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Case Report/Case Series |

Dermatological Findings in Early Detection of Complex Regional Pain Syndrome

Rameez Kabani, BSc1; Alain Brassard, MD, FRCPC1
[+] Author Affiliations
1Division of Dermatology and Cutaneous Sciences, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
JAMA Dermatol. 2014;150(6):640-642. doi:10.1001/jamadermatol.2013.7459.
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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.

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Figure.
Complex Regional Pain Syndrome: Confluent Erythematous Patch on the Left Forearm With Continuous Distribution and Associated Edema

A close-up view of the patient’s affected arm. Erythema and edema are seen, and the continuous patch can easily be distinguished from the unaffected areas of the same arm.

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