We recruited a population of people who clinically suffer from the symptoms of erythromelalgia, red, hot, painful feet made worse by heat and improved by cooling, to better characterise this population and measure their quality of life (QOL). Ninety-two individuals completed the QOL surveys, and 56 individuals were clinically assessed. There was a 3？:？1 ratio of females to males with an average age of 61 years. The estimated prevalence of people who had clinical symptoms of erythromelalgia in the Dunedin community was 15/100,000. Only 27% of people had received a diagnosis for their symptoms despite seeking medical attention. People in the study population had worse quality of life than the general New Zealand population . In the majority of participants symptoms had a mild-moderate effect on their quality of life. The results of this study indicate that the number of people who have clinical symptoms of erythromelalgia is much greater than is commonly accepted and that the majority of these individuals go unrecognised by the medical profession despite seeking help. They have significantly diminished QOL with the majority of people having mild-to-moderate symptoms. 1. Introduction Erythromelalgia (EM) defines a clinical syndrome of erythema, increased temperature, and associated discomfort, including burning pain, tingling, or similar sensations, preferentially involving the extremities brought on or aggravated by standing, walking, or heat and relieved by the horizontal position and by cold [1–4]. The symptoms most commonly affect the feet and legs bilaterally but can affect hands and even the face [5]. The condition is also associated with anhidrosis [6]. Erythromelalgia has been documented in the literature for almost 150 years, but its prevalence, aetiology, and pathogenesis remain elusive. Even its nomenclature is complex. Erythromelalgia [1, 2], erythralgia [3], and erythermalgia [4]describe overlapping diseases and are used synonymously by most authors, while other distinguish between them based on underlying disorders. Erythromelalgia here will be used as an overarching term for the symptoms described previously. Erythromelalgia occurs either as a primary or secondary disorder. Secondary EM occurs in association with a number of conditions including small fibre peripheral neuropathy of any cause, for example, diabetes, or secondary to myeloproliferative diseases, mushroom poisoning, as a side effect of some medications or as a paraneoplastic syndrome [5, 7–18]. Those who suffer from primary EM develop symptoms without an identifiable cause. A
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