Paraesthesia and pruritus was present in all the 6 patients; 4 patients had trophic changes
with 2 patients suffering from foot ulcer.
Due to a large area of involvement and trophic changes
in the foot, excision of the tumour was not attempted.
2) There were symptoms of motor or trophic changes
and vasomotor, sensory, and sudomotor/vasomotor changes.
There are four subgroups for CRPS based on signs and symptoms that include abnormal pain processing, changes in skin color and temperature, vasomotor abnormalities and edema, and motor dysfunction/ trophic changes
CRPS type I is indicated by pathological sensory, motor, sudomotor, vasomotor, and/or trophic changes
, most commonly localized to the distal part of the extremities (1,3).
Changes in skin color and temperature, trophic changes
in hair and nails, sweating and edema accompany pain.
Presence of at least one of the symptoms from each of the four main symptom groups: Sensory - Hyperesthesia Vasomotor - Changes in temperature and/or changes in skin color and/or asymmetrical skin color Sudomotor/edema: Edema and/or changes in perspiration and/or asymmetrical perspiration findings Motor/trophic: Decreased range of joint motion and/or motor dysfunction (weakness, tremor, and dystonia) and/or trophic changes
(skin, nails and hair)
Some patients develop postural tremor, or trophic changes
Relationship between pain symptoms and referred sensory and trophic changes
in patients with gallbladder pathology.
Stage I disease is characterized by ankle edema without trophic changes
, stage II by edema plus hyperpigmented or depigmented areas and indurations, and stage Ill by open or healed leg ulcers.
In case studies given in the article are lake acidification where sedimentary diatoms have been used extensively to develop histories of acidification and recovery; lake trophic status where trophic changes
can be inferred from changes in taxa abundance; and past climatic change.