OSCE — Erythema ab igne

Brief (to candidate)

You will assess a patient with a presentation consistent with Erythema ab igne.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Erythema ab igne (EAI, toasted skin syndrome) is a localised cutaneous reaction caused by chronic, repeated exposure to moderate heat — insufficient to cause a thermal burn but enough to damage the superficial dermal vasculature — producing a characteristic reticulated (net-like), brownish-purple hyperpigmentation on the heat-exposed skin. Modern causes include laptop computers on the lap, heating pads, hot water bottles, heated car seats, space heaters, electric blankets, and open fires. Histology may mimic actinic keratosis (atypical keratinocytes — 'thermal keratosis'). Long-standing lesions carry a small but real risk of malignant transformation to squamous cell carcinoma. Management: re

Candidate tasks

1. Clarify onset, severity, associated features, and red-flag symptoms.
2. State focused examination priorities.
3. List first-line investigations and any named score/criteria.
4. Give immediate resuscitation steps.
5. Outline definitive management with doses/routes where standard.
6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
7. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.^[1]