Quantitative estimation and recommendations for supplementation of protein lost through scaling in exfoliative dermatitis

Kanthraj, Garehatty Rudrappa; Srinivas, C. R.; Devi, P. Uma; Ganasoundari, A; Shenoi, Shrutakirthi D; Deshmukh, R.; Suresh, B.; Pai, Satish

doi:10.1046/j.1365-4362.1999.00408.x

Cited by 22 publications

(9 citation statements)

References 28 publications

(29 reference statements)

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“…[7] Hypoproteinemia could be due to protein loss through scaling, chronic malnutrition, or dilution due to hypervolemia. [1116] Elevated levels of blood urea and serum creatinine were seen in two (6.6%) patients who were also known diabetics; pre-existing diabetes could be the cause for this finding. In study by Rafael et al ., increased serum creatinine was observed in 41% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…showed that daily protein loss increased by 25-30% in psoriatic erythroderma and 10-15% in non-psoriatic erythroderma. [11] Previous studies have shown that generalized erythema and scaling are the most common findings, seen in up to 100% of cases. [56] In a study by Pal, scaling was seen in 84.4% of cases[4] and in an Indian study, scaling in 100% and erythema in 80% of cases was observed.…”

Section: Discussionmentioning

confidence: 99%

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Clinico-etiological study of 30 erythroderma cases from tertiary center in South India

Hulmani

Nandakishore

Bhat

et al. 2014

Indian Dermatol Online J

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Background:Erythroderma is a morphological reaction pattern of skin having many underlying causes and finding the etiology helps in the proper management of erythroderma cases.Aim:To evaluate the clinical profile, etiology of erythroderma and to correlate clinical diagnosis with histopathology.Materials and Methods:This study was performed at the department of dermatology, Father Muller Medical College and Hospital, Mangalore, South India. We studied 30 consecutive cases of erythroderma with respect to the epidemiological, clinical and histological data. Clinico-histological correlation was analyzed for etiology of erythroderma.Results:The mean age of onset was 52.3 years with a male to female ratio of 14:1. In addition to erythroderma, other co-existent features included pruritus, fever, lymphadenopathy, and edema. Of the pre-existing dermatoses, psoriasis was the most common (33.3%) disease followed by eczema (20%), atopic dermatitis (6.6%), pityriasis rubra pilaris (3.3%) and drug-induced erythroderma (16.6%). In 16.6% of cases, etiology could not be ascertained. Clinico-histopathological correlation could be established in 73.3% of cases.Conclusion:Clinical features were identical irrespective of etiology. Detailed clinico-histopathological examination helps to establish the etiology of erythroderma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinico-etiological study of 30 erythroderma cases from tertiary center in South India

Hulmani

Nandakishore

Bhat

et al. 2014

Indian Dermatol Online J

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“…General measures for a case of erythrodermic psoriasis (Burden & Kirby, ; Cuellar‐Barboza et al, ; Kanthraj et al, ; Mistry, Gupta, Alavi, & Sibbald, ; NICE, ; ; Rothe, Bernstein, & Grant‐Kels, ; Shepherd, )…”

Section: Treatment Strategies For Specific Types Of Psoriasismentioning

confidence: 99%

“…It is estimated that patients of erythrodermic psoriasis have 25% increase in the daily protein loss (in scales) equivalent to 22.5 g which may result in hypoalbuminemia and negative nitrogen balance if not corrected. The daily protein intake should be increased by 25–30% above the normal balanced diet content which is 56 g for men, 44 g for women and 34 g for children (Kanthraj et al, ).…”

Section: Treatment Strategies For Specific Types Of Psoriasismentioning

confidence: 99%

Practical compendium for psoriasis management

Ibrahim

Amer

Nofal

et al. 2020

Dermatologic Therapy

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Psoriasis management is complex and challenging. It should be tailored for each patient. Treatment strategy differs according to patient's age, sex, disease type, disease severity, burden on patient's quality of life, comorbidities, involvement of specific sites, and pregnancy. The choice of the appropriate therapeutic must take into consideration the availability, the price, and the patient's preferences. It is very important that the chosen treatment is not more unpleasant, intolerable, or dangerous than the disease itself. According to the disease type, severity, and effect on patient's quality of life, dermatologist chooses whether to start with topical therapy, phototherapy or systemic therapy, or a combination of two or more of them. Under each category, there are different types of therapies that can be the first line therapeutics, second line, or even contraindicated. In this compendium, we provide dermatologists with different treatment plans considering all the mentioned variables so that a dermatologist can choose the optimum plan for the patient.

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“…Protein loss in the form of desquamation and exudation is significant, resulting in hypoproteinemia. The daily loss of scales increases from 500-1000 mg to 20-30 g (1,14). Typically, there is hypoalbuminemia with a relative increase in immunoglobulins, especially γ-globulins.…”

Section: Pathogenesismentioning

confidence: 99%

Exfoliative Erythroderma

NEUHOLD¹,

WOLFRAM²

Encyclopedia of Cancer

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SUMMARY Exfoliative erythroderma refers to the skin that is diffusely red and inflamed with varying degrees and types of scaling. There are many causes of erythroderma, but the most common are exacerbations of an underlying skin disease, drug reactions and underlying malignancies. Erythroderma is a rare, potentially serious skin condition. Protein loss in the form of desquamation and exudation is significant, resulting in hypoproteinemia. Usually more than one skin biopsy should be done. Biopsy analysis is important to rule out cutaneous T-cell lymphoma. Patients should be carefully evaluated for underlying disease. Erythroderma can represent a serious medical threat to the patient, and may require hospitalization. Various forms of exfoliative erythroderma are presented, considering the etiopathogenesis, physical findings, differential diagnosis and treatment.

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Quantitative estimation and recommendations for supplementation of protein lost through scaling in exfoliative dermatitis

Abstract: ED may increase the daily protein loss by approximately 25-30% in psoriasis and 10-15% in other causes. Standard treatment for ED and protein supplementation based on our recommendations can minimize the adverse effects of a negative nitrogen balance.

Cited by 22 publications

References 28 publications

Clinico-etiological study of 30 erythroderma cases from tertiary center in South India

Clinico-etiological study of 30 erythroderma cases from tertiary center in South India

Practical compendium for psoriasis management

Exfoliative Erythroderma

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