Managing late onset primary erythromelalgia with oral pregabalin

Abstract

Erythromelalgia, a rare vascular peripheral pain disorder characterized by erythema, warmth and severe burning pain of the distal extremities, more commonly affects the feet than hands. Generally, the worsening of the pain is noted with increase in temperature and exercise. In the absence of treatment, the disease episodes may last infinitely and are quite debilitating. Measures such as resting, elevation and cooling of involved extremities are typically adopted to relive pain. Previous case studies have reported symptomatic improvement with aspirin, vasodilators, beta-blockers, local anesthetics and gabapentin. Here we report the case of a 34-year-old army officer suffering from erythromelalgia for the 8 years, which was earlier misdiagnosed as plantar fasciitis. All previously described treatments were ineffective but oral pregabalin proved very effective in reducing the frequency and severity of pain episodes.