'Toasted skin syndrome' explained as parents warned over condition rising among children

Doctors have issued a warning to parents after a pre-teen boy was diagnosed with erythema ab igne (EAI), also known as 'toasted skin syndrome'.

EAI is a net-like rash caused by long-term exposure to low-level heat.

While toasted skin syndrome is usually found in adults who use water bottles or heated pads, it is becoming increasingly common among youngsters who use electronic devices, with the boy in question regularly resting his laptop on his stomach for up to eight hours a day.

Writing in BMJ Case Reports, Dr Mara Znagoveanu, of University Hospitals of Leicester NHS Trust, said the patient went to the children’s emergency department with 'spontaneous bruising'.

Doctors have issued a warning to parents over 'toasted skin syndrome' (Getty Stock Images)

Neither the child nor his parents could figure out what had caused the rash, and he otherwise seemed fit and healthy with no trauma or symptoms such as fever or weight loss.

Blood tests and scans were normal, and he was discharged.

Just two weeks later, however, the child returned to hospital as the rash had gotten worse and become tender, with areas of skin peeling.

Medics questioned the boy and his family about common heat sources, to which he reported resting his laptop on his stomach for up to eight hours a day, usually while it was charging.

Dr Znagoveanu said: "As more commonly reported in adults, EAI may be overlooked in children, especially when the source of heat is less obvious than the traditional sources such as hot water bottles and heating pads.

"The increasing use of electronic devices, particularly during home schooling, has emerged as an under-recognised cause of EAI in paediatric populations."

EAI, also known as 'toasted skin syndrome', is a net-like rash caused by long-term exposure to low-level heat (Getty Stock Images)

She added that EAI might be misdiagnosed in children, leading to 'unnecessary investigations' such as blood tests or scans.

While EAI is usually reversible, with the rash improving over weeks to months once the heat source is removed, in some cases it can lead to persistent hyperpigmentation.

A number of months later, during a phone consultation, the boy’s father told doctors that the rash had eventually disappeared.

Dr Znagoveanu said: "There are currently no formal paediatric guidelines for EAI, and diagnosis remains clinical, based on history and characteristic findings.

"A limitation of this case is the lack of in- person follow- up, with resolution confirmed by the patient’s family via telephone call.

"This case highlights the importance of considering EAI in children presenting with reticulated rashes, particularly in the context of increasing electronic device use.

"Early recognition through targeted history-taking can prevent misdiagnosis and avoid unnecessary investigations."