Dermatologic Manifestations of Eosinophilia-Myalgia Syndrome Treatment & Management

Updated: May 24, 2019
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

The most important component of eosinophilia-myalgia syndrome (EMS) treatment is to discontinue the use of any product containing L-tryptophan.

The mainstay of pharmacologic treatment is glucocorticoid therapy, which benefits many patients but is not effective for all symptoms of EMS.

Other care depends on the manifestations of the disease. In many cases, it is mostly supportive.

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Consultations

Because of the high morbidity associated with EMS, referral to mental health experts should be obtained. Psychotherapy may be helpful in dealing with alterations in mood and behavior secondary to the acquired disabilities. Furthermore, psychological evaluation may provide techniques to use in dealing with compromised function for patients who are affected.

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Complications

EMS is a multiorgan disease that affects the lungs, the skin, the gastrointestinal tract, the nervous system, and the blood system. Complications affecting these organs can arise from the disease or from adverse effects of therapy.

In one patient, juxta-articular adiposis dolorosa developed secondary to long-term treatment with high doses of corticosteroids. The condition involved multiple, painful, symmetrically distributed, fatty deposits that were localized to the lower extremities. The condition resolved when the corticosteroid dose was reduced.

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Prevention

The principal preventative measure is to avoid the use of products containing L-tryptophan.

The use of a multivitamin or a B-complex vitamin may also provide protection against some of the subacute symptoms in EMS. [42]

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Long-Term Monitoring

Physical rehabilitation in EMS

For most patients, a physician-directed rehabilitation program is recommended.

The rehabilitation program should be tailored for each individual.

Psychological support in EMS

Many patients experience anxiety and/or depression as a result of EMS.

Psychological distress should be treated with the appropriate psychotherapy and/or medication.

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