Reflex sympathetic dystrophy. Occurrence of inflammatory skin lesions in patients with stages II and III disease.

Reflex sympathetic dystrophy is a poorly understood syndrome of posttraumatic pain and sympathetic nervous aberration. We have observed previously unreported cutaneous manifestations of reflex sympathetic dystrophy. Seven patients with reflex sympathetic dystrophy were referred to our institution because of skin disorders. Three had recurrent ulcerating papules, and two had reticulate hyperpigmentation. Xerosis was common, and cutaneous atrophy was infrequent. Cutaneous ulceration and reticulate hyperpigmentation are previously unappreciated aspects of reflex sympathetic dystrophy. Further investigation regarding neural influences on the skin is warranted.