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25-Year-Old Female with Asymptomatic Eruption on Both Lower Legs

Can you diagnose this case?

David L. Kaplan – 2014 Series Editor University of Missouri: Kansas City, University of Kansas

Signs and Symptoms

A healthy 25-year-old female presented for evaluation of an asymptomatic eruption on both lower legs of 1 to 2 months duration. There is no history of trauma. She has been on the same birth control pill for the last 5 years. She gives no history of cold intolerance or sensitivity. She works as a bank teller.

What’s Your Diagnosis?

Choose one to reveal diagnosis and discussion

Cutis marmorata
Livedo reticularis
Erythema ab igne
Livedoid vasculitis
Poikiloderma vasculare atrophicans (parapsoriasis variegata)

 Erythema ab igne 

See the full case at Consultant360

I asked her if the bank kept the thermostat set at a low temperature, to which she replied that it was so cold where she sat, it was necessary to use a space heater. This confirmed the clinical impression of erythema ab igne (EAI), a skin condition characterized as localized areas of reticulated or net-like erythema and hyperpigmentation due to chronic and repeated exposure to infrared radiation.