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Erythromelalgia

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Erythromelagia (EM) is one possible diagnosis to differentiate from rosacea. What is it? According to the TEC web site:

"Erythromelalgia is a rare and frequently devastating disorder that typically affects the skin of the feet or hands, or both, and causes visible redness, intense heat and burning pain.

The term erythromelalgia describes the syndrome: erythros (redness), melos (extremity) and algia (pain). An alternate name is “erythermalgia” that emphasizes the thermos (heat) – an essential part of the syndrome.

While usually affecting the lower extremities (legs and feet) and upper extremities (arms and hands) other body parts like faces or just ears or the nose may be involved. It usually affects both sides of the body, but can affect just one.

The associated pain and burning sensations can be extremely severe. People with EM often make major adjustments to their lifestyles to avoid flare-ups. Even in mild-to-moderate cases, normal functioning such as walking, standing, working, socializing, exercising, and sleeping may be impaired." What is EM?

Treatment
"In this informal survey, the use of high oral doses of magnesium produced good and sometimes dramatic results in 8 of 13 patients who had been unresponsive to many other treatments. These results suggest a possible role for high-dose oral magnesium in the treatment of EM and, perhaps, other vascular disorders." [1]

"We tried oral mexiletine, a class Ib antiarrythmic agent, in view of its reported role in various chronic painful conditions. Dramatic improvement was observed with its use. Both patients improved after several weeks of use, and there were fewer soaking episodes. We observed no adverse effects with mexilitine therapy." [2]

"Lumbar sympathetic block and TSB are useful methods for treatment of primary erythromelalgia." [3]

"We conclude that thalamic stimulation was successful in this case of primary erythromelalgia." [4]

Ketamine 0.5% and Amitriptyline 1% has been used as a treatment not only for EM but also for rosacea. 

"Even when the correct diagnosis of erythromelalgiais made, treatment is difficult, with no single therapy consistently effective." [5]

Support

EM Thread at RF

EM Yahoo Group

End Notes

[1] Ann Pharmacother. 2002 Feb;36(2):255-60.
High-dose oral magnesium treatment of chronic, intractable erythromelalgia.
Cohen JS.

[2] Ann Saudi Med. 2009 Jul-Aug;29(4):316-8.
Experience with oral mexiletine in primary erythromelalgia in children.
Iqbal J, Bhat MI, Charoo BA, Syed WA, Sheikh MA, Bhat IN.

[3] Masui. 1989 Mar;38(3):388-93.
[A case of primary erythromelalgia (erythermalgia) treated with neural blockade].
Takeda S, Tomaru T, Higuchi M.

[4] Neurosurgery. 2005 Oct;57(4 Suppl):E404; discussion E404.
Thalamic stimulation as a treatment for primary erythromelalgia: technical case report.
Delye H, Lagae L, Vermylen J, Nuttin B.

[5] Dermatol Online J. 2017 Apr 15;23(4):
Erythromelalgia involving the face.
Gilmore RR, Applebaum DS, Parsons JL, Hsu S

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