alexa Laptop Computer Induced Erythema ab igne: A Systematic Review of Case Reports | Open Access Journals
ISSN: 2155-9554
Journal of Clinical & Experimental Dermatology Research
Like us on:
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Laptop Computer Induced Erythema ab igne: A Systematic Review of Case Reports

Alsharif S*

Dermatology Residency Program, Western region, Saudi Arabia

*Corresponding Author:
Sahar Hasan Alsharif
PGY-2 at the Dermatology Residency Program, Saudi Arabia
Tel: 00966555539141
E-mail: [email protected]

Received date: November 23, 2015 Accepted date: December 24, 2015 Published date: January 02, 2016

Citation: Alsharif S. (2016) Laptop Computer Induced Erythema ab igne: A Systematic Review of Case Reports. J Clin Exp Dermatol Res 7:319. doi: 10.4172/2155-9554.1000319

Copyright: © 2015 Alsharif S. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Clinical & Experimental Dermatology Research

Abstract

Background: Erythema ab igne (EAI) is a localized skin lesion characterized by areas of reticulated erythema and hyperpigmentation. It is caused by prolonged and repeated exposure to infrared radiation. Methods: We conducted a structured search using online databases to collect case reports and short case series on laptop computer-induced erythema ab igne. We restricted search to those studies involving case reports publication type, but we did not restrict the search by country of publication or publication dates or language. Results: Records screened were 116, and 94 were excluded through titles and abstract evaluation. Of 22 full-text articles assessed for eligibility, 22 were included in qualitative analysis. Eventually the number of cases analyzed was 22. There are 22 case reports of laptop induced erythema ab igne from different countries. In these reports, 13 of the 22 patients were females (62%), while 8 of the 22 patients were males (38%). The average age is 23.5 years. The majority of the cases located on the thighs. The duration of laptop exposure ranged from two weeks to two years. Conclusion: Laptop computer induced erythema ab igne is increasing in the last years. One of the important questions in evaluation erythema ab igne a patient is about the history of prolongs laptop exposure. We recommend awareness programs development in the future to laptop users about this condition and advise them to avoid placing laptops on their body for prolonged periods of time and direct them to place laptops on a solid barrier.

Keywords

Erythema ab igne; Laptop computer

Background

Erythema ab igne (EAI) is a localized skin lesion characterized by areas of reticulated erythema and hyperpigmentation. It is caused by prolonged and repeated exposure to heat (infrared radiation). The course of the lesion started with evanescent net-like erythema or transient reticulated macular erythema, it associated with slightly increase in skin temperature. After repeated heat exposures, the reticular erythema turn out to be persist and, later, finally it become gradually hyperpigmented [1,2]. Although the pathophysiology of this condition is poorly understood, There are some theories that may explain it. One of them is chronic heat exposure can causes damage to the epidermis and superficial vascular plexus due to cutaneous hyperthermia. In vitro study has been reported that moderate heat had synergistic effect with ultraviolet radiation to denature DNA in squamous cells [3]. Another explanation is dilation and deposition of hemosiderin in a reticulate distribution of the injured superficial blood vessels due to prolonged heat exposure [2]. Many heat sources may lead to this condition such as hot water bottles, heating blankets or heat pads, heated car seats, space heaters, or fireplaces. In the last decade, there was markedly increase in the use of the modern technology, laptop computers is one of these technology that has been implicated as the modern cause of Erythema ab igne [4]. So according to this different causes, Erythema ab igne is also termed hot water bottle rash, fire stains, laptop thigh [5,6].

The diagnosis of erythema ab igne is based on the history and clinical picture. A history will typically reveal prolonged and repeated exposure to thermal radiation at level lower than that which causes a thermal burn [1]. If the diagnosis of erythema ab igne is uncertain, we can perform a 3-mm or 4-mm punch biopsy, the histopathological findings depend on multiple parameters; the type of heat, the length of exposure, and the area of the body involved. Histologically, it is mimic solar-damaged skin, demonstrating in early lesions epidermal atrophy, then hyperkeratosis, melanin incontinence with abundant melanophages in dermis, and elastic fibre alterations [4]. Until now, there is no definitive treatment for erythema ab igne. In the management of erythema ab igne, start with non-pharmacological approach by eradicating the heat source. On the one hand, early removing of the heat source will give good prognosis that may resolute the reticulated erythema within more than a few months. On the other hand, chronic exposure to the heat source can cause permanent hyperpigmentation and may need tretinoin, and 5-fluorouracil cream to clear epithelial atypia [7,8]. Unfortunately, there is risk of malignant transformation with chronic erythema ab igne [9].

Moreover, there are still gaps in knowledge regarding this dermatological condition, especially the more recent one, Laptop computer-induced erythema ab igne. Our aim was to systematically review case reports of laptop computer-induced erythema ab igne, in order to outline the main features of it and increase the knowledge about this new skin condition.

Methods

We reviewed all cases of laptop computer-induced erythema ab igne from the first published case in 2004 to December 2013 using the online databases of PubMed, MEDLINE, Trip database, and Google Scholar. We limited our search only to those studies involving case reports publication type, but we did not restrict the search by country of publication or publication dates or language.

The electronic search strategy was as follows: (laptop[All Fields] AND ("computers"[MeSH Terms] OR "computers"[All Fields] OR "computer"[All Fields])) AND induced[All Fields] AND (("erythema"[MeSH Terms] OR "erythema"[All Fields]) AND ("abnormalities"[Subheading] OR "abnormalities"[All Fields] OR "ab"[All Fields]) AND igne[All Fields]) AND ("case reports"[Publication Type] OR "case report"[All Fields])

We screened the titles and the abstracts of the articles that found during the search and excluded any that were considered irrelevant or not a case report. We also checked the references of all obtained literature and all included papers to identify any further possibly related studies.

Results

The table below illustrates some of the main characteristics of the all case reports that we were reviewed:

Case Year of publication Age Gender Nationality Duration of exposure Daily use of laptop Location of the lesion Description of the lesion References
1 2004 50 Male Not reported 2 weeks considerable amount of time each day The left anterior thigh well-defined, brown, mildly erythematous, reticulated patch 10
2 2004 48 Female Dutch Not reported Not reported The right thigh more than the left. patchy reticulate pigmentation 11
3 2006 17 Female French 1 year 6-8 hours The front of the thighs, more pronounced on the left thigh patchy reticulated mildly erythematous to brownish lesions, non blanchable 12
4 2007 26 Female Indian-American Not reported 6 hours right thigh patch of reticulated hyperpigmentation 13
5 2007 40 Female American Not reported Not reported The thighs reddish-brown, reticulated eruption 14
6 2009 26 Male French Not reported several hours every day The anterior aspect of the right thigh, more discrete on the left thigh reticular and macular, brown pigmentation, fixed, nonmigrating, and not blanchable. 15
7 2009 25 Female French 6 months 6 hours The front two legs, predominantly on the left thigh asymmetrical, discrete erythematous lesions initially, having evolved into a fixed pigmentation, painless, non-itchy. 16
8 2009 21 Male Turkish 3 months Not reported The left thigh reticulated, dark reddish brown pigmented patch with an undefined border 17
9 2010 15 Male American Several months daily both thighs, but more pronounced on the left. a livedo reticulares-like eruption 18
10 2010 17 Female Italian 1 year Not reported the left anterior thigh brown, reticular, nonblanchable cutis marmorata with burning and itching 19
11 2010 9 Male Swedish Not reported Not reported The left thigh Reticular hyperpigmentation 20
12 2010 12 Male Swiss Not reported several hours per day left upper thigh only well defined, brownish-pigmented, reticulate, livedolike lesion, mildly erythematous with telangiectasias 21
13 2010 20 Female Canadian longstanding daily The front of the thighs pigmentation in a net-like distribution 22
14 2011 12 Female Brazilian 11 months several hours the anterior surface of the both thighs, but more visible on the dorsal surface of the right thigh 20-cm brownish macules with mild erythema along the edges. The lesion was affecting both thighs, but was more visible on the dorsal surface of the right thigh 23
15 2011 18 Female Not reported Not reported frequently The left breast, mainly over the upper medial quadrant 8*6-cm area of reticulated, brownish, macular pigmentation on a background of faint dusky erythema 24
16 2011 24 Female Canadian 9 months Not reported The anterolateral aspect of the thighs reticulated, erythematous to dull brownpattern 25
17 2012 20 Male Indian 2 years 2 to 3 hours one side of the abdomen diffuse reticular brownish hyperpigmentation 26
18 2012 16 Male Canadian Not reported on a daily basis Mid of the left thigh and progressed upwards toward the groin. patch diffusely hyperpigmented, reticulate, and morbilliform violaceous-brown with minimal scaliness, warm to touch. 27
19 2012 20 Female Spanish Not reported several hours a day The anterior aspect of the left thigh reticulated hyperpigmented macule with poorly defined borders 28
20 2012 24 Male Spanish Not reported Not reported The anterior aspect of the left thigh hyperpigmented macule with ill-de?ned borders 28
21 2012 21 Female Not reported 2 years Not reported lower legs more pronounced on the left net-like Hyperpigmented, reticulated lesions 2
22 2013 36 Female German 18 months 1 hour the anterior aspect of both thighs reticulated, reddish-brown macules with an ill-defined border 29

Table 1: Main characteristics of the all case reports.

Discussion

Erythema ab igne (EAI) is a reticular erythematous pigmented dermatosis consequential from repeated exposures to infrared radiation or reasonable heat in the range of 43-47ºC; it is usually insufficient to bring into being a burn [2]. It can arise at any site of the skin of the body depending on the heat or radiation source, usually it occur in an asymmetrical distribution corresponds to the different sources of heat that are currently in use [4].

Previously, EAI was first started as an occupational disease in the shins who work nearly to heat source such as open fires or coal stoves. Recently, the typical EAI has been declined in this group of populations due to use of central heating [29]. In the other hand, it has been notice in the individuals who appliance of heating pads on the back or the abdomen to decrease the chronic pain [5]. In the more recent, with increase the modern technology, the rising incidence of the use of electronic devices which can generate thermal radiation that may cause Erythema ab igne [15].

In our review of the literature, there are 22 case reports of laptop induced erythema ab igne from different countries; Netherland, France, India, America, Turkey, Italy, Sweden, Switzerland, Canada, Brazil, Spain, and Germany [2,10-29]. In these reports, 13 of the 22 patients were females (62%), while 8 of the 22 patients were males (38%) (Figure 1).

clinical-experimental-dermatology-composition-males-females

Figure 1: Showing the composition of males and females.

The average age is 23.5 years when the condition was discovered. The site of the erythema ab igne lesion is corresponding to the area of contact with the laptop’s heating element. The majority of the laptop induced erythema ab igne cases located on the thighs (20 of 22 cases, 91%) (Figure 2). Over half of those cases reported that the lesion is predominantly on the left thigh (13 of 22 cases, 65% on the left thigh, while 4 of 22 cases, 15% on the right thigh, and 3 of 22 cases, 20% on the both thighs).

clinical-experimental-dermatology-lesion-Thigh-Breast

Figure 2: Showing location of the lesion in Thigh, Breast and Abdomen.

(Figure 3) There is only one report of laptop induced erythema ab igne located in left breast for 18-year-old girl who was use of her laptop computer while reclining [24]. There is another one report of laptop induced erythema ab igne located in left side of the abdomen for a 20- year-old male engineering student who had the habit of placing the laptop computer on the bare skin of his abdomen [26].

clinical-experimental-dermatology-lesion-predominantly

Figure 3: Showing the Location of the lesion predominantly on the thighs.

Almost all of the laptop induced erythema ab igne cases were asymptomatic macular, erythematous and hyper pigmented, reticulated lesion except one case that was associated with burning and itching [19]. The duration of laptop exposure ranged from two weeks to two years (Figure 4).

clinical-experimental-dermatology-laptop-exposure

Figure 4: Showing duration of the laptop exposure.

Biopsy was not frequently performed. In fact, in case of laptop computer induced erythema ab igne the diagnosis is easily made by history and direct examination [1]. Biopsy would be most useful in chronic erythema ab igne, while in patients who are in risk of malignant transformation [9].

Limitations

Limits in our results are due to incomplete information in the cases about the exact duration of laptop exposure and the duration and frequency of the daily use of laptop. Actually, 50% of the reports did not mention the exact duration of laptop exposure. (Figure 4) Moreover, publication bias is a potential problem in systematically reviewing case reports. Lack of publications about the laptop computer induced erythema ab igne during two years; 2005 and 2008, hence it is not possible to rule out present of this condition during this period. (Figure 5) Unfortunately it was not possible to extract from the case reports the type of the laptops.

clinical-experimental-dermatology-year-publication

Figure 5: Showing the year of publication.

Conclusion

Erythema ab igne is a localized reticulated erythema and hyperpigmentation lesion by prolonged and repeated exposure to heat. Laptop computer induced erythema ab igne is increasing in the last years. One of the important questions in evaluation erythema ab igne patients are about the history of prolongs laptop exposure. We recommend awareness programs development in the future to laptop users about this condition and advise them to avoid placing laptops on their body for prolonged periods of time and direct them to place laptops on a solid barrier.

References

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Recommended Conferences

Article Usage

  • Total views: 8054
  • [From(publication date):
    January-2016 - Nov 25, 2017]
  • Breakdown by view type
  • HTML page views : 7987
  • PDF downloads : 67
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords