Treatment of Primary Erythromelalgia with Cyclosporine

To the Editor: Erythromelalgia is a rare disease of unknown cause, characterized by redness of the skin, increased temperature, and pain in the extremities. Erythromelalgia is often primary, but it may also be secondary to disorders such as myeloproliferative diseases. Although a wide variety of therapies have been tried, no effective treatment is yet available. A 28-year-old woman presented with severe, persistent burning pain in the legs and feet, with marked erythema, swelling, and warmth (Figure 1, left-hand panels). The erythema had begun at the age of four years, with no associated disorder. After adolescence, the symptoms became continuous, with . . .