erythromelalgia

see also:

• reflex sympathetic dystrophy (RSD) / complex regional pain syndrome / causalgia

• a chronic, life-long, rare condition which causes periodic erythema, hot, burning skin sensation, mainly of feet but may also affect hands, legs, arms or face.

• idiopathic
• inherited

• autoimmune diseases - systemic lupus erythematosus (SLE), multiple sclerosis (MS)
• essential thrombocytosis
• polycythaemia rubra vera
• Raynaud's phenomenon
• Neuropathies

• episodes which may include:
  • erythema, hot, tingling to burning skin sensation, mainly of feet but may also affect hands, legs, arms or face
  • may also have pruritus, excessive local sweating, tender, blotchy skin
  • may be unilateral or bilateral
• between episodes, skin may feel cold to touch

• usually due to a sudden increase in skin temperature
  • dehydration
  • caffeine intake
  • alcohol intake
  • spicy food
  • exercise
  • stress
  • warm environments
• ice baths usually make it worse

• avoid triggers
• consider tests to rule out secondary or genetic causes
• elevate affected limb
• rest on a cool but not cold surface
• use a fan
• consider cold pack wrapped in cloth
• dietary supplements may be tried such as magnesium
• medications may be helpful
  • anti-depressants such as amitryptiline
  • neuropathic pain modulators
  • aspirin
  • analgesics
• severe cases may warrant nerve blocks