of the forehead, cheeks and chin.

What causes baby acne? We don’t know exactly what causes this condition, but it may be related to exposure to maternal hormones when the baby is in the womb.

So what do you do about baby acne? Baby acne is not harmful so you can leave it alone. This condition usually goes away in weeks, if not months. In the meantime, continue gentle skin care for your baby. Since rashes can be difficult to distinguish to an untrained eye, mention any concerning features to your pediatrician or dermatologist.

Got jock itch? Treat it!

Photograph of tinea cruris, aka "jock itch"

“Jock itch” is the common term for a skin rash called tinea cruris.  It is also known informally as ringworm of the groin, crotch rot, etc… It’s an infection with a fungus that causes the skin to be red, scaly and itchy. These fungi like warm, dark places like between the skin folds.

So how did you get jock itch?

The fungus can be transmitted from other areas. If you have athlete’s foot (tinea pedis) or a fungal rash elsewhere on your skin or scalp, then scratching that other area then the groin area can spread the fungus. If you are sitting on a contaminated bathtub, or other surface with the fungus, you could pick up the fungus that way as well.

What should you do if you have jock itch?

First, see a doctor who can confirm that it’s jock itch. He/She may take a painless scraping of the skin to confirm that there is fungus. You may be given an antifungal cream to use. Some common over the counter medications include terbinafine (aka Lamisil), miconazole, or clotrimazole. Or, your doctor may prescribe a medication.

Remember that fungus can spread! Avoid contact with surfaces that might be contaminated. If you or a family member has athlete’s foot, you may want to disinfect your bathtub before you sit in your tub. Also, make sure not to spread the fungus from other infected areas to your groin — e.g. don’t cleanse infected feet then cleanse your groin — do it the other way around!

Also, keep the area clean and dry. If clothing gets wet or sweaty, change it!

And if your rash doesn’t go away, see your physician again — there are other mimickers of jock itch!

Is your jewelry giving you a rash?

Is your jewelry giving you a rash? If so, you may be allergic to it!

Your metal jewelry can contain several components and nickel could be one of them. Nickel is a relatively common allergen that causes a rash. It may be found in earrings, rings, necklaces, and bracelets. Besides jewelry, it can also be found in watch straps, belt buckles, the metal tab at the waistband of jeans, bra clasps, hair clips, etc. If you develop an itchy red rash at an area in contact with these items, you may be allergic to the item and you should stop using it.

You can actually test for nickel in your product. Check out Nickel Alert (which tests for nickel) and Nickel Guard (which protects your skin from the nickel).

And believe it or not, nickel is also found in certain foods, so you may find that a low-nickel diet could help your skin and your gastrointestinal tract!

There are definitely other components in jewelry that can give you a rash as well. Gold, cobalt, etc. More on those later.

Jewelry such as earrings can cause an itchy rash. Image courtesy of Wikipedia user Chatsam.

Hand rash in health care workers

Did you know that health care workers are much more likely to develop a hand rash called irritant contact dermatitis? This happens due to frequent handwashing, exposure to disinfectants or cleansers, or other irritating substances. The skin becomes dry, pink or red, and scaly. Fissures can occur. The rash can itch, burn or sting. If you develop the rash, seek evaluation with a doctor. Special medicated creams or ointments can be used to help speed up recovery. Also, avoid contact with irritants and unnecessary exposure to water. Moisturize with a thick cream after washing the hands.

What is ringworm? Neither a ring nor a worm.

Ringworm is neither a ring nor a worm.  It’s the common name used for a rash called tinea corporis (yes, another fancy name).  This is a rash caused by an infection of your skin by fungus.  The reason it’s called ringworm is that it characteristically causes a rash that can look like a red (scaly) ring.  Sometimes the rings can be quite intricate too!  There are a lot of mimickers of ringworm, so you should get your rash checked out by a doctor — eczema, psoriasis, pityriasis rosea, lyme disease, etc. can look like ringworm to the untrained eye.  By looking at your rash and scraping it to look for fungi, your doctor can make the diagnosis.  Usually, creams are used to treat ringworm but if your rash is really extensive, you might need pills to get rid of your rash.

Cruising in the Caribbean? Beware the seabather’s eruption.

Hopefully this hasn’t happened to you during your summer vacation, but if it does, you’ll know what it is! I recently saw someone who came in with itchy pink bumps of the torso and buttocks in a one-piece swimsuit distribution. Turns out it was “Seabather’s eruption” — aka “sea lice” which is actually caused by larvae! The culprits are either tiny little thimble jellyfish larvae in the waters off of Florida, Mexico and the Caribbean, or sea anemone larvae in the waters off of Long Island, NY. After you emerge from the water, these little critters get trapped under your swimsuit. Your body then develops a sensitivity reaction to these larvae. Thus the itchy rash in the swimsuit areas.

The seabather’s eruption typically occurs between May and August so we’re right at the tail end of the season for this rash. Now, if you get an itchy rash after a dip in the ocean, you might know what you have! (And no, this does not mean that you should necessarily go for a dip in the nude. But if you do, remember your sunscreen. If it’s during the day.)