Mimicking the Usual Suspects: Erythromelalgia in the Differential Diagnosis

Erythromelalgia is a rare condition characterized by severe paroxysmal pain in the extremities and erythema that leads to significant morbidity and incapacity. We report on the case of a female with a history of erythromelalgia, presenting with worsening bilateral leg pain and purple discoloration of her feet following a surgical procedure. After ruling out secondary causes, a diagnosis of atypical erythromelalgia flare was established. A multimodal pain management strategy was instituted, and the patient improved upon follow-up. The clinical presentation of erythromelalgia presents diagnostic and therapeutic challenges, and atypical presentations highlight our poor understanding of the disease.