Peripheral Arterial Disease (PAD) Expert Forum
Erythromelalgia, leg-swelling, hypertension
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Questions in the Peripheral Arterial Disease forum are answered by Dr. Lee Kirksey, associate professor at The University of Pennsylvania School of Medicine. Topics covered include abdominal aortic aneurysm , amputation, arteriovenous fistula, atherectomy, carotid artery surgery , cholesterol , claudication, deep vein thrombosis (DVT) , endovascular aortic stent graft (EVAR), stent placement , stroke prevention, varicose veins , and venous insufficiency .

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Erythromelalgia, leg-swelling, hypertension

I was recently diagnosed with Erythromelalgia by a Dermatologist.  (This was not the purpose of the consultation; I also have Raynaud's, lichen planus, and have had erythema nodosum, now resolved.)  The Dermatologist has not recommended follow-up for this; she says that there isn't much that can be done for this disorder other than to take Advil when I have flares.

I have chronic swelling in my legs (source uncertain), improved to a certain extent by a diuretic I take for hypertension.  (I'm female, age 46, and have had hypertension for several years.  My weight is low-average, but I tend not to exercise enough, given the swelling/pain.) I was hoping that follow-up regarding the Erythromelalgia might provide me with some information/help regarding the swelling.  Do you feel that follow-up for this would be warranted, or is this just something that one lives with, likely unrelated to the leg swelling (which is present even when I'm not visibly flaring)?      
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The blood vessel related causes of leg swelling are chronic venous insufficiencey from incompetent vein valves and chronic lymphedema secondary to impaired lymphatic drainage. Both can be assessed by testing. the venous insufficiency by ultrasound in a 10-15 test and the lymphedema by nuclear scan.

If there are underlying anatomic abnormalities of the veins,these can be managed with minimally invasive therapies. If  there are no surgical treatments to optimize your veins then high grade 30-40 mm high grade prescription support hose will palliate your leg swelling

Nocturnal compression pumps are helpful moderate to more severe symptoms. Consult your local wound care center or a vascular surgeon for treatment. Good luck
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Lee Kirksey, MDBlank
The Cleveland Clinic Foundation
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