A novel cause of erythromelalgia due to pseudoephedrine

• Published in: Oxford Medical Case Reports Vol. 2024; no. 4; p. omae037
• Main Authors: Kravvas, Georgios, Aboukhatwah, Nada, Ali, Lana, Bray, Adam P
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.04.2024
• Subjects: Aspirin; Biopsy; Blood vessels; Case reports; Conflicts of interest; Dermatitis; Dermatology; Erythema; Literature reviews; Pharmacists; Skin; White people; burning; erythromelalgia; neuropathic pain; drug reaction; desquamation; pseudoephedrine
• ISSN: 2053-8855; 2053-8855
• DOI: 10.1093/omcr/omae037

Objective Erythromelalgia is a rare, highly debilitating disorder characterised by severe episodes of discomfort, erythema, and desquamation of the extremities. Its causes include genetic factors, medications, and several underlying medical conditions. This paper describes a novel cause of erythromelalgia through a case report and literature review. Case description A 47-year-old Caucasian man presented with a two-year history of intermittent pain, redness and desquamation of the hands. He experienced several such episodes, each lasting 3-4 weeks. A skin biopsy confirmed the diagnosis of erythromelalgia. After several recurrences, he admitted to the intermittent use of pseudoephedrine as a nasal decongestant, which coincided with the episodes of erythromelalgia. Complete resolution of symptoms was reported on cessation of this medication. Conclusion Pseudoephedrine has been reported to cause a wide range of cutaneous reactions but has not been known to precipitate erythromelalgia. Recognition of this rare side effect may offer early diagnosis and reduced morbidity.