To the Editor.
—Erythromelalgia is a rare condition manifested by burning pain in the extremities, accompanied by local warmth and erythema. Erythromelalgia may occur alone or in association with other conditions, particularly the myeloproliferative disorders.1 Much of the literature regarding the pathogenesis of erythromelalgia advocates a theory of platelet-mediated vascular inflammation and thrombosis.2 We describe a man with diabetes in whom erythromelalgia developed; evidence from the skin biopsy specimens supports the theory that a neuropathy can be involved.
Report of a Case.
—A 38-year-old diabetic man presented with burning pain in both feet, which developed about 6 weeks after an episode of diabetic ketoacidosis. The pain was aggravated when standing and when the feet were exposed to warmth. The pain was partially relieved by ice water soaks, which the patient eventually used almost constantly. Examination of the lower extremities showed brightly erythematous warm skin with nonpitting edema involving
Staub DB, Munger BL, Uno H, Dent C, Davis JS. Erythromelalgia as a Form of Neuropathy. Arch Dermatol. 1992;128(12):1654-1655. doi:10.1001/archderm.1992.04530010090023