Erythromelalgia
Key points
- Erythromelalgia is a paroxysmal bilateral vasodilatory disorder of unknown cause.
- The chief symptoms are erythema, warmth, and bilateral burning pain that lasts minutes to hours, at first involving circumscribed areas on the balls of the feet or palms and often progressing to involve the entire extremity.
- No findings are generally present between attacks.
- In primary erythromelalgia, aspirin (650 mg every 4-6 hours) often provides excellent relief and may in fact be diagnostic.
Erythromelalgia is a paroxysmal bilateral vasodilatory disorder of unknown cause. Idiopathic (primary) erythromelalgia occurs in otherwise healthy persons and affects men and women equally. A secondary type is occasionally seen in patients with polycythemia vera, hypertension, gout, and neurologic diseases.
The chief symptoms are erythema, warmth, and bilateral burning pain that lasts minutes to hours, at first involving circumscribed areas on the balls of the feet or palms and often progressing to involve the entire extremity. Symptoms occur in response to vasodilation produced by exercise or heat and can be prominent at night when the extremities are warmed under bedclothes. Relief may be obtained by cooling and elevating the affected extremity.
No findings are generally present between attacks. With onset of an attack, skin temperature and arterial pulsations are increased and the involved areas are warm, erythematous, and sweaty.
In primary erythromelalgia, aspirin (650 mg every 4-6 hours) often provides excellent relief and may in fact be diagnostic. Warm environments are to be avoided. ß-Blockers, epidural corticosteroid injections, and lidocaine patches have reported anecdotal success. Secondary erythromelalgia may improve with treatment of the primary disease process.
Davis MD et al: Lidocaine patch for pain of erythromelalgia. Arch Dermatol 2002;138:17.
Stricker LJ et al: Resolution of refractory symptoms of secondary erythermalgia with intermittent epidural bupivacaine. Reg Anesth Pain Med 2001;26:488.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.
Explore health topics
More in this topic
Heart & Blood Vessels →
NewsGene associated with sudden cardiac death identified by ICD monitoring
A gene associated with sudden cardiac death in the general population has been identified using implantable cardioverter defibrillator (ICD) monitoring in research presented for the first time at ESC Congress today.1…
1 September 2015
NewsPatients with abnormally fast heart rhythms to benefit from modification of treatment
A simple, safe and cost-free modification to a physical technique used to treat patients in the emergency department with an abnormally fast heart rhythm could improve its effectiveness by more than a quarter, according…
26 August 2015
NewsSupercomputers listen to the heart
New supercomputer models have come closer than ever to capturing the behavior of normal human heart valves and their replacements, according to recent studies by groups including scientists at the Institute for…
