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TOPLINE
Patients with erythromelalgia and Raynaud phenomenon (RP) who used stimulants experienced significantly more extensive anatomic involvement and greater facial flushing than nonusers, and nearly all reported new or worsened symptoms after starting a stimulant.
METHODOLOGY
- Researchers conducted a retrospective cohort study of patients (54 female; 59 White) with confirmed erythromelalgia and RP at Mayo Clinic from June 2018 to January 2024.
- The researchers collected symptom data from pre-visit questionnaires, and stimulant exposure data from clinical documentation, prescription history, and patient-reported use.
- Patients were grouped into stimulant users (those with active prescription or recreational stimulant use overlapping with symptoms; n = 36) and non-stimulant users (those without stimulant use or whose use did not overlap with symptoms; n = 27).
- The primary outcome was number of anatomic areas involved with erythromelalgia between groups.
TAKEAWAY
- Patients on stimulants had significantly more extensive anatomic involvement with erythromelalgia than those not on stimulants (mean, 2.9 vs 2.1; rate ratio, 1.39; P = .005).
- Facial involvement with erythromelalgia was more frequent in the stimulant group (36.1% vs 7.4%; P = .015).
- Episodes of erythromelalgia lacking an identifiable trigger occurred only in patients on stimulants (19.4% vs 0%; P = .017).
- Among 33 stimulant users with timeline data, 97% had new or worsened symptoms after starting a stimulant. Of eight patients who stopped stimulants, five had resolution or improvement of erythromelalgia, and three had no response data.
IN PRACTICE
"We recommend clinicians inquire regarding stimulant use in patients presenting with erythromelalgia and RP, especially in those with extensive anatomic involvement, facial flushing, or episodes lacking an identifiable trigger, as stimulant discontinuation may lessen symptoms and can be considered through shared decision-making," the authors wrote.
SOURCE
The study was led by Rachel L. Ziebart, Massachusetts General Hospital for Children, Boston. It was published online on October 20 in the Journal of the American Academy of Dermatology.
LIMITATIONS
The authors did not report any limitations.
DISCLOSURES
The study received no funding. The authors reported having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
