Child's mysterious skin condition traced back to how he uses a laptop

When a boy with a strange honeycomb pattern on his stomach was brought into the University Hospitals of Leicester emergency department, nursing staff suspected a case of spontaneous bruising.Otherwise well, with immunizations all up-to-date and no signs of fever or pain, it seemed like just the kind of bruising a child would get from rough-housing with friends. The patient even disclosed that they had recently been play-fighting with their sibling, resulting in being pushed into a chair.With scans showing no internal trauma, and other conditions like livedo reticularis (mottled skin from cold exposure) ruled out, it seemed like the case was closed. A prescription was given for a mix of amoxicillin and clavulanic acid before the patient was sent home to rest.Several weeks later, the boy returned to the hospital. The fishnet bruising had darkened. Now more tender, it was accompanied by a pink, tender rash. Photos taken of pre-teen patient's skin on his first hospital visit (left) and his second (right)(Znagoveanu, et al., BMJ Case Reports, 2026) Thoughts turned to toasted skin syndrome, also known as erythema ab igne – a condition caused by prolonged exposure to mild heat that damages blood vessels near the surface of the skin.Initially, the parents couldn’t think of anything hot enough that could have caused the rash. No hot water bottles, no space heaters.Then it all became clear. A laptop balanced on the boy’s abdomen, often while charging, for up to 8 hours a day.Though not uncommon in young adults, particularly students, erythema ab igne from laptop use may not be something many physicians tend to consider in diagnosing children.Toasted skin syndrome isn’t particularly dangerous, with any color changes resolving once the source of heat is removed. There have been rare cases of cells turning pre-cancerous, with one severe case triggering a squamous cell carcinoma, though erythema ab igne is typically regarded as a benign condition.In this event, a phone call with the boy’s father several months later confirmed the rash had vanished.The authors of the study, GP Mara Znagoveanu and paediatrician Edward Artley, note the importance of considering the condition when coming across similar fishnet-pattern bruising and rashes in children."Early recognition through targeted history-taking can prevent misdiagnosis and avoid unnecessary investigations," they conclude in their case study.Skin rashes may be the least of our health problems when it comes to using technology for long periods. Sitting in a reclined position for up to 8 hours a day while staring at a screen can come at a great cost to children’s neck and back, their cardiovascular fitness, weight, sleep, eyesight, and even behavior.Putting down the laptop more frequently and roughhousing with friends might still lead to some occasional bruising, but might be safer for children in the long run.Source: ScimexThis research was published in BMJ Case Reports