A case of erythromelalgia successfully controlled by systemic steroids and pentazocine--is it related to a unique subtype of neutrophilic dermatosis?

Erythromelalgia is a rare cutaneous disorder characterized by erythema, burning discomfort, and warmth of the extremities. Its form may be adult- or early-onset, and it may be further classified as idiopathic or secondary. Its pathogenesis and histopathologic findings have not yet been clearly defined. Various treatment modalities have been tried, but, for the idiopathic type, none has been successful. We present a case of adult-onset idiopathic erythromelalgia with unusual histopathological findings which showed a remarkable response to corticosteroids and pentazocine.