Is this erythromelalgia?

Posted by tangledlimbs @tangledlimbs, Dec 12, 2021

My 16 year old daughter had a flare-up of something today that the on-call nurse couldn't explain and I can't find anything online that helps. This flare-up presented like hyperemia in her face and ears that systemically cascaded to all joint areas (anteriorly, dorsally on wrists); although her very first indication was a visceral burning sensation in the 5th quadrant of her abdomen--right above her naval. This occurred minutes after getting up out of bed in the morning. She described the sensation of burning pain (not severe), intense heat radiating from her skin, and a tight-skin/inflammation. She said it felt just like having a sunburn. There was a tingly/scratchy feeling on the dorsal side of her wrists that burned when she rubbed/scratched the area.The pain was like a rug-burn. Her face and ears were bright red to start and it rapidly spread down her body only encircling her joints with exception to her ankles, toes and fingers. The redness did present on the distal 2/3 of her quadriceps along with her knees. There were not other symptoms.: no fever, dizziness, irregular pulse or breathing trouble. She had not eaten or drank anything. She has not allergies. She had not used any topical product or changed clothes. No physical exertion or exposure to a heat source. The hyperaemia/erythema presented in a consistent bright redness encircling each joint and fading out at edges in micro splotches, but her face presented with large splotches on forehead, cheeks, and chin. The burning in her stomach was the first symptom to fade away after 30 minutes, then her face and ears regulated in the minutes after but it took another 20 minutes for other areas to return to normal. It later occurred to us that this was not the first time and that she hands experienced similar episodes previously but it was isolated to her feet or hands. She was sick with minor cold virus symptoms a week ago but was recovered, and at no time during her mild illness did she have a fever. Could this be erythromelalgia?

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@tangledlimbs, you must be so concerned for your daughter. Here on Mayo Clinic Connect we are fellow patients and parents. We can't offer a diagnosis. Has she since been to see a doctor? What did you learn?

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@tangledlimbs Would be interested to hear what happened. My 20-year-old daughter has very similar symptoms. On the way to urgent care now.

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Hello @medtalker and welcome to Mayo Clinic Connect. I hope your daughter found some help at Urgent Care. Is she doing better now?

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Hello @tangledlimbs

How is your daughter doing now? Did she get some relief from the pain or find out the cause?

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@hopeful33250

Hello @medtalker and welcome to Mayo Clinic Connect. I hope your daughter found some help at Urgent Care. Is she doing better now?

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Yes, thank you! No clear diagnosis - psoriasis for now. Tests largely normal. Just doesn't fit the feet/hands burning and itching profile, though. Cosxsackie, maybe? Hopefully it will be gone by next week.

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@medtalker

Yes, thank you! No clear diagnosis - psoriasis for now. Tests largely normal. Just doesn't fit the feet/hands burning and itching profile, though. Cosxsackie, maybe? Hopefully it will be gone by next week.

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@medtalker

Problems that come and go like that are difficult to pinpoint. I'm glad that she is doing better.

Will you keep in touch as you learn any new information?

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Hello. Did you ever find out the cause? For the past two weeks, I have had red and burning in my head, face, ears, and neck (basically right on the spots that are sun exposed). The doctor ran blood and urine to rule out anything serious (such as blood cancers, carcinoid syndrome, etc...). I have also had several CTs and MRIs of my head and abdomen because I suffer from classic migraine, vestibular migraine, and cluster headaches, and besides gallstones, there is nothing else there. I can't find any allergy patterns with food or cosmetics. I did have COVID in early October and I read a paper about long COVID and activation of mast cells, but I am still perplexed.

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I have had burning face since June and almost every day and then into nights. Thing is the burning was occurring when face pale as usual, or with red cheeks; so when nurse looked at face it looked normal; it progressed and became more often and even woke up thru night with it and was more "red" then but not like rosascea. First time was right side of neck and had been removing plants from bouquet sent to me and odd looking greenery. then both sides of neck and was red. Then nothing for a few weeks and mask on at clinic came home and right ear was red and burning, then left, i thought from elastic on mask but dont wear one every day. Then, sorry if this is boring.,. but then the right cheek like someone had a fame to it and month ago both cheeks and nose and also a bit of a rash top of chest you cannot see but i can feel and still there, and I never had a lot of spots etc on face but when really "red" get red dots on nose!! Nurse didnt know whether to send me to dermatologist or neurologist and then sge went on indefinite leave so waited 2 months to get a referral and to dermatologist. It is very very painful. I am not a "flusher" of face or anything, and didnt even thru menopause as had cancer before of cervix. So in August got referral to see Dema. but not til January. Right now as I type it is like your daughter said, very bad sunburn or dozens of bees stinging my face and goes down shoulders but not red; I have, touch wood, not had covid nor the vaccinations. I am 79 and never had anything like this before and together with other list of illnesses am finding it hard to cope. I am trying to rule out food allergies etc., nothing adds up but i checked internet and saw the two illnesses you mention, but no doctor to test me for it. I don't think they realize how painful it is. Now when flushing happens I am taking selfies.. feel I almost have to prove it....hope we can all find out what this is or might be.... J. p.s. Lasts for up to five hours and rare is the day i dont have it since June...ps dont use makeup, etc. have changed toothpaste, pillow, detergent, etc etc, ??

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