Erythromelalgia

Case:

33 yo M with a long history of recurrent pain, swelling, redness of feet > hands induced by heat, lasting 30-60 min, & relieved with cold. More recently, he has also developed cold-induced tricolor changes in his fingers. Adjusting temperature for one symptom induces the other. He has found a “sweet spot” between 65-72 degrees F (ideally 69 degrees F). Physical exam normal, as was his CBC. ANA negative. This is most certainly a case of concomitant primary erythromelalgia and Raynaud’s.

Learning points:

• Associated with pain, redness, and warmth
• Involves feet more than hands
• Precipitated by warm/hot
• Relieved with cold
• Pathogenesis unknown – maybe hyperemia
• May be primary or secondary
• Treatment is unsatisfactory