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Erythromelalgia:     more detail

Small fiber neuropathy underlies erythromelalgia.(Skin Disorders): An article from: Family Practice News by Jane Salodof MacNeil, 2006-04-01 Red scrotal syndrome: a localized phenotypical expression of erythromelalgia.(CASE REPORTS)(Case study): An article from: Journal of Drugs in Dermatology by Noel Prevost, Joseph C., III English, 2007-09-01 A case of erythromelalgia: good response to treatment with gabapentin.(CASE REPORTS)(Clinical report): An article from: Journal of Drugs in Dermatology by Ali Murat Ceyhan, Ipek Gurses, et all 2010-05-01 Two cases of erythromelalgia (Mitchell) by Daniel Webster Prentiss, 1897 A case of erythromelalgia,: With microscopical examination of the tissue from an amputated toe, (American journal of the medical sciences) by S. Weir Mitchell, 1899 The occurrence of erythromelalgia in diseases of the spinal cord: An account of ten cases by James Collier, 1898 Erythromelalgia: Report of two cases, with cure. From the clinic of Dr. Otto Lerch, professor of medical diagnosis, postgraduate department, Tulane University by Albert Emile Fossier, 1913 Hysterical rapid respiration, with cases: Peculiar form of rupial skin disease in an hysterial woman by S. Weir Mitchell, 1893

lists with details

41. Dorlands Medical Dictionary
    erythralgia (er·y·thral·gia) (er²schwathral¢jschwa) erythro- +-algia erythromelalgia. erythromelalgia of the head, cluster headache.  
    http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszS

42. Erythromelalgia
    Home Health Conditions and Diseases Rare Disorders erythromelalgia (4) Groups A support group for those willing to help others who have erythromelalgia.  
    http://www.thenewhealthfind.com/Health/ConditionsandDiseases/RareDisorders/Eryth

43. ERYTHROMELALGIA
    erythromelalgia I have a60 yo male with a one-year history of erythromelalgia confined to the feet.  
    http://dermatology.cdlib.org/rxderm-archives/erythromelalgia
    
    Extractions: ERYTHROMELALGIA - I have a 60 y.o. male with a one-year history of erythromelalgia confined to the feet. The pt. does not have an elevated platelet count. He has hypertension, controlled with beta blockers. Calcium channel blockers worsened his erythromelalgia symptoms as noted in the literature. Aspirin and other NSAIA's had no effect. Pushing beta blockers had no effect. Any suggestions for treatment? Ethan D. Nydorf, M.D. - I have had great sucess with 40% urea in aquaphor. Bob Aylesworth M.D. - It sounds like the patient might have a Trental deficiency. Haines Ely MD - I have been a silent observer for a few months and have found the discussions interesting and occasionally helpful (esp IRBD). It takes a while to become comfortable with this modality - but the potential for good is great. Yesterday, I saw an 18 year-old woman with burning tender feet for two to three weeks. She's in good general health; a college student active in dance and cheerleading, she takes no medications other than OCP. The exam showed bright red warm feet, no papules or plaques, hands were normal. No edema. I suspect this is erythromelalgia (sometime called erythermelalgia) and can only remember seeing one similar case in the distant past. Three textbooks painted different pictures - not surprising since this is realtively rare. I obtained cbc and chemistries and ua (since thrombocythemia, diabetes and a host of other disease have been associated); held off on any more esoteric studies - recommended elevation, cold compresses and ASA 650 mg qid and will see her back in a week. May use an NSAID if ASA is not helpful. Does this picture suggest any other diagnosis (we see chilblains here commonly, and this looks quite different) and has anyone treated a number of these patients - and what seems to work best? Thank you for your help. David J. Elpern Your address (Hawaii) seems to rule against cold induced diseases such as erythromelalgia. The most common cause of what you are seeing is a mixed corynebacterial infection in sweaty feet. The best treatment is a month or so of erythromycin, orally. Careful exam of the hands usually reveals some fingertip erythema and desquamation as well. Haines Ely Quick search lead to piroxicam rx (JAAD l991-Jan), propranolol rx, and I was wondering about Trental as a possibility? Note that it has been associated with SLE and as a sign of internal malignancy- Diane Thaler Haines, would you say keratolysis exfoliativa is corynebacterium as well? What do you use in people who cannot tolerate erythro? And why do some people get it only in the late Fall through Winter-at least here in cold country. If David's patient does have erthromelalgia, what do you think of Trental rx? Diane Thaler No suggestion for other dxs. However, an elderly woman (already on aspirin) complained of burning feet. Exam showed increased erythema otherwise normal. KOH was neg. Tried Zostrix cream and warned of burning sensation with application. Patient thrilled!! Burning of feet completely resolved within one week. Currently tapering, so do not know if "cured" or controlled by Zostrix cream. Mary K. Cullen I suggest "neuropeptidogenic acral dermatitis" as described in the International Journal of Dermatology by Italian Dermatologists several years ago. Zostrix was very useful. Robert I. Rudolph, M.D., FACP There is a condition called symmetric lividities of the feet. I'm sure it was described in the JAAD about 1987. I've seen it several times usually in young males who are very active in sports. Your patient may have this condition. James G. Rothschild The proper name is acral neuropeptidogenic dysesthesia. Robert I. Rudolph, M.D., FACP If ASA not helpful, would consider something like Zyrtec to treat this as possible pressure urticaria(?from the dancing and cheerleading?) Hal Rehbein Excerpt from Rook's Textbook of Dermatology on CD-Rom "Diffuse erythematous eruptions/Scarlatiniform eruptions Scarlatiniform eruptions (Fig 41-8 . The known causes include the exotoxins of the haemolytic streptococcus and staphylococcus causing scarlet fever, and certain drugs (Chapters 23 and 74). The onset is usually acute and the eruption may be generalized or it may be restricted to localized areas, e.g. the palms and soles. There is a diffuse erythema which may be associated with a burning sensation in the skin and sometimes some itching. There may be fever and variable systemic symptoms. Spontaneous resolution usually occurs in 10-21 days and is often followed by desquamation. There may also be shedding of nails and sometimes of hair. In those cases where no cause is detected recurrences are not infrequent. The presence of an exanthem helps to distinguish scarlet fever from other scarlatiniform eruptions but is not completely reliable. Intradermal injections of a specific streptococcal antitoxin will cause blanching of the erythema in scarlet fever (Schultz-Charlton test), a test now very seldom used." Erythermalgia occurs in short attacks precipitated by heat which would seem to exclude it from the diagnosis Philip Bekhor Diane, I'm writing the next in the series of my Cutis articles on this very topic. Keratosis exfoliativa is corynebacterial, but it comes on in October and May more than any other months. SO deos herpses zoster. I have pondered this timing for 20 years. WHy? Maybe som one smart on the list knows the answer. As to erythromelalgia: I like Trental, DIltiazem, and a baby aspirin in combination. Of course, keeping warm is the best bet. Haines Ely I have treated several patients with erythromelalgia. Assuming a negative systemic workup, I have had success with combination therapy using beta blockers, trental and tricyclic antidepressants. This in patients who have failed aspirin therapy. Ethan D. Nydorf, M.D. I'd like to thank those who gave me advice on the young woman with erythromelalgia. I saw her back yesterday (after five days) and to my surprise she is symptom free on ASA 650 mgs qid. Feet no longer hot, slight erythema. Labs normal. I'm surprised this was so simple, but improvement may have nothing to do with medications. My second choice based on advice and readings would have been to add periactin. The suggestion of a localized scarletiniform eruption was interesting, and reaction to bacterial exotoxin similar to that seen with TSS and SSSS should have been considered. What I learned: 1) It's erythermalgia not erythromalgia 2) There's primary erythromelalgia, secondary erythromelalgia and erythermalgia. Much more complicated than I thought. Medline had 48 references in the past 3 years. David J. Elpern Erythromelalgia/erythermalgia Caper: In the Lancet, 1990: Vol 336, pp 183-4, JJ Michiels made the following observation: "The erythromelalgia patient finds: warmth intensifies discomfort a single dose of aspirin gives complete relief for several days the patient has a chronic myoproliferative disease with thrombocytopenia. platelet clumping leads to thrombi in the small vessels with resultant acrocyanosis and finally necrosis. "The erythermalgia patient experiences the same redness and burning pain of the extremities brought on by heat or exercise, but by contrast finds: no response to aspirin no progression to necrosis" The conclusion: "Watch your vowels or you'll get the diagnosis wrong. " See also JAAD 1989, Vol 21, pp 1128-30 on Idiopathic erythermalgia. Jerry Litt

44. PodiatryNetwork.com - Erythromelalgia
    Browsing by Circulation Disorders erythromelalgia, erythromelalgia is a fairly raredisorder manifested by vasodilatation of the blood vessels in the feet.  
    http://www.podiatrynetwork.com/document_disorders.cfm?ID=254

45. Startplane /Health/Conditions_and_Diseases/Rare_Disorders/Erythromelalgia
    erythromelalgia. See also Links. erythromelalgia (EM) Email group to discusstreatments and the affects of the condition. NORD erythromelalgia  
    http://www.startplane.com/Health/Conditions_and_Diseases/Rare_Disorders/Erythrom

46. :: Ez2Find :: Erythromelalgia
    Guide erythromelalgia, Global Metasearch Any Language Guides, erythromelalgia.ez2Find Home Directory Health  
    http://ez2find.com/cgi-bin/directory/meta/search.pl/Health/Conditions_and_Diseas
    
    Extractions: Any Language English Afrikaans Arabic Bahasa Melayu Belarusian Bulgarian Catala Chinese Simplified Chinese Traditional Cymraeg Czech Dansk Deutsch Eesti Espanol Euskara Faroese Francais Frysk Galego Greek Hebrew Hrvatski Indonesia Islenska Italiano Japanese Korean Latvian Lietuviu Lingua Latina Magyar Netherlands Norsk Polska Portugues Romana Russian Shqip Slovensko Slovensky Srpski Suomi Svenska Thai Turkce Ukrainian Vietnamese Mode

47. Burning-feet (Erythromelalgia) - Healing With Herbs, Vitamins And Minerals.
    Burningfeet (erythromelalgia). Clinically called erythromelalgia, burning-feetsyndrome causes feet to suddenly burn and redden with heat.  
    http://www.herbs2000.com/disorders/feet_burning.htm
    
    Extractions: Bach flower remedies ... Z Let herbs be your medicine and medicine be your herbs ! Burning-feet (Erythromelalgia) Clinically called erythromelalgia, burning-feet syndrome causes feet to suddenly burn and redden with heat. In some cases, the burning is an intensely painful experience. For others, it is only bothersome. Walking on a cold floor relieves symptoms and feels good. With this condition the feet feel quite hot to the touch, and often appear swollen. Rest, cooling applications, and raising the legs usually offer some relief. Burning feet are most common at night. Most cases of burning-feet syndrome are due to circulatory and nervous system problems. Persons suffering from diabetes polyneuropathy of the nerves, liver problems high blood pressure , blood-sugar instability or a B-vitamin deficiency are susceptible. Burning feet are a symptom of thiamine (vitamin B1) deficiency in some cases. Thiamine is not stored by the body and must be provided daily through the diet. The best sources are whole grains, nutritional yeast, brown rice, peanuts, raw wheat germ, green and yellow vegetables and milk. Poor circulation can be improved through a radical change in diet to a whole foods regimen of natural

48. Health, Conditions And Diseases, Rare Disorders: Erythromelalgia
    erythromelalgia (EM) Email group to discuss treatments and the affects of the condition.NORD erythromelalgia - Sample report, plus links to organisations.  
    http://www.combose.com/Health/Conditions_and_Diseases/Rare_Disorders/Erythromela
    
    Extractions: Related links of interest: Disease marked by paroxysmal, bilateral vasodilatation, particularly of the extremities, with burning pain, and increased skin temperature and redness. Help build the largest human-edited directory on the web. Submit a Site Open Directory Project Become an Editor The combose.com directory is based on the Open Directory and has been modified and enhanced using our own technology.

49. Health - Conditions And Diseases - Rare Disorders
    Top Health Conditions and Diseases Rare Disorders erythromelalgia NORDerythromelalgia Sample report, plus links to organisations.  
    http://www.sedirectory.net/Health/Conditions_and_Diseases/Rare_Disorders/Erythro
    
    Extractions: Web Hosting Dir Web Design Dir Search Engine Dir Hardware Info ... Resources Search: Top Health Conditions and Diseases Rare Disorders ... Erythromelalgia See also: Health: Conditions and Diseases: Cardiovascular Disorders: Vascular Disorders The Erythromelalgia Association - A non-profit organization dedicated to research and education regarding this painful disorder. Offers details about the disorder, the organization, FAQs and membership information. Erythromelalgia (EM) - Email group to discuss treatments and the affects of the condition. The Merck Manual: Erythromelalgia - A basic description of this disorder, which causes severe burning, pain, and redness, primarily in the hands and feet. NORD: Erythromelalgia - Sample report, plus links to organisations. [Fee required for full report.]

50. Erythromelalgia - New Treatments, March 2, 2004
    erythromelalgia. erythromelalgia is as common in children as adults, butin children it is less likely to be associated with erythromelalgia.  
    http://www.medical-library.org/journals3a/erythromelalgia.htm
    
    Extractions: Click here to view next page of this article Primary erythromelalgia is a rare syndrome of paroxysmal vasodilatation with burning pain, increased skin temperature, and redness of the feet and, less often, the hands. Like Raynaud's phenomenon, secondary erythromelalgia can occur in patients with underlying disease processes, most commonly systemic lupus erythematosus, myeloproliferative disorders, hypertension, venous insufficiency, or diabetes mellitus. Erythromelalgia is as common in children as adults, but in children it is less likely to be associated with erythromelalgia. The condition is characterized by attacks of burning pain and striking erythema of the tips of the fingers or toes. Attacks are not triggered by cold and occur most commonly during modest ambient temperatures. When measured, the skin temperature of the involved digits is high compared with the patient's core temperature. Symptoms may remain mild for years or may become so severe that disability results. Tissue loss and trophic skin changes do Diagnosis is based on the demonstration that the patient's complaints are related to objectively increased skin temperatures. Secondary erythromelalgia should be differentiated from the more common primary disorder because in the former, correction of the underlying disorder may relieve symptoms.

51. Erythromelalgia - General Practice Notebook
    erythromelalgia. This is rare condition where the fingers or toes become painful,purple and bloated. Relapses are episodic, often worse in the summer.  
    http://www.gpnotebook.co.uk/cache/-328531925.htm

52. Erythromelalgia
    erythromelalgia. Self Help Clearinghouse. The erythromelalgia Association(TEA). National network. Founded 1999.Provides  
    http://www.meritcare.com/hwdb/showTopic.asp?pd_hwid=shc29ery

53. Conditions And Diseases: Rare Disorders: Erythromelalgia
    Health and Home. erythromelalgia. http//www.merck.com/pubs/mmanual/section16/chapter212/212f.htm.erythromelalgia. Last Update Mon May 10 2004.  
    http://www.health-home.net/Conditions_and_Diseases/Rare_Disorders/Erythromelalgi

54. Erythromelalgia Sertraline ★
    Selected erythromelalgia sertraline resources. Click here if you are searchingfor erythromelalgia sertraline. erythromelalgia sertraline.  
    http://www.information-on-zoloft-drug.com/zoloft-resources/erythromelalgia-sertr

55. Gimenei >> Health >> Conditions_and_Diseases >> Rare_Disorders >> Erythromelalgi
    Gimenei.com, Search for Scope All Words, Results per page 10.Request Timeout 2,  
    http://www.gimenei.com/directory/top/Health/Conditions_and_Diseases/Rare_Disorde

56. Dictionary Definition Of ERYTHROMELALGIA
    Dictionary definition of erythromelalgia. Medical dictionary. BrowseDictionary by alphabet. 0 1 2 3 4 5 6 7 8 9 A B C D E F G H I  
    http://www.dictionarybarn.com/ERYTHROMELALGIA.php

57. Healthwise
    Topic erythromelalgia, Back to previous page. Synonyms weeks. Thespecific underlying cause of erythromelalgia remains unknown.  
    http://www.stlukes-sf.org/health/healthinfo/index.cfm?section=healthinfo&page=ar

58. Health Library -
    erythromelalgia. General Discussion. erythromelalgia is a rare condition thatprimarily affects the feet and, less commonly, the hands (extremities).  
    http://12.42.224.152/Library/HealthGuide/IllnessConditions/topic.asp?hwid=nord24

59. Journal Of Drugs In Dermatology: Erythromelalgia: Vasculopathy, Neuropathy, Or B
    Content provided in partnership with Thomson / Gale. Print friendly Tell a friendFind subscription deals erythromelalgia vasculopathy, neuropathy, or both?  
    http://articles.findarticles.com/p/articles/mi_m0PDG/is_1_3/ai_113650091
    
    Extractions: The authors of this study set out to assess the frequency and type of vascular changes and neurologic abnormalities in patients with erythromelalgia. Erythromelalgia is a syndrome characteristic for heat, tingling, burning, erythema and pain of the affected limb. This is a prospective study of patients with no spontaneous symptoms at the time of their visit and with provoked symptoms. There were sixty-seven patients presenting with erythromelalgia at Mayo Clinic, Rochester, Minn, from 1999 through 2001. Vascular studies were perfomed on the test patients; vascular function with and without symptoms was assessed by measurement of local skin temperature, laser Doppler flow, and transcutaneous oximetry. Neurologic assessment included electromyography, nerve conduction studies, and autonomic reflex screening. The authors used the quantitative sudomotor axon reflex test (QSART), adrenergic function testing, heart rate response to deep breathing, and the Valsalva ratio. QSART involved the application of acetylcholine to the suspect area and measuring the response after application.

60. Entrez PubMed
    Click here to read erythromelalgiaa thrombotic complication in chronicmyeloproliferative disorders. Tarach JS, NowickaTarach  
    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1

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