Recurrent squamous cell carcinoma complicating erythema ab igne

Erythema ab igne (EAI) is a reticulated dermatosis caused by chronic heat exposure.Although typically benign, malignant transformation into squamous cell carcinoma (SCC) can occur and exhibit aggressive behavior.We report the case of a 64-year-old male presenting with a large, ulcerated, invasive SCC on his right leg, arising from chronic EAI induced by 20 years of electric heater and hot water bottle use.Despite successful surgical excision with clear margins, the patient continued heat application postoperatively for pain relief.Two years later, he developed a massive local recurrence with bone invasion, leading to a fatal outcome.This case highlights the critical importance of permanent cessation of the thermal source, not only for prevention but as a cornerstone of management to avoid fatal recurrences in heat-induced malignancies.