Erythromelalgia

Erythromelalgia is a rare skin condition that commonly affects your feet. Symptoms can also occur in your hands in about 1 in 4 people.

Erythromelalgia can be classified as:

• primary erythromelalgia
• secondary erythromelalgia

Primary erythromelalgia is mainly seen in people over 60 years of age and is a little more common in females.

Erythromelalgia is also known as Weir-Mitchell disease and erythermalgia.

The symptoms of erythromelalgia are having episodes of:

• redness — this may look different on dark skin
• pain — which may start as itching
• warm or hot skin
• swelling
• sweating more than normal

The symptoms most often affect your feet and sometimes your hands. Symptom episodes can last anywhere from a few minutes to days. Symptoms are more common in the evening and night.

Rarely, you may get symptoms on your face, ears and other parts of your body.

Primary erythromelalgia is caused by inherited genetic differences.

Secondary erythromelalgia is linked to blood cancers caused by changes to your bone marrow. Occasionally it can be related to:

• diabetes
• infectious diseases
• diseases that affect your joints and muscles

Symptom flares can be caused by:

• dehydration — not drinking enough fluids
• drinking alcohol or eating spicy food
• exercise
• hot weather
• stress
• wearing tight clothes and shoes

If you have symptoms of erythromelalgia, see your doctor. They can diagnose the cause of your condition.

Your doctor will ask about your symptoms. They might also ask you about your family medical history.

It may help to take photos of your skin during a flare-up, to show your doctor.

You might be asked to have:

• blood tests
• genetic testing

Your doctor may also refer you to a specialist.

Treating erythromelalgia can be difficult. The main aim of treatment is to prevent flare-ups.

If your erythromelalgia is caused by another condition, your doctor will treat that condition.

Self-care at home

During a flare, you can try to relieve your symptoms by:

• raising the affected area
• cooling the area
• wearing loose clothing

Be careful putting your feet or hands into cold water. While this will give you temporary relief, it can cause other problems. It can also cause a vicious cycle, as the changes in temperature may cause another flare.

Wearing loose clothing and not letting yourself get too hot can help prevent or reduce flares.

Medicines for erythromelalgia

Most treatments aim to prevent flare-ups.

Your doctor may prescribe medicine to help with your symptoms, such as:

• aspirin
• sodium channel blockers
• calcium antagonists
• prostaglandins
• capsaicin cream
• anticonvulsant medicines
• some antidepressants

You may need to try different combinations of treatments to find one that works for you.

Erythromelalgia can lead to skin ulcers or gangrene (tissue death).

Severe wound infections can occasionally lead to amputation.

Erythromelalgia can cause ongoing pain and affect your quality of life. If the pain is affecting your mental health, you may want to see a counsellor or psychologist.

Because the cause of primary erythromelalgia is not well understood, it can't be prevented.

Treating the cause of secondary erythromelalgia can help stop the symptoms.

For erythromelalgia caused by genetic differences, support can be found through Genetic Alliance Australia.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.