Reticular Erythema of the Lower Back

REPORT OF A CASE A 38-year-old white man was involved in an automobile accident in 1967 with resulting damage to the T-10 vertebrae and chronic pain. Two years ago, the patient bought a chair with an electric vibrator and a heater cushion to ease his lower back pain. He started using it every night for a few hours while watching television. One month after starting the device, an eruption developed on his lower back. The eruption was sometimes accompanied by crusted areas on the location where the heater and vibrator touched his skin. Figure 1 shows the diffuse, blue-to-purple erythematous reticulated eruption, with hyperpigmentation of the lower back without vesicles or hyperkeratosis. A 3-mm punch biopsy specimen was obtained from this area. Histologic findings are demonstrated in Fig 2. What is your diagnosis? DIAGNOSIS: Erythema ab igne. DISCUSSION Erythema ab igne, otherwise known as toasted skin syndrome, 1,2 is a persistent macular erythema and hyperpigmentation occurring in a