Erythema ab igne presents as reticulated or mottled red, violaceous, brown, or hyperpigmented patches that appear in heat exposed areas (eliciting this part of the history is of the utmost importance to delineate from livedo reticularis, which can look similar in darker skin tones). Additional symptoms may include mild itching and burning.

Over time, or with recurrent heat exposure, lesions evolve in dusky hyperpigmentation. In late-stage, presence of epidermal atrophy and poikiloderma may also be appreciated which is highlighted by the hypopigmented macules seen in the last image. In darker skin tones, erythema ab igne may be difficult to differentiate from livedo reticularis as the latter also presents as reticulated patches but less dark brown and/or more violaceous in color. Discerning factors of livedo reticularis, aside from history, include change in intensity of color with elevation of the affected extremities and the confluent and often bilateral presentation.

Log into your JDD account to access high resolution images and request permissions.