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다발성 단신경병증을 보이는 원발성 피부홍통증 1예

A Case of Erythromelalgia with Mononeuropathy Multiplex

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초록

Erythromelalgia is a rare poorly understood and not easily treatable disease characterized by burning pain, erythema and increased skin temperature. Most patients with erythromelalgia have small fiber neuropathy and vasculopathy, and half of them has large fiber neuropathy. A 9-year-old girl presented with burning pain, erythema and heating sense on bilateral hand and foot. Findings of electrodiagnostic studies were compatible with overlapping mononeuropathy multiplex. After daily bilateral stellate ganglion laser therapy for 3 days and oral administration of gabapentin and clonazepam, her symptoms were completely disappered. Follow up electrodiagnostic study showed improving of her neuropathy.

Abstract

Erythromelalgia is a rare poorly understood and not easily treatable disease characterized by burning pain, erythema and increased skin temperature. Most patients with erythromelalgia have small fiber neuropathy and vasculopathy, and half of them has large fiber neuropathy. A 9-year-old girl presented with burning pain, erythema and heating sense on bilateral hand and foot. Findings of electrodiagnostic studies were compatible with overlapping mononeuropathy multiplex. After daily bilateral stellate ganglion laser therapy for 3 days and oral administration of gabapentin and clonazepam, her symptoms were completely disappered. Follow up electrodiagnostic study showed improving of her neuropathy.

참고문헌 (10)

  1. Davis MD, "Erythromelalgia: vasculopathy, neuropathy, or both? A prospective study of vascular and neurophysiologic studies in erythromelalgia", Arch Dermatol, 139, pp.1337~1343 (2003)
  2. Davis MD, "Natural history of erythromelalgia: presentation and outcome in 168 patients", Arch Dermatol, 136, pp.330~336 (2000)
  3. Nathan A, "Primary erythromelalgia in a child responding to intravenous lidocaine and oral mexiletine treatment", Pediatrics, 115, pp.e504~e507 (2005)
  4. Waxman SG, "Erythermalgia: molecular basis for an inherited pain syndrome", Trends Mol Med, 11, pp.555~562 (2005)
  5. Waxman SG, "Erythromelalgia: a hereditary pain syndrome enters the molecular era", Ann Neurol, 57, pp.785~788 (2005)
  6. Drenth JP, "Three types of erythromelalgia", Bmj, 301, pp.454~455 (1990)
  7. Davis MD, "Thermoregulatory sweat testing in patients with erythromelalgia", Arch Dermatol, 142, pp.1583~1588 (2006)
  8. Littleford RC, "Impaired skin vasomotor reflexes in patients with erythromelalgia", Clin Sci (Lond), 96, pp.507~512 (1999)
  9. Mork C, "Impaired neurogenic control of skin perfusion in erythromelalgia", J Invest Dermatol, 118, pp.699~703 (2002)
  10. Zivkovic SA, "Vasculitic neuropathy - electrodiagnostic findings and association with malignancies", Acta Neurol Scand, 115, pp.432~436 (2007)

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