Erythromelalgia

Erythromelalgia is a rare disorder characterized by burning pain, heat, and redness in the hands and feet. The condition can be primary, meaning it occurs on its own, or secondary, meaning it is caused by another underlying medical condition.

Causes

The exact cause of erythromelalgia is not fully understood, but it is thought to be related to abnormalities in the blood vessels and nerves. In primary erythromelalgia, the condition is often inherited in an autosomal dominant pattern, meaning a single copy of the mutated gene is enough to cause the condition. Secondary erythromelalgia can be caused by a variety of underlying conditions, including:

• Myeloproliferative disorders, such as polycythemia vera or essential thrombocythemia
• Merkel cell carcinoma
• Neurological disorders, such as peripheral neuropathy or multiple sclerosis
• Autoimmune disorders, such as lupus or rheumatoid arthritis
• Certain medications, such as calcium channel blockers or serotonin reuptake inhibitors

Symptoms

The symptoms of erythromelalgia can vary in severity and may include:

• Burning pain in the hands and feet, which can be severe and debilitating
• Heat or warmth in the affected areas
• Redness or flushing of the skin
• Swelling or inflammation of the affected areas
• Sensitivity to temperature changes, with symptoms often worsening in warm temperatures
• Pain that worsens at night or with exercise

Diagnosis

Diagnosing erythromelalgia can be challenging, as the condition is rare and its symptoms can be similar to those of other disorders. A diagnosis is typically made based on a combination of:

• Medical history and physical examination
• Laboratory tests, such as complete blood counts or blood chemistry tests
• Imaging studies, such as X-rays or MRI scans
• Nerve conduction studies or electromyography (EMG) to evaluate nerve function

Treatments

Treatment for erythromelalgia typically focuses on managing symptoms and improving quality of life. Options may include:

• Pain management medications, such as aspirin or acetaminophen
• Medications to reduce inflammation, such as corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs)
• Medications to improve blood flow, such as vasodilators or calcium channel blockers
• Physical therapy to improve mobility and reduce pain
• Lifestyle modifications, such as avoiding warm temperatures or wearing loose clothing
• Alternative therapies, such as acupuncture or massage

Complications

If left untreated, erythromelalgia can lead to a range of complications, including:

• Chronic pain and disability
• Depression or anxiety
• Sleep disturbances
• Reduced mobility or activity level
• Increased risk of infection or ulcers in the affected areas

Prognosis

The prognosis for erythromelalgia varies depending on the underlying cause and severity of symptoms. With proper treatment, many people with erythromelalgia are able to manage their symptoms and improve their quality of life. However, in some cases, the condition can be debilitating and may require ongoing medical attention.