Erythromelalgia is a rare skin disease causing painful burning sensations and redness in the hands and feet, often triggered by heat or friction. Treatment options vary based on severity and underlying cause, with surgery as a last resort. It can be hereditary or linked to autoimmune and neurological conditions.
Erythromelalgia is a rare skin disease that causes painful burning sensations and redness in the hands and feet. Symptoms are typically worst when a person’s extremities are exposed to hot temperatures or bound by shoes or gloves. In some cases, erythromelalgia is severe enough to become debilitating. Treatment decisions are made based on the severity of symptoms and whether or not an underlying medical cause is discovered. Home remedies and medications are usually enough to relieve the problem, but some patients eventually require surgery to sever nerve connections and prevent serious complications.
Many cases of erythromelalgia have no identifiable cause. Most patients with idiopathic erythromelalgia are over the age of 60. Younger individuals may experience symptoms if they have a genetic blood vessel disease or an underlying autoimmune disease such as lupus or diabetes. The disease has also been linked to neurological conditions such as multiple sclerosis. Rarely, erythromelalgia can be hereditary and be passed on to a child if one of his parents carries a specific genetic mutation.
The severity of symptoms can vary widely from patient to patient. Some people experience mild itching and tingling sensations that last only a few minutes. Others have intense pain in their extremities and severe skin discoloration for weeks or months at a time. Problems are usually triggered by high temperatures or friction, although flare-ups can be somewhat spontaneous. It is possible, but very rare, for burning and redness symptoms to affect other areas of the body, such as the scalp and ears.
A dermatologist can usually make an initial diagnosis of erythromelalgia based on the patient’s reported symptoms and the physical characteristics of their extremities. If the patient is not experiencing a flare-up at the time of the exam, the doctor may try to induce an episode by dipping a hand or foot in warm water. Blood tests, neurological exams, and imaging scans are then done to look for signs of an underlying condition.
People with idiopathic erythromelalgia and relatively mild symptoms may not need medical attention. A doctor may suggest that the patient avoid wearing shoes, stay indoors on hot days, and try soaking their feet and hands in cold water during active flare-ups. In severe cases, a soothing topical cream may be prescribed. Aspirin and other oral anti-inflammatory drugs are effective in reducing symptoms in many patients.
Surgery may be considered if all other treatments fail. A procedure called a sympathectomy involves cutting the nerve endings that transmit pain signals from the extremities. There are serious risks to be considered with sympathectomy procedures, but it is generally considered to be more beneficial than harmful to a patient whose quality of life is severely impaired by debilitating erythromelalgia.
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