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Case Study Features Association Between Rare Skin Condition and Basal Cell Carcinoma

By: Susan Reckling
Posted: Monday, July 27, 2020

A case study published in Dermatology Online Journal illustrates a potential connection between the unusual skin condition manifested by chronic heat exposure known as erythema ab igne and the development of cutaneous basal cell carcinoma. Zahra Razavi, MD, of the Tehran University of Medical Science, and colleagues noted that to their knowledge, this may be the first case to show this rare cutaneous association.

“Being familiar with the type of cutaneous malignancies that may arise in the site of erythema ab igne is considerably important,” commented the authors.

An asymptomatic 60-year-old man had a nonhealing erosion localized to a hyperpigmented parch on this left thigh for 4 months. The man had noted a reticulated erythematous hyperpigmented patch in the same area for more than 10 years.

Physical examination revealed a small (1–2 cm), erythematous eroded plaque in the upper part of the reticulated patch of the left thigh. Neither bullae nor keratotic lesions were observed. It was learned the man had used a heater close to the inside of his thighs, as his occupation necessitated working outside in the winter. A clinical diagnosis of erythema ab igne—a skin condition caused by prolonged exposure to heat that is not sufficient to cause a burn—was made.

The man underwent a punch biopsy of the erosive lesion. Histopathologic findings revealed some basaloid nests in the dermis, along with peripheral palisading and peritumoral clefting. Features in support of the diagnosis of erythema ab igne included the presence of vasodilation of dermal vessels, pigment deposition in the dermis, and epidermal atrophy/flattening of the rete ridge. The association of basal cell carcinoma resulted in surgical excision, with 4-mm margins.

Generally, erythema ab igne has a benign course. However, the authors noted, “the development of squamous cell carcinoma and Merkel cell carcinoma has been reported even after decades.”

Disclosure: The authors reported no conflicts of interest.

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