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Resolution of Refractory Symptoms of Secondary Erythermalgia With Intermittent Epidural Bupivacaine
  1. Lori J. Stricker, M.D. and
  2. Carmen R. Green, M.D.
  1. From the Multidisciplinary Pain Center, Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan.
  1. Reprint requests: Carmen R. Green, M.D., Department of Anesthesiology, 1G323 UH, University of Michigan Medical Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0048.


Background and Objectives Erythermalgia is a rare disorder characterized by erythema, edema, elevated skin temperature, and burning pain of the hands and/or feet. The etiology of primary erythermalgia is idiopathic while secondary erythermalgia is associated with autoimmune and rheumatologic factors. Symptoms are typically refractory to medical management. We report the use of epidural bupivacaine as a treatment option for secondary erythermalgia.

Case Report A 28-year-old woman presented with secondary erythromelalgia that was characterized by severe pain, swelling, and erythema. Medical management failed and a lumbar epidural dosed with bupivacaine was used. This resulted in complete resolution of the patient's symptoms.

Conclusion Intermittent epidural bupivacaine may provide treatment of the refractory symptoms of secondary erythermalgia.

  • Erythermalgia
  • Erythromelalgia
  • Treatment
  • Bupivacaine
  • Epidural
  • Lower extremity pain

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