Exfoliative Dermatitis

Nicolis, G.

doi:10.1001/archderm.1973.01620270014003

Cited by 92 publications

(14 citation statements)

References 19 publications

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“…The percentage of malignancies as a cause for erythroderma is still relatively low in our study and previous reports [8,16]. Mycosis fungoides and Sézary syndrome were the most frequent malignant causes of erythroderma, but occasionally, erythroderma was associated with internal malignancies.…”

Section: Discussionsupporting

confidence: 48%

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: Discussionsupporting

confidence: 48%

Erythroderma: A Clinical and Prognostic Study

Zheng²

2012

Dermatology

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“…The blood and dermal eosinophilia was found in all cases except case 4. However, its pathogenesis is obscure, as is in patients with exfoliative dermatitis in which it is frequently observed [4], There is no previous administration of drugs, nor any common factor in the occupation. From these points, it is differentiated from exfoli ative dermatitis as described so far.…”

Section: Commentmentioning

confidence: 99%

Papuloerythroderma

et al. 1984

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The main macroscopic features of 4 cases presented here are erythroderma-like lesions and solid papules. The former covers extensive areas over entire trunk and extremities, especially extensor surfaces. The latter is observed mainly on flexor surfaces of extremities and around the former. The axillae, inguinal regions, cubital and popliteal fossae, and big furrows on abdomen are spared from these lesions. Rashes appear first as papules and form erythroderma-like lesions through their assembly and confluence. Histologically, both show almost the same findings. Patients are older males with no general symptoms except itching. Although the course is chronic, lesions improve slowly and heal only after years.

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“…A subset of patients with cutaneous T-cell lymphoma were tested for literature. Recent studies include those from Finland, 8 India, 7 USA, 10,11 Spain, 12 and Brazil. 13 None of these series an association between erythroderma and HIV, e.g.…”

Section: Introductionmentioning

confidence: 99%