title: Results of computer-assisted sensory evaluation in 41 patients with erythromelalgia.
abstract: BACKGROUND
  Erythromelalgia is a rare disorder characterized by the clinical syndrome of burning pain, warmth and redness of the limbs. Neurological abnormalities (both large- and small-fibre neuropathy) are common. There have been few published reports on the sensory status of patients with erythromelalgia.
  
  
  OBJECTIVE
  To investigate the results of quantitative sensation testing in erythromelalgia using computer-assisted sensory evaluation, including vibratory detection threshold, cool detection threshold and heat-pain threshold (HPT).
  
  
  METHODS
  Patients who underwent dermatological or neurological evaluation of suspected erythromelalgia at our institution and received a final diagnosis of erythromelalgia were identified from a master diagnosis index covering the period January 1994 to June 2008. A retrospective chart review was performed. Main outcome measures were sensory abnormalities (e.g. pain, burning sensation, tingling) in response to heat, cooling and vibration during computer-assisted sensory testing.
  
  
  RESULTS
  In total, 41 patients with erythromelalgia were enrolled in the study and underwent computer-assisted sensory evaluation. Of these, 34 patients (82.9%) had abnormal results. The commonest abnormality was isolated HPT: 11 patients (26.8%) had heat hypoalgesia and 18 (43.9%) had heat hyperalgesia, whereas only 2 (4.9%) of the healthy control patients had hyperalgesia on testing.
  
  
  CONCLUSIONS
  Multiple sensory modalities were found to be abnormal in patients with erythromelalgia, with the commonest clinical abnormality being isolated heat-pain abnormality. These findings lend support to the notion that neuropathy underlies the clinical diagnosis of erythromelalgia. Future studies will explore the nature of the relationship between these sensory abnormalities and the clinical features of erythromelalgia.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: J
authors.initials: J
authors.lastname: Genebriera
authors.forename: J D
authors.initials: JD
authors.lastname: Michaels
authors.forename: P
authors.initials: P
authors.lastname: Sandroni
authors.forename: M D P
authors.initials: MD
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003080:Cold Temperature; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003943:Diagnostic Techniques, Neurological; D004916:Erythromelalgia / Q000503:physiopathology*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold / Q000502:physiology; D012189:Retrospective Studies; D012684:Sensory Thresholds / Q000502:physiology*; D020886:Somatosensory Disorders / Q000175:diagnosis / Q000503:physiopathology*; D014732:Vibration; D055815:Young Adult