A 39-year-old woman presented with pain in distal extremities. The patient had tingling pain, particularly in the lower legs, with heat sensation and redness, which was typically exacerbated in a hot environment and continued for hours. Since the patient had no pain with an examination of the feet showing normal findings (Picture A), we soaked her feet in warm water. Consequently, the patient developed strong foot pain 10 seconds after exposure, with markedly swollen, red-colored feet (Picture B). The symptoms subsided within half an hour following cold water exposure. As further examinations revealed no findings for myeloproliferative, autoimmune or other underlying diseases, a diagnosis of idiopathic erythromelalgia was made. She was advised to avoid heat exposure and misoprostol relieved her symptoms.
Picture.
Erythromelalgia is a rare, poorly understood condition characterized by intermittently affected, painful extremities with erythema caused by dysfunction in the vascular dynamics, which worsens with heat exposure (1). Erythromelalgia should be actively considered as symptoms may only be apparent only during a flare in mild cases.
The patient was informed of the contents of this article and provided their consent for publication.
The authors state that they have no Conflict of Interest (COI).
References
- 1.Mann N, King T, Murphy R. Review of primary and secondary erythromelalgia. Clin Exp Dermatol 44: 477-482, 2019. [DOI] [PubMed] [Google Scholar]