Case Study · April 23, 2014
TAKE-HOME MESSAGE
- This case report suggests that complex regional pain syndrome (CRPS), while demonstrating significant neurological symptoms, also is associated with skin abnormalities such as edema and erythema in most patients, as well as dermatitis, erythematous papules, folliculitis, atrophy, ulceration, and bullae in some.
- Dermatologists should consider a wide variety of etiologies that eventuate in skin complaints, including CRPS, which can assist in making this diagnosis and lead to focused treatment.
– Joshua Arbesman, MD
ABSTRACT
IMPORTANCE
Complex regional pain syndrome (CRPS) is a chronic pain condition usually affecting the extremities. It mostly occurs in 3 distinct stages with intense pain being the hallmark feature in every stage. Skin abnormalities are common, and often necessary, in the clinical findings required to diagnose CRPS.
OBSERVATIONS
A man in his 30s presented to the dermatology clinic with complaints of recurrent redness, swelling, and burning pain in his left arm. Based on this clinical presentation with normal findings from a neurological examination and unremarkable findings on diagnostic imaging, the diagnosis of CRPS was made.
CONCLUSIONS AND RELEVANCE
It is important for dermatologists to understand and recognize CRPS as a neurological disorder with major dermatologic implications. The ability of dermatologists to identify and direct patients with this syndrome is a critical factor in determining the likelihood of favorable outcomes following diagnosis of CRPS. This report outlines and reviews a neurological condition presenting with clinically significant cutaneous changes. We illustrate the bias that dermatologists may have in exclusively associating patient complaints with dermatological implications. This stresses the necessity for dermatologists to perform comprehensive medical histories and physical examinations to minimize diagnostic error and improve patient care.
JAMA dermatology (Chicago, Ill.)
Dermatological Findings in Early Detection of Complex Regional Pain Syndrome
JAMA Dermatol 2014 Apr 23;[EPub Ahead of Print], R Kabani, A Brassard