Are your hands and feet also burning and red? This could be (Erythromelalgia)!

Have you ever seen, or experienced, a sudden, unbearable burning sensation in your arm or leg? Along with that, the area turns red and sometimes becomes extremely painful. This may not be a simple thing. Today, we're going to talk about a rare condition that can happen, but many people don't know about it.

What is this (Erythromelalgia)?

Simply put, (Erythromelalgia) is a very rare condition. What happens in this is that there is a sudden increase in blood flow to certain parts of our body, especially the limbs. This is why the symptoms mentioned earlier occur. This is a chronic condition, meaning it can last a lifetime. Over time, these symptoms, especially the burning pain, can gradually increase. Therefore, it is very important to be aware of this.

Where does this affect the most?

Most often, this condition (Erythromelalgia) affects your legs, especially your feet . However, that's not all. There are other areas that can be affected:

• Your hands
• Face
• Palms and soles
• Rarely, the earlobes can also be affected.

Are there different types of (Erythromelalgia)?

Yes, there are several types of this too. Let's see what they are.

1. Primary (Primary Erythromelalgia)

This is when there is no other underlying disease, and this condition (Erythromelalgia) occurs alone. This also has two parts:

• Idiopathic Erythromelalgia: This is the most common type. No clear cause has been found yet.
• Inherited Erythromelalgia: This is caused by mutations in our genes . These mutations can affect the way our pain signals travel. This condition can also run in families, meaning it can be passed down from generation to generation.

2. Secondary (Secondary Erythromelalgia)

This type of erythromelalgia is caused by another medical condition . That is, it can occur as a side effect of another medical condition you already have. Here are a few examples:

• Autoimmune diseases: Examples include lupus and multiple sclerosis.
• Essential thrombocythemia: This is a blood disorder. Simply put, the body produces too many platelets, a type of cell.
• `(Polycythemia vera)`: This is also a disease in which the number of red blood cells increases.
• `(Raynaud's phenomenon)`: In this, the fingers and toes become sensitive to cold and mental stress and turn pale or blue.
• `(Thrombocytopenia)`: This is a decrease in the number of platelets in the blood.
• Neuropathy: Conditions caused by damage to the nerves.

What are the symptoms of this? Let's find out exactly!

There are three main symptoms of Erythromelalgia. They are:

1. Increased skin temperature: The affected area feels warmer to the touch than other areas.

2. Pain: This is the main problem for many people. While some people may feel a slight tingling sensation, others may experience severe pain accompanied by a burning sensation . Some describe the pain as burning or stabbing.

3. Skin redness: The affected area may change color from pink to dark red.

In addition to these main features, some other features can be seen:

• Itching: Some people experience itching along with the burning sensation.
• Cold skin when there are no symptoms: Once the inflammation and redness have gone, the affected area may feel colder than other areas when touched.
• Sweating: The affected area may sweat more than usual.
• Swelling: Sometimes the area may swell a little.
• Skin sensitivity, spots: The skin may feel painful when touched, and sometimes it may appear as spots.
• Numbness: Your hands and feet may feel numb.

These symptoms can occur on one side of the body or on both sides . Also, while they are mild for some people, they can be unbearable for others. For some people, these symptoms begin in childhood , while for others, they only affect them as adults .

Why do these symptoms suddenly increase (flares)?

People with Erythromelalgia have periods of sudden increase in symptoms. We call them ``flares.`` These usually occur when your body temperature suddenly increases . Think about these times:

• Drinking beverages containing caffeine: Drinking things like tea and coffee.
• Dehydrated: When the body does not get enough water.
• Drinking alcohol: Alcohol use.
• Eating spicy foods: Eating chili, spicy food.
• Exercise: When you do strenuous exercise.
• Feeling stressed: When you feel pressure or anxiety.
• Being in a hot environment: in a hot room, or in a hot place outdoors.

"I remember one day I went to a party and ate a spicy biryani, then danced with my friends and when I came back, both my legs felt like they were burning. They were red. I thought my shoes were stuck. It was only later that a doctor told me that this could be (Erythromelalgia)." - There are people who have had similar experiences.

How do doctors diagnose this?

There is no specific test to diagnose erythromelalgia. Your doctor will listen to your symptoms, examine you when you have symptoms, and look at photos you took at the time. Sometimes , tests are needed to rule out other conditions and to further investigate your symptoms. Some of these tests include:

• Blood tests: Check for other underlying diseases.
• Genetic testing: If there is any doubt about the genetic type, check for related mutations.
• Thermography: This is a test that uses a special camera to accurately measure temperature changes in different parts of the skin.
• X-rays or other imaging studies: These may also be done if necessary.

Is it okay to put ice in water? This is wrong!

When the inflammation comes, you may feel like putting the affected arm or leg in a bowl of ice water . While it may provide immediate relief, this is not a good idea at all . In fact, using ice water can actually make the symptoms of erythromelalgia worse . Not only that, there is a great risk of skin wounds not healing, and sometimes even cell death (necrosis) conditions . These are also very difficult to treat. Therefore, no matter how much inflammation there is, do not use ice water.

So what is the treatment for this?

The treatment that is right for you will depend on the cause of your erythromelalgia.

• If it is secondary (secondary erythromelalgia) , meaning it is caused by another disease, your symptoms may also improve once the underlying disease is treated .
• In the case of primary erythromelalgia , medications are mainly used.

What kind of medications are used?

Oral medications are the most common treatment for (Erythromelalgia). Many of these medications are actually used for other conditions. However, they are also very effective in controlling the symptoms of (Erythromelalgia).

Some examples:

• Anticonvulsants: such as gabapentin or carbamazepine.
• Antidepressants: such as amitriptyline or venlafaxine.
• Antihistamines: such as cetirizine or diphenhydramine.
• Aspirin: This is only given to adults . It is not good to give it to children.
• Blood pressure medicines: Either increase or decrease blood flow.
• Prescription painkillers.

What other treatments can be done?

In addition to oral medications, there are other treatment options:

• Lidocaine infusions: This is a painkiller. It is injected into a vein in the arm.
• Nutritional supplements: Examples include magnesium and alpha-lipoic acid.
• Pain management therapies: This includes things like nerve blocks.
• Topical medications: Creams that are applied to the skin.

Are there ways to get relief without medication?

Yes, in addition to medication, there are some things you can do yourself to reduce this inflammation and pain:

• Elevate the affected area: If it's the leg, place a pillow over it.
• Rest on a cold surface: For example, lying on a cold surface like a tile floor.
• Use a fan.
• Place cool first-aid gel packs wrapped in a thin towel on the skin. (Do not apply ice directly!)

Can this be prevented from happening? (Prevention)

There really isn't much we can do to prevent Erythromelalgia. However, if someone in your family has the condition, you can get genetic testing to see how likely it is that your child will also have it.

What is the future for someone with this disease? (Prognosis)

Flares can affect your quality of life . However, they are rarely fatal . Most people live a normal life. They work, travel, and enjoy hobbies. However, sometimes, if treatment is not successful, it can be difficult to carry out daily activities.

How is daily life with (Erythromelalgia)?

According to people with this disease, there are several feelings that come with these symptoms:

• The skin feels tight: as if the clothes you are wearing are squeezing you.
• As if on fire, or as if hot water had fallen on it: an unbearable burning sensation.
• Like being cut with razor blades: a sharp pain.
• Like a severe sunburn: Like the pain you feel when your skin is burned by a severe sunburn.

It's not easy to live with things like this, but there are ways to cope with it.

What can you do to prevent flares and stay comfortable?

You can make a few small changes to your lifestyle to reduce the frequency of these flares and make them easier to manage when they do occur.

• Avoid foods and drinks that increase symptoms: Be careful about what you eat and drink. Stay away from things that increase body temperature, such as caffeine and spicy foods.
• Be careful when choosing exercises: Choose gentle exercises that don't raise your body temperature too much at once. For example, things like swimming, yoga, and Tai Chi are good.
• Try to stay in a cool environment: If you go out, go when the heat is less, like in the morning.
• Be careful when bathing: Take showers rather than soaking in a tub of water. Use lukewarm water to avoid damaging your skin. It's even better if you can keep a window open in the bathroom.
• Plan ahead: Since symptoms tend to occur at night, schedule your important tasks during the day.
• Prepare before bed: Keep a fan or a small AC (portable air conditioning unit) near your bed. Use as thin a bed sheet as possible, or sleep without a blanket on top.

Do you also need to think about mental health?

Yes, of course. Living with a rare disease like this can make some people feel lonely and helpless . They may feel that family, friends, and even doctors don't understand the disease. At times like these, it can be discouraging .

But, you are not alone. There are support groups online for people with Erythromelalgia. By joining them, you can talk to others who are going through the same experiences as you and learn from their experiences. That will give you a great sense of strength and relief.

So, the final things to remember (Take-Home Message)

Erythromelalgia is a rare but potentially very distressing condition that is characterized by unbearable burning and redness of the hands and feet.

Don't worry! There are many treatments for this. Although sometimes it is difficult to completely control the symptoms with treatment, many people live successful, happy lives with this condition.

The most important thing is to talk to a doctor about your symptoms, get an accurate diagnosis, and start the treatment that's right for you. It's also important to make small changes to your lifestyle to try to prevent symptoms from getting worse. Stay strong!

` Erythromelalgia, skin inflammation, skin redness, chronic diseases, exacerbation of symptoms, pain in the feet, pain in the hands