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Q. My palms and soles are red with burning sensation and occasional swelling. Why?

Answered by
Dr. Kamal Kant Sahu
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 12, 2020

Hello doctor,

I was diagnosed with MGUS (IGA) when I was seeing a neurologist for some burning in my palms of my hands and soles of my feet which is awful at night and prohibits me from sleeping. This has been going on for six months but has gotten worse so I went back to the neurologist. Neurologist ordered an MRI for next week to see if the six white matter brain lesions I had were changed.

Since the MGUS, I followed up with hematologist three times and he said my numbers are so low they do not show up on M spike. All other labs were normal. I saw a dermatologist to see if burning was skin related. She said no maybe vascular so I saw a cardiovascular doctor who is also running tests. I also saw a rheumatologist so does not believe it is rheumatology based on blood work. My question is if my numbers at hematology were so low they do not show M spike could they be causing the random burning in the palms of my hands and soles of my feet. Just want answers and as of right now I get the neuro saying it is MGUS and hematologist saying it neuro. I am scared and exhausted. Please help.

My Primary complaint is burning red palms of my hands and red soles of my feet, not fire engine red just slightly red. My hands tend to get a little swollen on the top and my veins are swollen and then it goes away and my hands are looking normal and are cold sometimes. Well, it happens all day regardless of what I am doing with the activity is it randomly pops up definitely when I am moving around or running the vacuum or doing something like that but it is really bad at night. So far I have done myeloma profile, CBC, ANA, and CRP tests.

#

Hi,

Welcome to ciliniq.com.

I am sorry to hear with regards to your complaints and how much you are going through. I have seen your hand pictures. (attachment removed to protect patient identity). To be frank, it is really a tough case.

There can be a few things that can be looked for:

1. Chronic inflammatory demyelinating disorder.

2. Rarely, MGUS (monoclonal gammopathy of undefined significance) can be associated with neuropathy.

3. It can be Raynaud's phenomenon.

4. ? Any heavy metal related.

I have a few suggestions which you can ask your neurologists or hematologists if they have thought about them.

Did anyone think of getting a nerve conduction study? Later on, can a nerve biopsy give an answer if we are thinking CIDP (chronic inflammatory demyelinating neuropathy)? Sometimes, can any heavy metal can cause this kind of symptoms. Lab work for Raynaud's phenomenon if your symptoms fit into that criteria, looks less likely though. Any remote chance of amyloidosis. There is a test for that as well known as fat pad biopsy.Please ask the doctors to consider these points.

To your question, MGUS has been shown to have an association with neuropathy related pain, though less likely. I am here always if you need further guidance.

I hope this helps.

Thank you doctor,

So what would the tests be for Raynaud's? Also, they tested for amyloidosis and the doctor said based on the results it is highly unlikely. I just had my SED rate Westergren results and its result is 30. Normal is 15 right? But before two months my sedimentation rate was 20. Is that a concern or does it tell us anything?

#

Hi,

Welcome back to icliniq.com.

I am not worried about that ESR (erythrocyte sedimentation rate) to be frank. Also, I am not sure if clinical you will fit into the criteria for Raynaud's. It can occur in the background of many other connective tissue disorders. So we start with ANA (antinuclear antibody) but it is negative in your case. In some cases, we do anti-topoisomerase and anti-centromere antibody to rule out scleroderma which has a common association with Raynaud's.


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