Title: “Dermatological Findings in Early Detection of Complex Regional Pain Syndrome” JAMA Dermatology June 2014 Volume 150, Number 6
Authors: Rameez Kabani, BSc; Alain Brassard, MD, FRCPC
Fishman comments: This is an extremely complex condition and the question for dry eye specialists is whether some of the eyelid and eye findings are a similar manifestation. It is crucial that we continue to investigate the neurobiology behind this syndrome and its possible dry eye syndrome associations.
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 manin 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