Erythema ab igne

165 Erythema ab igne

Instruction

Examine this patient’s legs.

Examine this patient’s abdomen.

Salient features

History

• Ask the patient whether she exposed the affected area to heat.

Examination

• Reticular erythematous or pigmented rash, usually on the forelegs (or abdomen), known as ‘Granny’s tartan’

Proceed as follows:

• Look for features of hypothyroidism (pulse, ankle jerks).

• Tell the examiner that you would like to proceed as follows:

• measure serum thyroxine and thyroid-stimulating hormone

• investigate for chronic pancreatitis and intra-abdominal malignancy.

Note: If the rash is present over the anterior abdominal wall or lumbar region, it is very likely that there is an intra-abdominal malignancy or chronic pancreatitis.

Diagnosis

This patient has a reticular pigmented rash (lesion) on the abdomen caused by local heat from a hot-water bag (aetiology); I would like to exclude an underlying intra-abdominal malignancy.

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Tags: 250 Cases in Clinical Medicine

Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off

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