Topically Applied Midodrine, 0.2%, an α1-Agonist, for the Treatment of Erythromelalgia

Research Letter | May 06, 2015

Topically Applied Midodrine, 0.2%, an α1-Agonist, for the Treatment of Erythromelalgia ONLINE FIRST

Mark D. P. Davis, MD1; Claudia S. Morr, MD1; Roger A. Warndahl, BS Pharm2; Paola Sandroni, MD, PhD3

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JAMA Dermatol. Published online May 06, 2015. doi:10.1001/jamadermatol.2015.0511

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This before-after study reports that midodrine, 0.2%, is well tolerated and improves symptoms associated with erythromelalgia.

We report the response of patients with erythromelalgia to topical midodrine hydrochloride, an α1-agonist. Erythromelalgia is a rare syndrome characterized by red, hot, painful feet and hands, sometimes extending proximally. Episodes are generally intermittent, lasting from minutes to hours, but can be continuous.1 Although numerous therapeutic regimens have been described,2 none is universally effective. Since symptoms are generally localized, topical treatments might be preferable to avoid systemic adverse effects.3- 5

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