A young woman burns her arm with a cigarette | Stock image | Colourbox

Cigarette Burn Scars In Self-harm Photograph by Dr P. Marazzi/science ...

Diseases Mimicking a Burn – Outcome and Treatment

Cigarette Burn Scars In Self-harm Photograph by Dr P. Marazzi/science ...

Several skin lesions present like burns. Disruption of the skin layers or its blood supply due to any reason produces similar lesions that mimic a burn injury. Some of these diseases are Stevens-Johnson disease, Lyell’s syndrome, erythema multiforme, necrotizing fasciitis, automatic skin necrosis and coagulation disturbances (purpura fulminans, coumarin-induced skin necrosis syndrome), pemphigoid, and subacute cutaneous lupus erythematosus. All of these diseases affect the function and viability of skin and underlying tissues in a way resembling the loss of skin in burns. Patients suffering from any of these diseases should be admitted to a burn care unit (BCU). 1, 2

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Introduction

Scrub typhus is caused by Orientia tsutsugamushi, a Gram-negative coccobacillus. It is endemic in Asia–Pacific region with incidence of 1 million cases/year. 1 It has varied clinical spectrum, and apart from constitutional symptoms, patient often present with shock, thrombocytopenia, hepatitis, Acute Respiratory Distress Syndrome or CNS manifestations. Eschar is the pathognomic sign, which appears at the site of thrombiculid mite bite. 2 , 3 Immunofluorescence assay is the gold standard, but Weil-Felix test and scrub typhus IgM ELISA are more commonly used diagnostic modalities. 2 , 3 Doxycycline is the drug of choice. 1 , 4

A 64-year-old man from an Indian dengue endemic area was admitted with 9 days history of fever, rashes and decreased urine output. Clinically, he was febrile with generalized macular rash over the body. On investigations, he had decreased platelet counts (60 000/mm 3 ), increased hematocrit (52%) and increased serum urea and creatinine levels (108 and 3.8 mg%, respectively). He was treated empirically for dengue hemorrhagic fever, but his condition progressively deteriorated. On re-evaluation, he was found to have a papular lesion on right middle quadrant of his abdomen, 15 mm in diameter, with central blackened crust, resembling cigarette burn ( Figure 1). Patient was totally unaware of this lesion. Based on provisional diagnosis of scrub typhus, doxycycline was started. The patient’s condition improved dramatically within 3 days of treatment. The diagnosis of scrub typhus was confirmed by Weil Felix test.

Do Cigarette Burns Scar? What to Do If You Burn Your Skin

Figure 1 from Cigarette burns in forensic medicine. | Semantic Scholar

Les soins des brûlures ne sont pas limités uniquement aux brûlures. Il y a plusieurs maladies qui possèdent la symptomatologie, la présentation clinique, les complications, les exigences de traitement et les résultats des brûlures. Ces maladies sont les suivantes : 1. maladie de Stevens-Johnson ; 2. syndrome de Lyell ; 3. fasciite bactérienne ; 4. nécrose cutanée unie à des troubles de la coagulation ; 5. pemphigoïde ; 6. lupus érythémaeux cutané subaigu.

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Burns-mimicking diseases

The eschar resembling ‘cigarette burn mark’ is seen in 95% of cases and is most important diagnostic clue of scrub typhus. 4 It often goes unnoticed by both the physician and patient. Patients are often unaware of this mark as it is painless and non-itching. Early diagnosis by carefully examining the patient and prompt treatment is necessary as delay in treatment can result in life-threatening complications. 2

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The ‘cigarette burn’ sign

Cigarette burns on the dorsum on the left hand of a girl aged 8 years ...

Burn care is not reserved uniquely to burns. Several diseases have the symptomatology, clinical presentation, complications, treatment requirements, and outcome of burns. Such diseases are: 1. Stevens-Johnson disease; 2. Lyell’s syndrome; 3. bacterial fasciitis; 4. skin necrosis combined with coagulation disturbances; 5. pemphigoid; and 6. subacute cutaneous lupus erythematosus.

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Résumé

Stevens-Johnson disease presents as a hypersensitivity erythema with a sudden onset. It is characterized by erythematous, multicentric circular lesions also called “target lesions ”, which have a positive Nikolsky’s sign. It can involve all the body surface but is usually present in the hands, feet, and mucous membranes. The cause of Stevens- Johnson disease is unknown. 3 Several viruses have been suspected, such as the herpes viruses, the Epstein-Barr virus, and HIV. 4 The presence of a connective tissue disease, lymphoma, cancer, or Wegener’s granulomatosis would seem to be a frequent feature. The administration of certain drugs 5, 6, 7 has been implicated as a cause of the disease (Figs. 1 , 2 ).

Eschar with central dark necrotic crust, resembling cigarette burn.

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Figure 1 from Cigarette burns in forensic medicine. | Semantic Scholar

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Figure 7 from Cigarette burns in forensic medicine. | Semantic Scholar

Figure 2 from Cigarette burns in forensic medicine. | Semantic Scholar

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