Full skin thickness burns caused by contact with the pavement in a heat-stroke victim

A 70-year-old woman, with a previous history of heat-stroke, suffered another heat-stroke on a hot summer day (air temperature 43 degrees C (109 degrees F)). She presented the rare complication of a heat-stroke plus deep burns sustained while lying unconscious on the pavement. In addition to age, obesity, previous illness, incidental fever, drugs, dehydration and physical effort, a previous history of heat-stroke is probably an important risk factor for a second heat-stroke. Burns from contact with the pavement are uncommon but possible, especially if the patient is obese, immobile and poorly insulated.