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Skin manifestations in erythromelalgia: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Erythromelalgia is a disease that occurs as a result of vasomotor disorders.
Causes and pathogenesis. Depending on the origin, there are 3 types of erythromelalgia: type 1, associated with thrombocythemia, type 2 - primary, or idiopathic, which exists from birth, and type 3 - secondary, resulting from inflammatory and degenerative changes in blood vessels. In the development of erythromelalgia, an important role is played by the disruption of the exchange of vasoactive substances, in particular serotonin, vasodilatation, etc. Often the disease is of a family nature. The presence of erythromelalgia in the fifth generation was established.
Symptoms. The disease occurs equally often in men and women. Affected usually arms and legs, sometimes one limb. For all types of acute exacerbation of the disease after a warm bath, exercise, even after sleeping in a warm bed. Patients complain of soreness, burning, redness of the skin and fever. The height of the attack is manifested by purple-red or livid staining, massive swelling and cyanosis of the skin of the hands, feet and legs. Attacks last from several minutes to several hours. With the prolonged existence of the process, trophic disorders develop (hyperkeratosis of the palms and soles, paronychia), up to the formation of ulcers.
The course of the disease is chronic, febrile, with a duration of up to many years, with a periodic increase in the process.
Treatment. Prescribe vitamin therapy (B1, B12), anti-neurological, antihistamines, corticosteroids and angioprotectors (trentap, komplamin), conduct paravertebral blockade, sympathotomy, topical application of epinephrine.
Differential diagnosis. The disease should be distinguished from erysipelas, chronic atrophic acrodermatitis.
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