Erythromelalgia: Difference between revisions
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(Created page with "== Background == * Inherited disorder that causes episodes of hot, red, painful extremities * Rare, but more common in women than men, usually starting in adulthood == Clini...") |
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+ | ==Background== |
| − | * |
+ | *Inherited disorder that causes episodes of hot, red, painful extremities |
| − | * |
+ | *Rare, but more common in women than men, usually starting in adulthood |
| − | == |
+ | ==Clinical Manifestations== |
| − | * |
+ | *Hot, red, painful extremities |
| − | * |
+ | *More commonly involves feet, but can involve hands |
| − | * |
+ | *May be associated with [[myeloproliferative disorders]] including [[essential thrombocytosis]], [[chronic myelogenous leukemia]], [[polycythemia vera]], and [[myelofibrosis]] |
| + | |||
| + | == Management == |
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| + | |||
| + | * Non-pharmacologic |
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| + | ** Identify and avoid precipitants, such as heat and exercise |
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| + | ** Cool with water for short periods (5 to 10 minutes every 1 to 2 hours) |
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| + | ** Cool with a fan for short periods (5 to 10 minutes every 1 to 2 hours) |
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| + | ** Limb elevation |
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| + | ** Avoid applying ice or very cold water directly to the skin |
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| + | * Pharmacologic |
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| + | ** No clear benefit but many have been tried |
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| + | ** Topical treatments |
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| + | *** For pain, can try lidocaine patches, compounded amitriptyline and ketamine, capsaicin, topical diclofenac gel, gabapentin ointment |
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| + | *** For erythema, can try midodrine |
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| + | ** Systemic treatments |
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| + | *** Aspirin, especially if concomitant [[Myeloproliferative disorders|myeloproliferative disorder]] |
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| + | *** For neuropathic pain, [[gabapentin]], [[pregabalin]], [[venlafaxine]], [[amitriptyline]], [[misoprostol]], [[sertraline]], [[mexiletine]], [[carbamazepine]], [[diltiazem]], [[sodium nitroprusside]], high-dose[[magnesium]] |
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[[Category:Dermatology]] |
[[Category:Dermatology]] |
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Revision as of 14:18, 28 March 2021
Background
- Inherited disorder that causes episodes of hot, red, painful extremities
- Rare, but more common in women than men, usually starting in adulthood
Clinical Manifestations
- Hot, red, painful extremities
- More commonly involves feet, but can involve hands
- May be associated with myeloproliferative disorders including essential thrombocytosis, chronic myelogenous leukemia, polycythemia vera, and myelofibrosis
Management
- Non-pharmacologic
- Identify and avoid precipitants, such as heat and exercise
- Cool with water for short periods (5 to 10 minutes every 1 to 2 hours)
- Cool with a fan for short periods (5 to 10 minutes every 1 to 2 hours)
- Limb elevation
- Avoid applying ice or very cold water directly to the skin
- Pharmacologic
- No clear benefit but many have been tried
- Topical treatments
- For pain, can try lidocaine patches, compounded amitriptyline and ketamine, capsaicin, topical diclofenac gel, gabapentin ointment
- For erythema, can try midodrine
- Systemic treatments
- Aspirin, especially if concomitant myeloproliferative disorder
- For neuropathic pain, gabapentin, pregabalin, venlafaxine, amitriptyline, misoprostol, sertraline, mexiletine, carbamazepine, diltiazem, sodium nitroprusside, high-dosemagnesium
