TY - CHAP M1 - Book, Section TI - ERYTHROMELALGIA A1 - Arnold, W. David A1 - Freimer, Miriam L. A2 - Dean, Steven M. A2 - Satiani, Bhagwan A2 - Abraham, William T. Y1 - 2015 N1 - T2 - Color Atlas and Synopsis of Vascular Diseases AB - A 52-year-old woman with controlled hypothyroidism presented for symptoms of painful burning and discolored feet. She reported 1 to 2 years of progressive disabling lower limb burning pain and numbness associated with fluctuating skin discoloration. Her symptoms were worsened with lower limb dependency, warmth, and exertion. Examination was notable for erythema of the distal legs and feet associated with slightly increased palpable warmth. There was distal pain and temperature sensation loss with relative preservation of vibration and position sense. Distal pulses were normal as were strength and muscle stretch reflexes. Her workup included electromyography and nerve conduction studies that confirmed a length-dependent, predominantly axonal neuropathy. Skin biopsy showed severely diminished intraepidural nerve fiber density consistent with small fiber neuropathy. Laboratory evaluation demonstrated an elevated hemoglobin A1c of 9%, but otherwise no additional contributing factors were identified. She was diagnosed with small fiber predominant neuropathy related to diabetic mellitus and secondary erythromelalgia (EM). Management of her diabetes and symptomatic treatment with gabapentin resulted in partial pain relief. SN - PB - McGraw-Hill Medical CY - New York, NY Y2 - 2024/10/05 UR - accesssurgery.mhmedical.com/content.aspx?aid=1105292824 ER -