Dermatologic manifestations of complex regional pain syndrome improved after dorsal root ganglion stimulation.

Abstract

Background: Complex regional pain syndrome is a condition that causes autonomic dysfunction, including severe pain, swelling, temperature fluctuations, and cutaneous flushing.

Case description: The patient was a 38-year-old woman with complex regional pain syndrome type I of the right foot that developed after a work-related accident. At the time of presentation, she complained of a stabbing and burning pain, which subjectively felt like extreme warmth for 6 weeks. On physical examination, she presented with diffuse cutaneous flushing, erythema, nonpitting edema, skin mottling of the medial aspect of the right foot and ankle, a purple macule on the right inferomedial aspect of the great toe, and a purple patch on the inferomedial aspect of the heel. The patient underwent right-sided L5/S1 open dorsal root ganglion (DRG) stimulation under the care of neurological surgery. Postprocedurally, the cutaneous flushing, erythema, edema, mottling, purple macule, and patch had completely resolved. At the 1-year postoperative appointment, the patient continued to have a significant improvement in her preoperative pain and notably improved allodynia, flushing, mottling, and temperature sensitivity.

Conclusion: We have described the successful resolution of complex regional pain syndrome associated dermatologic manifestations in the setting of DRG stimulation. To our knowledge, a case of this nature has yet to be described in the literature.