I think I may have erythromelalgia. How to manage it?

Question

Hello doctor,

I highly suspect that I have erythromelalgia. My hands have been constantly red since November 2016, and they often feel hot, uncomfortable, and as if they are swelling. These symptoms appeared suddenly in November 2016. The heat and swelling improve when my hands are elevated or placed in cold water. What treatment options are available to help reduce or alleviate the redness and pain in my hands? Please help.

Thank you

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

I am very sorry about your medical condition, and I am glad that you are paying attention to changes in your body. Please do not worry, I am here to help you, and thank you for sharing this. Your description does fit with erythromelalgia (a condition that causes redness, heat, swelling, and burning pain in the hands or feet, which improves with cooling and elevation).

I will walk you through the key points. Erythromelalgia can be:

Primary (a rare genetic condition)
Secondary to other conditions such as:
- Blood disorders (for example, essential thrombocythemia [a condition with too many platelets], polycythemia vera, a condition with too many red blood cells, and myeloproliferative disease, a group of disorders where the bone marrow makes too many blood cells).
- Autoimmune or neuropathic causes (for example, lupus, an autoimmune disease where the immune system attacks the body, and small-fiber neuropathy, damage to small nerve fibers that control pain and temperature sensation).

Since your symptoms started suddenly, it is important to have certain investigations done to rule out underlying causes. Please get the following tests:

ANA (Antinuclear Antibody test) – checks for autoimmune diseases
CBC (Complete Blood Count test) – checks for abnormalities in blood cells
Nerve studies, if needed, to look for nerve-related causes

I will offer both pharmacological treatment (medications) and non-pharmacological treatment (lifestyle and supportive care) options:

Non-pharmacological treatment options:

Elevation of the affected area.
Use of fans for cooling.
Brief immersion in cool water (avoid prolonged ice water immersion, as this can damage the skin).
Wear cotton gloves or socks to protect and keep the area cool.
Avoiding triggers such as heat, strenuous exercise, tight clothing, alcohol, and spicy foods.

Pharmacological treatment options (medications):

Aspirin 75 mg orally once daily for two weeks (helps in conditions related to blood clotting or platelet disorders).
Duloxetine 50 mg orally once daily for two weeks (a nerve pain medication and antidepressant).
Paracetamol (acetaminophen) 500 mg, two tablets orally twice daily for two weeks (for pain relief).

Please reply if you have more concerns or questions. You may also schedule a direct appointment or follow up via chat, phone, or video consultation.

 I hope this helps.

Kindly revert if there are any queries.

Thank you.