Erythromelalgia

[Guest guest]

New study just published (abstract below) for those with

erythromelalgia symptoms along with their rosacea... It is probably

relevant to many rosaceans anyway.

Journal of Investigative Dermatology

Volume 118 Issue 4 Page 699 - April 2002

Impaired Neurogenic Control of Skin Perfusion in Erythromelalgia

Cato Mørk, Ole Magne Kalgaard, and Knut Kvernebo*

Erythromelalgia is a clinical diagnosis characterized by erythema,

increased temperature and burning pain in acral skin. The pain is

relieved by cooling and aggravated by warming. The symptoms have been

hypothesized to be caused by skin hypoxia due to increased

arteriovenous shunting. We examined skin microvascular perfusion in

response to vasoconstrictory and vasodilatory stimuli, to

characterize local and central neurogenic reflexes as well as

vascular smooth muscle and vascular endothelial function, using laser

Doppler perfusion measurements in 14 patients with primary

erythromelalgia and healthy control persons. Skin perfusion preceding

provocative stimuli was significantly reduced in patients with

erythromelalgia (p<0.01). The laser Doppler flowmetry signal after

sympathetic stimulation of reflexes mediated through the central

nervous system, was significantly diminished in patients with

erythromelalgia as compared with healthy controls (Valsalva's

maneuver p<0.01; contralateral cooling test p<0.05). Local neurogenic

vasoconstrictor (venous cuff occlusion and dependency of the

extremity) and vasodilator reflexes (local heating of the skin), as

well as tests for vascular smooth muscle and vascular endothelial

function (postocclusive hyperemic response) were maintained. These

results indicate that postganglionic sympathetic dysfunction and

denervation hypersensitivity may play a pathogenetic role in primary

erythromelalgia, whereas local neurogenic as well as endothelial

function is unaffected.