Primary erythromelalgia with leukonychia combined with ulcerations and infection by Monilia guilliermondii.
An 8-year-old girl presented with recurrent redness, warming, and pain of the lower extremities for more than 4 years, with exacerbation and accompanying swelling for the past 1 year and ulcers for 1 month. The episodes were triggered by exertion and heat. Her family history revealed that her mother had experienced similar symptoms. Physical examination showed proximal white nails and the distal border in normal color. There was some ulceration in the dorsum of the feet with thick, yellowish secretions, covered by some crusted lesions. Laboratory culture result showed that there were many Monilia guilliermondii in the ulcer specimen. Finally, she was diagnosed with juvenile onset of primary erythromelalgia and was given symptomatic treatment for neuropathic pain and pedal ulcers.