A Different Cause of Erythema Ab Igne in Chronic Pancreatitis

摘要

A 27-year-old woman with severe rheumatoid arthritis and chronic pancreatitis was found to have marked abdominal erythema ab igne (fig. 1). This was due to intermittent heating of her fentanyl patches whilst in situ, to increase their analgesic effect.Erythema ab igne is due to damage to the skin from heat radiation. It is a well-known sign in chronic pancreatitis , almost always attributed to hot-water bottles held against the abdomen to reduce pain. However, the florid erythema ab igne of our patient was due to application of heat to her opiate patches via a heated pad. Increased temperature causes more rapid delivery of fen-tanyl, leading to greater serum concentration and greater analgesia .