Primary erythromelalgia with leukonychia combined with ulcerations and infection by Monilia guilliermondii

An 8-year-old girl presented with recurrent redness, warming, and pain of the lower extremities for more than 4 years, with exacerbation and accompanying swelling for the past 1 year and ulcers for 1 month. The episodes were triggered by exertion and heat. Her family history revealed that her mother had experienced similar symptoms. Physical examination showed proximal white nails and the distal border in normal color. There was some ulceration in the dorsum of the feet with thick, yellowish secretions, covered by some crusted lesions. Laboratory culture result showed that there were many Monilia guilliermondii in the ulcer specimen. Finally, she was diagnosed with juvenile onset of primary erythromelalgia and was given symptomatic treatment for neuropathic pain and pedal ulcers.

摘要一名8歲女孩反復出現雙下肢潮紅、發熱及疼痛4年，加重伴發腫脹1年及潰瘍形成1月。症狀常在活動後或受熱後發作及加重，將雙足放入冰水或用電風扇吹可明顯緩解。家族史提示其母親曾出現相似症狀。體檢發現雙手及雙足近端指甲呈白色，足背出現潰瘍伴粘稠黃色分泌物，部分病變已結痂。實驗室檢查提示季也蒙念珠菌感染。臨床診斷為青年發作型原發性紅斑肢痛病，予以對症治療神經性疼痛及足部潰瘍。