Erythromelalgia is a rare disorder characterized by burning pain, warmth, and redness of the distal aspect of the extremities. Symptoms typically are precipitated by exposure to heat, and patients often soak their feet in ice water to alleviate the pain. We describe a woman with a 5-year history of intractable foot pain. With venlafaxine hydrochloride therapy, her symptoms improved markedly.
A 58-year-old woman complained of increasingly severe burning pain, warmth, and redness in her feet that had begun 5 years earlier. Exposure to heat exacerbated her pain, for which she continually soaked her feet in ice water. This constant immersion in water caused painful, nonhealing ulcers to develop on both feet (Figure 1). As a result, she confined herself to a wheelchair.