Skip to main content
Log in

Acute secondary erythermalgia and hypertension in children

  • Dermatology
  • Original Paper
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

We studied the clinical symptoms in nine children (seven females and two males; mean age 11.6 years) with severe but transient acute secondary erythermalgia. The classical symptoms at presentation were episodic attacks of painful burning hands and feet which felt warm with congested appearance of the feet. Each attack lasted for a mean period of 25 days (range from 6 to 56 days). The blood pressure was elevated in seven patients. Intravenous sodium nitroprusside was effective in ameliorating the symptoms with drop in blood pressure to normal in five patients; pizotifene, labetolol, prostaglandin E1 and hypnotherapy were effective in each of four separate cases. The episodes of acute secondary erythermalgia were transient in all and did not recur after a mean follow up period of 1.6 years. These cases suggest that acute secondary erythermalgia, however transient, is not rare and can be associated with mild to moderate hypertension which may respond to sodium nitroprusside. A greater awareness of this condition is necessary to make an accurate and timely diagnosis and institute appropiate therapy in order to prevent undue complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Blanchard P, Grenier B, Marchand S, Ruchoux MM (1987) Erythromélalgia, hypertension artérielle et excrétion accrue de catécholamines urinaires. Arch Fr Pediatr 44:799–802

    PubMed  Google Scholar 

  2. Chakravarty K, Pharoah PDP, Scott DGI, Barket S (1992) Erythromelalgia. The role of hypnotherapy. Postgrad Med J 68:44–46

    PubMed  Google Scholar 

  3. Drenth JPH, Michiels JJ (1990) Three types of erythromelalgia. Important to differentiate because treatment differs. BMJ 301:454–455

    PubMed  Google Scholar 

  4. Drenth JPH, Michiels JJ (1994) Erythromelalgia and erythermalgia. Diagnostic differentiation. Int J Dermatol 33:393–397

    PubMed  Google Scholar 

  5. Drenth JPH, Michiels JJ, Van Joost T, Vuzevski VD (1992) Verapamil induced secondary erythermalgia. Br J Dermatol 127:292–294

    PubMed  Google Scholar 

  6. Drenth JPH, Michiels JJ, Van Joost T, Vuzevski VD (1993) Secondary erythermalgia in systemic lupus erythematosus. J Rheumatol 20:144–146

    PubMed  Google Scholar 

  7. Drenth JPH, Michiels JJ, Van Joost T, Vuzevski VD (1993) Erythermalgia secondary to vasculitis. Am J Med 94:549–550

    Article  PubMed  Google Scholar 

  8. Foulds DM, Copeland KC, Franks RC (1987) Mercury poisoning and acrodynia. Am J Dis Child 141:124

    PubMed  Google Scholar 

  9. H'Mila R, Samoud A, Souid M, Bourassine A, Ben Didri MF (1991) L'érythermalgie, acrosyndrome vasculaire rare. Arch Fr Pediatr 48:555–557

    PubMed  Google Scholar 

  10. Kvernebo K, Seem E (1987) Erythromelalgia pathophysiological and therapeutic aspects. A preliminary report. J Oslo City Hosp 37:9–12

    PubMed  Google Scholar 

  11. Michiels JJ, Van Joost T (1989) Idiopathic erythermalgia, a congenital disorder. J Am Acad Dermatol 21:1128–1130

    PubMed  Google Scholar 

  12. Michiels JJ, Ten Kate FWJ, Vuzevski VD, Abels J (1984) Histopathology of erythromelalgia in thrombocythaemia. Histopathology 8:669–678

    PubMed  Google Scholar 

  13. Mitchell SW (1878) On a rare vasomotor neurosis of the extremities, and of the maladies with which it may be confounded. Am J Med Sci 76:2–36

    Google Scholar 

  14. National Heart Lung and Blood Institute's Task Force on Blood Pressure Control in Children. Standards for children's bloodpressure. (1977) Pediatrics 59:[Supple]:802–803

    Google Scholar 

  15. Özsoylu Ş, Coskun T (1984) Sodium nitroprusside treatment in erythromelgia. Eur J Pediatr 141:185–187

    Article  PubMed  Google Scholar 

  16. Özsoylu Ş, Caner H, Gökalp A (1979). Succesful treatment of erythromelalgia with sodium nitroprusside. J Pediatr 94:619–621

    PubMed  Google Scholar 

  17. Smith LA, Allen EV (1938) Erythermalgia (erythromelalgia) of the extremities: a syndrome characterized by redness, heat and pain. Am Heart J 16: 175–188

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Consortia

Additional information

Erythermalgia Multidisciplinary Study Group: K. Chakravarty, Warrington Hospital NHS Trust, Department of Rheumatology, Warrington, United Kingdom; J.P.H. Drenth, University Hospital St. Radboud, Department of Medicine, Nijmegen, The Netherlands; J.J. Michiels, University Hospital Dijkzigt, Department of Hematology, Rotterdam, The Netherlands: S. Özsoylu, Turkish Health and Therapy Foundation, Medical Center and Memorial Ahmet Örs Hospital, Ankara, Turkey; B.S. Shapiro, Children's Hospital of Philadelphia, Division of General Pediatrics, United States of America

Rights and permissions

Reprints and permissions

About this article

Cite this article

Drenth, J.P.H., Michiels, J.J., Özsoylu, S. et al. Acute secondary erythermalgia and hypertension in children. Eur J Pediatr 154, 882–885 (1995). https://doi.org/10.1007/BF01957497

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01957497

Key words

Navigation