Erythema ab igne

[massagedoula]

Guess what...I just discovered what the mottled rash that appears on my thighs after I use my heating pad/hot water bottle, take a hot bath/shower, etc...are! It is a skin condition called Erythema ab igne. It can lead to long term skin discoloration and tumors if the application of heat is not stopped immediately. What am I going to do now??? Heat is the only thing that helps my pain!!!

[massagedoula]

I just replied to my own post to get it back up on the boards. Do any other heat users get a mottled rash on their skin? I am hurting now and want to take a hot bath, but I can't because of this stupid erythema ab igne. It is even hard to spell!

[Janie Miranda]

masaggedoula,
I've noticed a red area but it goes away quickly once the heat is removed. I was getting something like that from standing under the hot shower but it has gone away now. Hope you find some answers.
jane

[Annie2]

Did you get this DX from a physician? I just did a search on this....found pictures and it looks exactly like what I have. I will be talking to my doctor about this soon. Please let me know if you learn more about this. You are not alone.

Annie

[massagedoula]

This is a mottled lace-like pattern. It does not go away, but it gets lighter after getting out of heat. It is definietly erythema ab igne, which is known aka:hot water bottle disease.

[Annie2]

Yep, that's it exactly! The back of my thighs look just like the pictures. We just returned from 2 months of traveling. We have heated seats in our vehicle and I had the heat on much of the time. We've been home almost 2 weeks now and it is getting better. I saw it on the front of my thighs when I was using heat frequently a year ago. That has diminished now. Great, just Great....NOT!

Have you talked to a physician about this? I certainly will talk to mine at my next appointment. Please let me know if you learn any more about this.

Annie

[massagedoula]

I found it on the internet, after my husband got worried about it. The picture I found was EXACTLY like mine, even on the same place (thighs). I printed it out and brought it to my uro and she had never seen it before, but read the article and looked at the photos and my thighs and said that I did have it. The only way to get rid of it is to catch it in the early stages and then not use heat. It should resolve in 3 months. I am still taking hot showers but not baths and bye-bye heating pad and hot water bottle..sigh...

PS, Heated car seats are mentioned in the article as a cause.

[Betsie]

This might sound like a strange question, but are you of gaelic descent? I ask because when my first daughter/baby was born my pediatrician pointed out how mottled her skin was and it showed that she had gaelic anscetory (did i spell that right? ;) )well as she grew it was very clear she had her father's complete Italian descent and my other daughter as well, and it was more clear from birth.....I however have the mottled blotchy stuff...I tan very well if careful, but on the off season I am often quite blotchy after warm/hot moisture...I try to take cooler showers, but like them real hot...however, I have never noticed it after a sauna for some reason...um, the last time I saw a sauna was 2 yrs ago. :( but I am wondering if the is a connection to this syndrome and your descent. I just also seem to be very blotchy, etc. I am 100% Gaelic....my kids claim they recieved none of this from me...rotten little tanners!

I am going to look this up too, thanks for the info, and I agree, what a name...I thought there was a problem with the boards when I saw it. LOL.........

Annie, it seems we continue to have things in common.....except for almost 10K mile road trips. :) will be in touch soon...good luck, Massagedoula (can I call you MD?) I hope all this is clear for you soon. Keep us posted.

[massagedoula]

Nope...nice german/italian descent. I never had any blotchy skin probs before. I just used too much heat, I guess...and now have this syndrome.

[Babs RN]

Good question Betsie--and I am curious now too. I am first generation Irish in the states from county Cork in Ireland. My daughter has wacky rashes and the mottled look at times too. She is also very, very pale skinned with blond hair and blue eyes. My dad is very fair skinned--he is Black Irish. I got the dark hair, dark eyes and more olive complexion as well as Chris.

Hugs,
Barb :grouphug:

[Annie2]

Betsie,

What an interesting point! My paternal heritage is totally British....mostly from Wales. A Scottish mix is in there, too, though. My maternal heritage is a mixture, Great Britain and Germany (Brandenburg descendant). I am very fair and, before my hair turned totally platinum blonde (ok,ok... white...started turning in my 30s), I was a blue-eyed blonde with fair complexion but, like you, I tanned well if I did it gradually. At birth I had very curly red hair which later turned blonde. My skin, when not tanned, has always been mottled. And freckled. My sister's complexion was much like mine but she was a brunette....until recently...we now have identical hair color. And my daughter....at birth looked like her father (Danish and English) with dark hair but very fair complexion. Then her hair turned curly blonde and raising her was like watching myself grow up (since I was a biologist, I was often accused of cloning her---that was before cloning was a reality). The list of our commonalities keeps growing, Betsie!

Massagedoula, I appreciate your bringing this up. I have absolutely no doubt I have this syndrome. The pictures and descriptions of this are identical to the appearance of my ugly thighs. How am I going to survive without my heating pad??? Please let me know if you think of a good substitute!!! As if Interstitial Cystitis weren't enough of a mouthful to pronounce, now there is this! :dizzy:

Since we just put another 10,000 miles on our vehicle, we decided it was time to start looking for a new one. We were offered a great price for ours and just ordered a new one today. The #1 option I absolutely insisted be on my new vehicle was heated seats. The order was placed, we came home and I decided to check the boards and saw this post. Guess the heated seats are useless to me now. Argggghhhhhhhhh!!!!!!!!!!!!!!!!!!! :headbang:

A very mottled Annie

[Betsie]

Annie,
That is so cool that you and your sister have the same hair color! J/K!!!! LOL. In my family I go for hair removal and for sure my brother reads the hair regrowth ads. Where is the justice? Okay way too much info...but dark hair on fair skin.....blech!

This is very interesting indeed and I still havent looked it up. Annie, my ancestors hail from Liverpool, as a matter of fact I just recently saw a picture of my great grandmother's manor-oh my....I do hope it is in the family. :) Anyway, another set is from Wales and I am a descendent of Robert Burns the poet. So, those two mixed with just about every other place in Great Britain is me....all this and my husband worked on those "Stealth ;) Parts" (sorry guys, rude to talk to one here).

Well I am more and more interested in this as I often overdo the heat thing-or do I? I am staring at my beloved heating pad right now and wondering....as for heated seats...you just keep them low until you are sure if they are an issue...Hey "MD" you have added a very interesting post and syndrome to this little IC world....will be sure to share any info....I have a close Dr friend, I just might email him and test his knowledge....if I learn anything I will be sure to share....but the heritage doesn't seem to play a role....still interesting though! :hmm:

[Betsie]

:bonk: I just popped this into a medical site....almost jumped off the couch and my laptop almost followed me.........by any chance do you guys use laptops? I am going to go read, but putting this link on as I just saw the article titles....oh boy. :bonk:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed

update:
Sorry guys, I cant get far with this. My Dr palput this on my computer, but without being a member I can't get anything unless its an abstract...I think, as I do know I read up on something recently.....but anyway, can't get into it now....will look elsewhere....maybe JAMA if I can remember my password. :loco:

[Annie2]

Thank you for the link, Betsie. Yes, use a laptop frequently. Used it all the way on our trip, too. We got a really cool mapping program and I was navigator. I have a lap tray meant to balance the laptop and keep it cool while using it but I seldom use it...not as comfortable as just holding the puter in my lap. Guess I have to use that thing all the time now. The tops of my thighs are ok now. Last year, before I started feeling better, I was using my heating pad over my bladder every day. Top of my thighs looked bad but it faded pretty well when I felt better and stopped using heat. My problem now is the back of my thighs from 2 months of sitting on heated seats. Guess, now that I know of the danger of all this, I have to watch all heat sources and be very careful. This is going to be hard as heat helps me so much.

I have never seen anything here on the boards about this before but I would bet there have been others who have had this problem. I hope others will take notice, watch carefully and use heat wisely. From what I have read so far, I gather this is not common but is seen especially in people with chronic pain using heat for relief. Because heat is used so frequently by those with IC, I think all here should be made aware of this syndrome so they know what to look for. Thabk you, again, Messagedoula, for bravely making us aware. You enlightened me, possibly saved me from further problems and have educated so many!

Annie

[Betsie]

Darn, I just wish I could see what the full texts say-laptops for me are like ponds for ducks....and worse? I typically set it on top of my comfy warm heating pad on top of my lap. I was concerned about the 'radiation" term, but not being able to see the text frustrates me. I will email my friend tmro and ask if he can sign in and email me the articles...well there were 53 on the subject, so maybe the pertinent ones.

I agree Annie, though I don't seem to have blatant symptoms, I have to wonder about the underlying effects and yes....we sure are a "heated" group here. it is also a very interesting concern and moreso by the mere rarity of it. will see if I can retrieve those articles.

Bets :)

Massagedoula...what was the main reason this came into focus for you and then a dx?

[massagedoula]

Hi guys...wow...you did alot of posting since I have been out to dinner!
Well, I found out about erythema ab igne (we can abbreviate it to EAI...like IC) b/c I started developing this mottled rash on my legs every time I used heat for my bladder pain...which was a lot. I didn't think much of it, and then it started not going away after I was done with the heat source. I still didn't think much of it, but my very laid back husband actually started worrying about it. He told me to ask the doctor, and then I ended up doing a search on Google for "rash on thighs from heat". The first thing that popped up was an article with a photo of exactly what my thighs looked like. It could have been a picture of me! That was when I found out about EAI. I printed the article and brought it into my urogyn who I was seeing that day. I highlighted the most relevant parts, such as "caused by repeated applications of heating pads, hot water bottles, or hot baths"...all of which have been my mainstay of pain control for the good ol' bladder. Also I highlighted "rare condition, usually seen on elderly people with chronic pain that use heat as a pain relief."
Neither her or the nurse had heard of it, but they read the whole article and said that I was definitely right on the money with my self DX.
The only way to make it go away is to stop the heat source, and I got worried. My doctor said that my bladder pain is the #1 thing I should address, and EAI is a secondary problem. She said that I should still use heat, but maybe not for so long or so hot, and try to keep it off my thighs. I did read that it can become permanent and possibly cause tumors, so I am playing it safe, and not using either my heating pad or hot water bottle. I am still taking hot baths however, but I try to let them cool for 10 min before I get in, and I try to take only 1 a day instead of 3.

It can take around 3 months for EAI to fade in an early caught case. Eventually we will be able to use heat again, but I think it is important to let it go away, even if I have to retire my heating pad. I guess it is practice for pregnancy, cause I can't use heat then either!

I have so many related conditions now...I also have developed severely dry eyes and the eye doctor said a possible allergy to my own eye secretions! I have worn contacts for 10 years with no problems, now all of a sudden since my bladder problems started I can't seem to tolerate them anymore!

I feel like my whole body is going haywire.

[Annie2]

massagedoula,

Giving up heat now is going to be almost as bad as giving up Coke and chocolate was for me. I depend on it whenever I flare. I don't use pain meds other than Elavil and have been able to get some relief just using heat when my IC flares. Fortunately, it isn't too often now. Hope I, too, will be able to go back to using it once in awhile. So I am thinking, what if I wrap my thighs in potholders? Would that be enough protection or would I just end up with the same thing on my lower abdomen over my bladder? There probably aren't enough potholders in the world to adequately protect me.

I really liked the quote about usually seen in the elderly. Yeah, I am 57 and my hair is white....but elderly...not yet! And you are only 25! Chronic pain is not just reserved for the elderly. This is what I miss about teaching, constantly learning more from younger people. Well, now I feel like I am more like many here since I've added another medical problem that has an acronym. I now have IC, EAI and IBS (not DXed but very probable). I am hanging on to my contacts still. My eyes, too, were getting a little dry and I switched to the newer advanced contacts that are more porous and have more moisture in them. I am doing ok with those, for now anyway.

EAI may be rare, but I do hope lots here will read about it since so many do use heating pads!

Good luck with your pregnancy plans! Certainly hope your IC goes into remission!

Annie

[massagedoula]

I liked your idea about potholders...Maybe it will work! Try it!
I took a warm, not hot bath last night...ok, I took 2 of them. But I am really trying to stop...I haven't used my heating pad or hot water bottle in 2 days. Geez...I feel like I am in AA. We can be a support group called HUA (Heat Users Anonymous).

PS. I am VERY interested in what brand of contacts you use. Do you know? Maybe I can ask to try them. I hate wearing glasses.

[Annie2]

Love the HUA idea! In fact, I could use some support today. I am feeling weak....I haven't flared in months but am doing so today....and WANT MY HEATING PAD!!! Don't know what I did to bring on a flare.....no diet slips and all is quiet. Oh, I do know! I posted my travel success story. I knew I shouldn't do that. I wrote it and my bladder is upset because I started thinking I am in charge, not my bladder. Oh well, even those who do well have flares once in awhile...I'll get that control back! I just may try potholders here cause I know 20 minutes of heat and I would feel much better! Now if I can just find enough old potholders in the kitchen to cover my thunder thighs.....

As far as the contacts go, I switched to the new Johnson & Johnson's Acuvue Advance with Hydraclear and use Complete Moisture Plus No Rub solution (says it has advanced dryness protection) and Complete Blink-N-Clean Lens Drops. I am doing ok with them. I never needed glasses until I passed 40 and then went straight to bifocals. I hate wearing glasses cause there isn't much bridge to my nose to hold them up, I am constantly scrunching my nose to keep glasses in place and glasses sit on my cheeks....I look like a chipmunk wearing them. Tried the bifocal contacts but they don't work for me. So I wear contacts for distance so I don't have to wear glasses all day long. Of course, I do have to have reading glasses with me at all times....and different computer glasses....and sunglasses........ Sometimes I end up with all 3 on top of my head! Some people worry about wax build up on their furniture. I have to worry about glass build up on my head!

Annie

[massagedoula]

I just got out of a warm...OK...it was HOT bath. I am not good at this no heat stuff. BUT I still have not used the heating pad or the hot water bottle. My thighs are already looking better. Hey, maybe you can scrunch the heating pad all up and try to put it just over the bladder, and as far from the thighs as possible.
I use the same contact solution as you, but I have these contacts called PROCLEAR Biocompatbles. They are suppsosed to be FDA approved for dry eye sufferers. I will go back to my contacts tomorrow. Hopefully a break for them was all I needed.

[massagedoula]

Did you try the pot holders? I am HURTING and I want my heating pad! I want to know if you thought that the pot holders worked. Maybe I will try a big towel to block the thighs.

[Betsie]

I don't think I have this, but now (eek, I do have my heating pad on-it is more of a "blankie" thing) it's cold so I don't do low temps....35 degrees in April is cold, even at night.

OMG Annie, the glasses-my story except I went to trifocals, tried progressives but they make me nauseous, so to fit it all in I have 2 glasses -one is reading distnce, the other reding computer..I can still tweak the distance...but the rest...am calling about lasik surgery next week...then the Rx sunglasses....yikes. I hate this over 40 and just squeaking into 50 stuff.

I am curious how you gals do with the heating dilemna...now can you sit in the sun? Your legs, will they be bothered by a really hot sunny day? I just got an issue of Jama today so I should be able to sign in and see if any articles are in the archives...willget back to you.

[ICNDonna]

One thing that might help is to turn the heating pad down to low --- and wrap it in a towel so you don't have the direct heat on your skin.

Donna

[Annie2]

Donna, it might be worth a try that way. I do know we have to be VERY careful with heat. MD, I did try potholders (hey, when you are desperate, you will try anything!). It did help a little but I didn't want to do it very long. The back of my thighs look really bad. It's better than it was but still ugly, especially my left leg. Looks like I have fish net stockings on that upper thigh. I am afraid I may have some permanent pigmentation change on that leg. I will ask my doctor about it. I do know I will have to be watched carefully for skin cancer. That isn't new, I am watched for it anyway. That's what scares me. Over the last few years, I had 8 suspicious growths removed. None were melanomas but some showed pre-malignant changes. That's why I am really trying so hard to stay away from heat since, with this condition, further heat exposure can damage skin cells and begin malignant growth. Before you brought this up, I really didn't think about how direct heat sources over time can cause these changes in the skin. We know full well what what the sun can do...so why didn't it dawn on me that a heating pad could do this, too? Duh!!!!!!!! Oh, I hope others are reading this thread!

MD, I hope you are feeling better. It really is hard to resist using the heat that brings so much relief. I think wrapping the thighs in towels to protect them would be a good idea...along with using lower heat settings and for shorter periods of time. Hope tomorrow brings a better day for you!

Annie

[jrowley]

I agree with Donna as a matter of fact if you read the papers that come with your pad it will tell you that is how to use it. You are not suppose to put it directly on your skin. I usually turn it to a med low temp and put a towel between me and the area. I would also try maybe 10 mins on and 10 mins off kind of thing so that you dont have the heat on the area for the whole day.

[Sarojini]

Hmmm... I get the mottled rash after heat but it always goes away in an hour or two. My skin is very fair, have auburn hair and green eyes -- am always asked if I am Irish, but I have only Polish and French Canadian in me. My husband is Scandinavian and light as well; very light brown hair, with blue eyes and fair skin and he tends to "blotch" too, probably worse than I do. We both get it in the shower, in the hot tub, and with heating pads, but it goes away and never stays longer than an hour. HE actually can get blotchy just sitting there... if he's really happy about something, or concentrating really hard, he gets blotchy. :lmao: I always pick on him about it -- but I think he's just a very "vascular" person as he gets migraines (as do I) and it just seems like the vasculature in him is very sensitive to any stimulation, causing the blotchiness.