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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, erythromalalgia, erythromelalgea an 

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.


Although rest, elevation of the extremities, and cold compresses or immersion in ice may provide temporary relief, no consistently effective treatment has been found for the multiple episodes of pain that may occur daily. In primary erythromelalgia, a modest dosage of aspirin (600 mg, 1 to 4 times daily) may produce significant relief. Vasoconstrictors such as ephedrine or beta-blockers may 

Marked clinical improvement in symptoms of erythromelalgia may occur with serotonin reuptake inhibitors. Venlafaxine, a serotonin reuptake inhibitor that also has an effect on the reuptake of norepinephrine. Sertraline, another serotonin reuptake inhibitor, also has been found 

Erythromelalgia pain has also been successfully managed with gabapentin (Neurontin). Because it is safe and generally well tolerated, it would appear reasonable to initiate therapy for erythromelalgia with gabapentin before administering more erythromelalgia, erythromalalgia, erythromelalgea