How is erythromelalgia treated?

Updated: Sep 17, 2018
  • Author: Antoine N Saliba, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Evaluation and treatment can be conducted in an outpatient setting. Treatment is primarily medical and supportive. Local measures, such as cooling or elevating the extremity, may relieve symptoms. Avoid excessive warming or dependency of the extremity. The environment should be modified so that it is not too hot.

In patients with myeloproliferative disorders, chemotherapy to reduce the platelet count often alleviates symptoms, but it is not universally effective. Some patients with polycythemia vera have responded to phlebotomy. A hematologist may be consulted if an associated myeloproliferative disorder is present.

Surgery probably has no role in the management of erythromelalgia except to treat the rare complication of gangrene. Surgical sympathectomy has been attempted, with variable results.

No specific dietary restrictions are necessary. Vigorous exercise may induce an acute episode and should therefore be avoided.

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