Fears that modern electronic devices may harm children are nothing new. Gadgets with screens of any size have long been allegedly melting, rotting, and/or corrupting the brains of youths for decades. However, a medical case report published this week offers a new and alarming way our digital doodads may cause physical harm.
In BMJ Case Reports, two UK doctors, Mara Znagoveanu and Edward Artley, report the case of a boy who came to an emergency department with alarming marks on his abdomen. The marks were described as being in a patch about 15 centimeters (six inches) wide, made of flat, reddish-brown “interlacing lines forming irregular circles and a lace-like morphology.” A picture of the marks is here.
Mysterious marks
The boy, whom they described only as being in “mid-childhood,” was not in any pain, and the rash was not warm to the touch or tender. He and his parents said they couldn’t think of any recent injuries or trauma that might explain the marks. He was otherwise healthy, hadn’t recently been ill, and had no systemic symptoms, such as fever or fatigue. Everything about the boy’s health, growth, and medical history looked normal.
Nurses in the emergency department initially described it as “spontaneous bruising.” A physical exam yielded no insights; there were no other skin abnormalities, abdominal tenderness, or signs of organ trouble. They did a chest X-ray, searching for an explanation. It revealed a small patch of whiteness over his left lung, indicating cells or fluid, such as pus or blood.
As the doctors were taking blood for further testing, the boy told them that he did have one injury: About a week prior, around when the marks appeared, he was play-fighting with his siblings and got pushed into a chair. He said he didn’t mention it before because he didn’t want his siblings to get in trouble.
The new information pointed the doctors to the idea of an underlying traumatic injury. They did a computed tomography (CT) scan, looking for internal abdominal injuries. But they found none, besides the small blip in his lungs that the X-ray showed—which could have just been incidental from a minor infection.
Without finding anything else of note, the doctors discharged the boy with a short course of antibiotics used to treat lung infections. But they conveyed their uncertainty about what was actually going on, advising his parents to check back if anything changes or if the marks didn’t go away.
Getting warmer
Two weeks later, the boy was back in the hospital, and the marks were worse. They were bigger, darker, and tender. There were patches of pink, and some of his skin was visibly breaking down. A picture of the marks is here.
Based on the appearance, the doctors started reconsidering some sort of bruising and started asking him more questions. This is when he mentioned that he was homeschooled and used a laptop for his schoolwork. He said he typically did his work by resting his laptop on his abdomen while he worked, sometimes for up to eight hours a day, and often while the laptop was charging. Then they understood what it was.
The doctors diagnosed the boy with erythema ab igne (EAI), which translates from Latin as “redness from fire” and is also sometimes called “ toasted skin syndrome.” This is a skin condition caused by repeated, prolonged exposure to low-grade heat—heat not hot enough to cause actual burns. It’s most often seen in adults, and common causes include using heating pads or hot water bottles for chronic pain or sitting too close to space heaters. Some people also develop it from certain occupational hazards, like glassblowing and metal work. EAI produces a lace-like rash, just like the boy’s.
It’s unclear how EAI develops exactly. But researchers hypothesize that chronic heat exposure leads to damage to superficial blood vessels and the release of red blood cells, forming the tell-tale red reticulated pattern.
While the boy’s condition looked ominous, the good news is that EAI is generally benign and reversible—once you remove the heat source. For severe or long-term conditions, some pigmentation and scarring can remain. But the boy’s parents checked back in over several months, reporting that the rash faded and then completely resolved. Hopefully, he also got some sort of laptop stand.
