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Treatment Articles

Complex management of a patient with refractory primary erythromelalgia lacking a SCN9A mutation Sarah A Low, Wendye Robbins, Vivianne L Tawfik.   Case of adult onset primary EM where there was negative genetic testing for an EM-associated mutation in the SCN9A gene, encoding the NaV1.7 sodium channel, suggesting a mutation in an alternate gene. .Journal of Pain Research.  April 2017.

Erythromelalgia in the Pediatric Patient:  Role of computed tomography-guided lumbar sympathetic blockade. Anjana Kundu1;Mahmood Rafiq2;Patrick S Warren3;Joseph D Tobias2,4.  Technical article on three case studies in juveniles with EM that did not respond to other treatments.  Journal of Pain Research.  October 2016.

Dual Effect of Ziconotide in Primary Erythromelalgia. Rosario Russo, Maria Cristina Caroleo, Erika Cione,Mariarita Perri, Maria Teresa Paparo, and Antonio Russo.  Improvement of symptoms in 31 year old female with Ziconotide administered through the spinal sheath. This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Topically Applied Midodrine, an a,1, Agonist for the Treatment of Erythromelalgia.  Mark Davis, MD, Claudia S. Morris, MD, Roger Warndahl, MD, Paolo Sandroni, MD.  jamadermatol.com.2015.0511.

A Case of Erythromelalgia: A good response to combination treatment with pregabalin and selective serotonin reuptake inhibitor.  Atiye Oğrum,1 MD, Zennure Takçı,2* MD, Güler Vahaboğlu,3 MD, Hatice Meral Ekşioğlu,3 MD.  Journal of the Turkish Academy of Dermatology.  2015.

Biorhythms and Erythromelalgia, Cohen, MD, Jay.  MedicationSense E-Newsletter 2013.  Explanation of autonomic nervous system and its effects on the timing of EM symptoms.

Hurt Blocker, Ehrenberg, Rachel, Science News, June 30, 2012, Vol. 181.  The next big pain drug may soothe sensory firestorms without side effects.  Discusses new information on Nav1.7.

Massage therapy techniques as pain management for erythromalalgia  Dicks, BA, RMT, CLT, Rizek, BSc, MSc, MD. International Journal of Therapeutic Massage and Bodywork 2010.  Case study of using massage therapy techniques to reduce pain in 31 year old woman with erythromelalgia. 

A case of inherited erythromelalgia. Novella SP, Hisama FM, Dib-Hajj SD, Waxman SG. Nature Clinical Practice Neu-rology 2007, 3:229-234. Case study of 15-year old boy with a sodium channel 1.7 mutation. Includes technical informa-tion on sodium nerve channels.

Erythromelalgia Davis MD, Rooke T. Current Treatment Options in Cardiovascular Medicine 2006, 8:153-165. An update of their 2002 paper with new information on treatment of EM.

Lidocaine patch for erythromelalgia: follow-up of 34 patients. Davis MD, Sandroni P. Archives of Dermatology 2005, 141(10):1320-1321. Improvement in pain of EM for 18 out of 34 patients.r pain of

Researchers find the right combination to unlock neuropathic pain</a>. Medical News Today, 16 Sep 2006. Pain relief with a combination of oxycodone and gabapentin.

Pregabalin and gabapentin for neuropathic pain and CRPS/RSD. Stacey BR, Campbell P. Oregon Health and Science Uni-versity. Published by Reflex Sympathetic Dystrophy Association 2006. Comparison of pregabalin and gabapentin for pain relief.

Combination gel of 1% amitriptyline and 0.5% ketamine to treat refractory erythromelalgia pain: a new treatment option? Sandroni P, Davis MD. Archives of Dermatology 2006, 142(3):283-286. Dramatic improvement of EM in 17 year old female with amitriptyline and ketamine gel.

Alleviation of erythromelalgia with venlafaxine. Dicaudo DJ, Kelley LA. Archives of Dermatology 2004, 140:621-623. Relief of EM in one woman given venlafaxine.

Fighting pain with fire: hot chili peppers offer relief. Field Mike. The Gazette, John Hopkins University July 25 1994. How capsaicin extracted from peppers can knockout pain.

The prostaglandin E1 analog misoprostol reduces symptoms and microvascular shunting in erythromelalgia – a double-blind, crossover, placebo-compared study. Mork C, Salerud EG, Asker CL, Kvernebo K. Journal of Investigative Derma-tology 2004, 122:587-593. Improvement of EM in 14 out of 21 patients given misoprostol.

Aspirin-responsive painful red, black toe, or finger syndrome in polycythemia vera associated with thrombocythemia. Michiels JJ, Berneman Z, Schroyens W, van Urk H. Annals of Hematology 2003, 82:153-159. Abstract only. Success with aspirin for 3 EM patients.

The one-size dose does not fit all. Cohen Jay. Newsweek December 6,1999. Physicians and patients should look beyond the guidelines recommended by drug manufacturers.

Resolution of refractory symptoms of secondary erythermalgia with intermittent epidural bupivicaine. Stricker LJ, Green CR. Regional Anesthesia and Pain Medicine 2001, 26:488-490. Remission of EM in 28 year old female.

Treatment of primary erythromelalgia with cyclosporine. Sano S, Itami S, Yoshikawa K. New England Journal of Medi-cine 2003, 349:816-817. Successful treatment with cyclosporine in adult with inherited EM.

Erythromelalgia: an endothelial disorder responsive to sodium nitroprusside. Chan MK, Tucker AT, Madden S, Golding CE, Atherton DJ, Dillon MJ. Archives of Diseases in Childhood 2002, 87:229-230. Dramatic response by 2 children to nitroprusside infusion.

Lidocaine patch for pain of erythromelalgia. Davis MD, Sandroni P. Archives of Dermatology 2002, 138:17-19. Success-ful pain relief using lidocaine patches for 15 year old girl.

Treatment of erythromelalgia with a serotonin/noradrenaline reuptake inhibitor. Moiin A, Yashar SS, Sanchez JE, Yashar B. British Journal of Dermatology 2002, 146:336-337. Improvement of EM in 10 patients treated with venlafaxine.

Erythromelalgia: response to serotonin reuptake inhibitors. Rudikoff D, Jaffe IA. Journal of American Academy of Der-matology 1997, 37:281-283. Rapid relief of EM in 3 adults with venlafaxine or sertraline.

Unexpected healing of cutaneous ulcers in a short child (with erythermalgia). Cimaz R, Rusconi R, Fossali E, Careddu P. Lancet 2001, 358:211-212. Cessation of EM and associated ulcers in 12 year old using growth hormone.

Refractory idiopathic erythromelalgia. Rauck RL, Naveira F, Speight KL, Smith BP. Anesthesia and Analgesia 1996, 82:1097-1101. Remission of primary EM in 2 adolescent males using various epidural infusions.

Nitroprusside treatment of erythromelalgia in an adolescent female. Stone JD, Rivey MP, Allington DR. Annals of Phar-macotherapy 1997, 31:590-592. Remission of EM in 15 year old using nitroprusside infusion.

Erythromelalgia pain managed with gabapentin. McGraw T, Kosek P. Anesthesiology 1997, 86:988-990. Successful treat-ment with gabapentin for one child and one adult.

A way to understand erythromelalgia. Zoppi M, Zamponi A, Pagni E, Buoncristiano U. Journal of the Autonomic Nerve th 10 daily sympathetic nerve blocks.

Treatment of refractory primary erythromelalgia in a child using a continuous epidural infusion. El-Dabe S. The Pain Clinic, Cleveland, UK 2000, 12 (1):65-69. Improvement of EM with bupivacaine and clonidine in 4 year old boy.

Primary Erythromelalgia in a Child Responding to Intravenous Lidocaine and Oral Mexiletine Treatment.  Nathan, Aruna,  Rose, John, Guite, Jessica, Hehir, David, Milovcich, Karen.  Official Journal of the American Academy of Pediatrics.  Vol. 115, No. 4, April 2005.  The effect of intravenous lidocaine infusion, with subsequent transition to oral mexiletine therapy on an 11 year old boy with chronic erythromelalgia.