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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(07): 491
DOI: 10.1590/0004-282X20170078
IMAGES IN NEUROLOGY

Burning pain attacks and red skin in a young woman

Ataques de dor em queimação e eritrodermia em uma mulher jovem
Paulo Victor Sgobbi de Souza
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Divisão de Doenças Neuromusculares, São Paulo SP, Brasil.
,
Thiago Bortholin
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Divisão de Doenças Neuromusculares, São Paulo SP, Brasil.
,
Wladimir Bocca Vieira de Rezende Pinto
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Divisão de Doenças Neuromusculares, São Paulo SP, Brasil.
,
Acary Souza Bulle Oliveira
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Divisão de Doenças Neuromusculares, São Paulo SP, Brasil.
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A 21-year-old woman presented with a five-year history of burning pain, redness, swelling and heat in her feet. The medical history disclosed palmar hyperhidrosis. Her family history was unremarkable. Examination showed erythema, heat and marked swelling in her feet, which improved after gabapentin and acetylsalicylic acid treatment ([Figure]). An extensive evaluation for secondary causes was unremarkable.

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Figure Examination for erythromelalgia. Note the presence of marked erythema, heat and swelling in feet (A, B) with marked response to acetylsalicylic acid and gabapentin treatment after three weeks (C, D).

Erythromelalgia is characterized by recurrent attacks of intense pain, redness, warmth and swelling, localized to the distal extremities due to secondary etiologies such as myeloproliferative or rheumatologic disorders, drugs (bromocriptine; calcium channel blockers)[1], or as primary erythromelalgia[2] caused by mutations in the SCN9A gene, coding sodium channel subtype Nav1.7.



Publication History

Received: 25 July 2016

Accepted: 15 April 2017

Article published online:
05 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Tang Z, Chen Z, Tang B, Jiang H. Primary erythromelalgia: a review. Orphanet J Rare Dis. 2015;10:127. https://doi.org/10.1186/s13023-015-0347-1
  • 2 McDonnell A, Schulman B, Ali Z, Dib-Hajj SD, Brock F, Cobain S et al. Inherited erythromelalgia due to mutations in SCN9A: natural history, clinical phenotype and somatosensory profile. Brain. 2016;139(4):1052-65. https://doi.org/10.1093/brain/aww007