Association of erythromelalgia and Raynaud's disease responding to a serotonin reuptake inhibitor

Abstract

Erythromelalgia is a rare acrosyndrome characterized by redness, warmth and burning pain of the extremities exacerbated by exposure to heat or exercise. It is known as the inverse Raynaud's syndrome and it can be induced by the treatment of this condition. Raynaud's phenomenon is a vasospastic disorder resulting in ischaemia of fingers and toes precipitated by cold or stress. However, cases of coexistence of the two entities have been reported. The pathogenesis of idiopathic erythromelalgia and Raynaud's disease remains unknown, but an unusual susceptibility to temperature stimuli (heat and cold) related to the liberation of vasoactive substances such as serotonin and prostaglandins has been suggested in both cases. Serotonin can cause vasodilation or vasoconstriction depending on the vessel involved. We report a patient with erythromelalgia and Raynaud's disease successfully treated with a selective serotonin reuptake inhibitor. In our opinion these drugs could represent a safe and effective therapeutic option in the therapy of these vascular disorders.

Key Words:

• Erythromelalgia
• Raynaud's syndrome
• Serotonin reuptake inhibitors
• Treatment