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A 42-year-old woman presented to our hospital with intermittent severe bilateral leg pain and red-violet skin discoloration for 4 years. She was known to have essential thrombocytosis for 7 years. High doses of analgesics (loxoprofen 600 mg/day, pregabalin 100 mg/day) provided temporary relief. Physical examination in the outpatient department revealed normal skin findings and no ischemic signs in her legs. We instructed her to take pictures of her abnormal skin findings during an attack. Paroxysmal skin findings noted on a photograph she took using her smartphone, (Figure 1) revealed erythromelalgia. Oral aspirin (100 mg/day) relieved her pain and reduced the need for other analgesics.

Intermittent signs of erythromelalgia diagnosed by smartphone selfie