Erythroderma

Rothe, Marti Jill; Bialy, Tracy L.; Grant‐Kels, Jane M.

doi:10.1016/s0733-8635(05)70189-3

Cited by 38 publications

(13 citation statements)

References 100 publications

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“…As in other studies, the majority of clinical features did not correlate with the etiology [3,5,6,7]. However, in the present study, nail changes were shown to be predictive clinical signs of psoriasis.…”

Section: Discussioncontrasting

confidence: 49%

Erythroderma: A Clinical and Prognostic Study

Zheng²

2012

Dermatology

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Background: Erythroderma is a rare skin disorder and studies on its causes and prognosis are rare in the literature. Objectives: We reviewed the clinical, laboratory and biopsy materials of 260 patients diagnosed with erythroderma who were treated in our department over an 11-year period. Patients were followed up to better understand the evolution of erythroderma. Methods: This study was performed at our hospital between January 2001 and 2012 and included 260 patients with erythroderma. We recorded epidemio-clinical, biological and histological data, treatments and outcomes. Clinical-histological correlation was analyzed. Overall survival and relapse-free survival for a limited number of etiologies were described using Kaplan-Meier estimates. Results: The mean age at onset in this study was 52.57 ± 17.94 (SD) years (range 13–87), with a male-to-female ratio of 3:1. Acute onset was present in 15.38% of patients. Clinical findings were dominated by pruritus (87.69%), fever (40%), edema (37.69%), chills (31.15%), nail changes (29.62%), weakness (19.23%), lymphadenopathy (19.23%), weight loss (14.62%) and islands of normal skin (13.46%). Skin biopsies revealed the cause in 55.56% (65/117) of the patients. The most common causative factors were pre-existing dermatoses (70.77%), followed by idiopathic causes (14.23%), drug reactions (12.69%) and malignancies (2.31%). Among the pre-existing dermatoses, psoriasis was the most common etiology (143/260, 55%). In the drug-induced group, carbamazepine was the most frequently implicated drug in our study (33.33%). Chinese traditional herbal medicines are among the causes of drug-induced erythroderma as well. We also found that Langerhans cell histiocytosis, tongue cancer, hypereosinophilic syndrome, bullous pemphigoid and dermatomyositis could be causes of erythroderma. From our follow-up study, 39 (31.2%) of the 125 patients from whom information was available had relapsed. The patients with idiopathic erythroderma had a higher relapse rate. Of the 5 patients who died, 4 deaths were directly related to erythroderma. Conclusion: Most of the clinical features of erythroderma are unspecific with few cause-orienting clues. Although numerous laboratory values were abnormal, most findings were nondiagnostic and were related to the inflammatory process, except for skin biopsy. Our study had a high percentage of erythroderma secondary to pre-existing dermatoses and a low percentage of malignancy patients. Repeated evaluations, close follow-up and biopsy are recommended.

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Section: Discussioncontrasting

confidence: 49%

Erythroderma: A Clinical and Prognostic Study

Zheng²

2012

Dermatology

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“…Most published series reveal that the majority of patients are diagnosed with psoriasis, spongiotic dermatitis, drug reactions or cutaneous T cell lymphoma (CTCL). [67]…”

Section: Etiologymentioning

confidence: 99%

“…[16] Hyperkeratosis, parakeratosis, acanthosis and a chronic perivascular inflammatory infiltrate, with or without eosinophils, are examples. [6] The clinicopathologic correlation is difficult because nonspecific features of erythroderma may mask the specific features of an underlying dermatosis. Direct immunofluorescence studies may be of diagnostic utility in cases of erythroderma secondary to pemphigus foliaceus, bullous pemphigoid, graft-versus-host disease and connective tissue disorders.…”

Section: Histopathologymentioning

confidence: 99%

Erythroderma : Review of a potentially life -threatening dermatosis

et al. 2009

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“…Erythroderma is a rare skin disorder caused by various pathologies, including inflammatory diseases (psoriasis, atopic dermatitis, contact dermatitis, drugs), occult malignancies and cutaneous T-cell lymphomas (CTCL), in which there is a skin-selective recruitment of lymphocytes from the blood [1,2,3]. Sézary syndrome (SS) is a CTCL characterized by erythroderma, peripheral adenopathies and circulating atypical lymphocytes with cerebriform nuclei [4, 5] and is considered a disorder of skin-homing memory Th2 cells.…”

Section: Introductionmentioning

confidence: 99%

Expression Pattern of Chemokine Receptors and Chemokine Release in Inflammatory Erythroderma and Sézary Syndrome

Fierro

Comessatti²,

Quaglino³

et al. 2006

Dermatology

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Background: Erythroderma can be caused by inflammatory dermatoses or cutaneous T-cell lymphoma. Even if chemokines and their receptors are involved in the skin-selective lymphocyte recruitment, their role in inflammatory erythroderma is yet unclear. Objective: To evaluate the chemokine release (TARC, MDC, IP-10) and to define the expression pattern of Th1- (CCR5, CXCR3) and Th2-related (CCR4) chemokine receptors in inflammatory erythroderma and Sézary syndrome (SS). Materials and Methods: Flow cytometry has been carried out on both circulating and skin-infiltrating T lymphocytes; serum chemokine levels have been evaluated using ELISA techniques. Results: CCR4, CCR5 and CXCR3 were expressed on about 40% of peripheral blood lymphocytes and on the majority of skin-infiltrating lymphocytes in the inflammatory erythroderma patients, whereas the leukemic CD4+CD26– subpopulation in SS was characterized by a high CCR4 expression without a concurrent increase in CCR5 or CXCR3. TARC, MDC and IP-10 serum levels were significantly increased in both erythrodermic and SS patients. Conclusions: Our results confirm that SS is a Th2 disorder with a selective expression of CCR4, whereas inflammatory erythroderma shares an overexpression of both Th1- and Th2-related chemokine receptors, suggesting an activation of different pathways driving reactive lymphocytes to the skin.

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Erythroderma

Cited by 38 publications

References 100 publications

Erythroderma: A Clinical and Prognostic Study

Erythroderma: A Clinical and Prognostic Study

Erythroderma : Review of a potentially life -threatening dermatosis

Expression Pattern of Chemokine Receptors and Chemokine Release in Inflammatory Erythroderma and Sézary Syndrome

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