Pediatric erythromelalgia treated with epidural ropivacaine infusion

Lee, Caroline E.; Paulk, Kelly L; Garvie, Kristen; Grieshaber, Elizabeth; Carter, Jeffrey; Ball, Brian

doi:10.1016/j.jdcr.2019.01.029

Cited by 11 publications

(8 citation statements)

References 8 publications

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“…Chemical or surgical sympathectomy is a nonspecific method to interrupt the nociceptive pain fibres or sympathetic fibres. 3 In this case, the patient improved markedly after the discontinuation of HRT and oral administration of glycyrrhizin and pregabalin for 3 months. Glycyrrhizin is able to relieve pain by acting on the cyclooxygenase/prostaglandin E synthase pathway, 4 and has been used to treat inflammatory diseases.…”

mentioning

confidence: 66%

A survey of mepacrine prescribing by dermatologists

Mulholland

O’Kane

McCourt

2022

Clinical and Experimental Dermatology

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confidence: 66%

A survey of mepacrine prescribing by dermatologists

Mulholland

O’Kane

McCourt

2022

Clinical and Experimental Dermatology

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“…[1,4]. In 2019, 14 EM cases have been reported in the literature despite the high probability of missed diagnosis and non-reported cases [5][6][7][8][9][10][11][12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…They use fans, cold water immersion, open shoes, reduced exercise and ice on affected areas [2,3]. Prolonged exposure causes skin maceration, infections (cellulitis), frost bite and hypothermia [2,3,6,15,17]. It causes depression, anxiety and suicidal ideation in patients [6].…”

Section: Discussionmentioning

confidence: 99%

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Primary Erythromelalgia Complicated by Cellulitis: A Case Report and Review of Literature

Sharif¹,

Haider²,

Freeman³

et al. 2020

AJMCR

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Background: Erythromelalgia is a rare disease with increasing incidence. It manifests as episodic painful red extremities triggered by heat. External cooling provides temporary symptomatic relief but may lead to complications such as cellulitis. Management includes trigger control, behavioral therapy and pain management. Case Presentation: A 47-year-old African American male presented to the hospital with worsening bilateral lower extremity pain for three months. It was episodic, triggered by running and associated with erythema and swelling. Patient used cold water immersion and air conditioning for pain relief. One week prior to presentation, he developed painful blisters on his feet. On presentation, vital signs were stable, patient was afebrile. Acute infection was ruled out and he was discharged with outpatient rheumatology follow up for erythromelalgia. He returned one week later with worsening symptoms. CT scan of lower extremities indicated bilateral cellulitis. Patient was managed by medicine, dermatology, rheumatology, and podiatry for cellulitis, fungal infection, trench foot and primary erythromelalgia with antibiotics, antifungals, gabapentinoids and behavioral therapy. His infection resolved and pain improved. He was discharged with outpatient rheumatology follow up. Discussion: Erythromelalgia is a highly debilitating disease with episodes of burning erythematous extremities triggered by increase in skin temperature. Patients seek pain relief by excessive external cooling. Pathophysiology involves gain of function mutation in voltage gated sodium channels causing autoregulatory dysfunction of skin. Underlying disease mechanisms are ambiguous and may involve unidentified genetic components and unknown triggers. It is a clinical diagnosis. Therapy requires a multidisciplinary approach. Complications should be promptly addressed given attention next to symptomatic relief. There is a lack of disease specific treatment and complete remission is unlikely. Our patient responded well to gabapentinoids and behavioral therapy.

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“…2 Additionally, it has been shown to be safe and effective in combination with immunosuppressive therapy. 3 We designed an online questionnaire to assess Dermatology prescribing practices of mepacrine in the UK and Ireland. The survey was distributed electronically to British Society of Medical Dermatology and British Association of Dermatology (BAD) members.…”

Section: Supporting Informationmentioning

confidence: 99%

Hormone replacement therapy-induced pain and redness of the feet

2022

Clinical and Experimental Dermatology

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Pediatric erythromelalgia treated with epidural ropivacaine infusion

Cited by 11 publications

References 8 publications

A survey of mepacrine prescribing by dermatologists

A survey of mepacrine prescribing by dermatologists

Primary Erythromelalgia Complicated by Cellulitis: A Case Report and Review of Literature

Hormone replacement therapy-induced pain and redness of the feet

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