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Not Another Presentation of Cellulitis: A Case Report of Erythromelalgia

Raymen Rammy Assaf, MD, MPH*^  and Kelly Winters, NP*^

*Harbor UCLA Medical Center, Department of Pediatric Emergency Medicine, Torrance, CA
^Children’s Hospital of Orange County, Emergency Medicine Specialists of Orange County, Orange, CA

Correspondence should be addressed to Raymen Rammy Assaf, MD, MPH at raassaf9@gmail.com

DOI: https://doi.org/10.21980/J8BD2K Issue 7:1
DermatologyPediatricsVisual EM
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ABSTRACT:

Cellulitis is among the more common conditions diagnosed and treated within pediatric emergency departments. However, unusual distribution, recurrence, and/or poor response to antibiotics may point towards another pathologic process. This case presentation illustrates a teenager with recurrent episodes of painful erythematous and swollen extremities misdiagnosed repeatedly as cellulitis. Careful history, exam, laboratory evaluation and rheumatologist consultation aided in making the correct diagnosis of erythromelalgia, which was successfully treated with supportive measures. This report reviews a rare presentation of erythromelalgia, as well as its pathophysiology, recommended therapies, and common misdiagnoses.

Topics:

Painful extremities; recurrent swelling; erythromelalgia.

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