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VIGNETTES
Neurovascular Instability Syndrome: A Unifying Term to Describe the Coexistence of Temperature-Related Vascular Disorders in Affected Patients
Rosalyn George, MD;
Gregory J. Fulchiero Jr, MD, MSBioEng;
James G. Marks Jr, MD;
Jennie T. Clarke, MD
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Temperature-related vascular disorders including pernio, erythromelalgia, and Raynaud phenomenon present a diagnostic and therapeutic challenge. We describe the unusual cooccurrence of perniosis and erythromelalgia. Although these conditions are aggravated by disparate environmental conditions, their coexistence may help to elucidate their pathophysiologic characteristics.
Report of a Case
A 37-year-old woman was referred to our institution 2 years after the onset of erythema, pain, and dusky papules on the feet for which extensive diagnostic workup and therapeutic trials had been unsuccessful. Initially, she had developed painful red papules on the toes triggered by cold temperature. Evaluation of a skin biopsy specimen showed findings consistent with pernio.
Her symptoms improved slightly under treatment with prednisone, but several months later, she developed episodic swelling, redness, and burning pain of her feet triggered by extended periods of walking and hot baths. . . . [Full Text of this Article] Comment
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