Erythroderma: analysis of 247 cases

Abstract

The profile of 247 patients with erythroderma during a 23 year period from January, 1962 through March, 1985, with a follow-up period ranging from 1 to 26 years were analysed. The patients presented with diffuse erythema, scaling and pruritus of more than 2 months' duration, and the age ranged from 16 to 60 years. Psoriasis was the most frequent underlying disease with an estimated frequency of 44.9%, the reaction to the use of drugs appeared in 7.3% of total cases and association with reticulosis showed a frequency of 4.1%. The cause of the erythroderma could not be determined in 29.2% of the cases. Six differences in terms of underlying diseases were not observed. One or more skin biopsies along with clinical findings were diagnostic or suggestive of the underlying disease in 63.6% of the cases. Repeated skin biopsies are recommended as the best method for etiologic diagnosis of erythroderma. At P = 0.05 significance level, masculine/feminine ratio of 2:1 was found. The question arises whether causal agent of erythroderma may not be somehow related to different exposure by sex to environmental antigens.

Dermatite esfoliativa: estudo clínico-etiológico de 58 casos

“…3,8,[10][11][12][13][14] In most of them, exfoliative dermatitis was related to the exacerbation of cutaneous diseases. Pal and Haroon, 8 studying 90 cases in Pakistan, found a defined cutaneous underlying disease in 74.4% of patients, drug reactions in 5.5%, malignancy in 5.5% and undetermined causes in 14.6 % of cases.…”

Reações cutâneas graves adversas a drogas - aspectos relevantes ao diagnóstico e ao tratamento - Parte I - Anafilaxia e reações anafilactóides, eritrodermias e o espectro clínico da síndrome de Stevens-Johnson & necrólise epidérmica tóxica (Doença de Lyell)

“…9 A disseminação de um quadro maculopapular causado por drogas pode levar ao surgimento da síndrome eritrodérmica, considerando-se que os diversos tipos de reações cutâneas causadas por drogas (incluindo dermatite de contato, fotossensibilização e reações maculopapulosas) seriam responsáveis por cerca de 7,3% dos casos de eritrodermia. 10 Os quadros de eritrodermia secundária à reação a drogas, ao contrário das eritrodermias devidas a outras etiologias, são em geral de instalação rápida e tendem a regredir rapidamente com a retirada do medicamento envolvido. 10 Uma a quatro semanas após o início do uso da droga surgem prurido associado ao eritema difuso, envolvendo cerca de 90% da superfície corpórea, e linfoadenopatia, seguida por descamação que, quando aguda, esfolia grandes lamelas de epiderme e, quando crônica, produz pequenos elementos 9 (Figura 3).…”

“…10 Os quadros de eritrodermia secundária à reação a drogas, ao contrário das eritrodermias devidas a outras etiologias, são em geral de instalação rápida e tendem a regredir rapidamente com a retirada do medicamento envolvido. 10 Uma a quatro semanas após o início do uso da droga surgem prurido associado ao eritema difuso, envolvendo cerca de 90% da superfície corpórea, e linfoadenopatia, seguida por descamação que, quando aguda, esfolia grandes lamelas de epiderme e, quando crônica, produz pequenos elementos 9 (Figura 3). Ocorrem prurido e sensação de queimação difusa.…”

“…9 neous reactions (including contact dermatitis, photosensitivity and maculopapulous reactions) would be responsible for roughly 7.3% of erythroderma cases. 10 The secondary drug-induced erythroderma conditions, as opposed to erythrodermas due to other etiologies, most often set in quickly and tend to regress quickly also after withdrawing the medication being used. 10 One 11,12,13 The effect of exfoliative dermatitis on the organism depends on the intensity and duration of the process.…”

“…10 The secondary drug-induced erythroderma conditions, as opposed to erythrodermas due to other etiologies, most often set in quickly and tend to regress quickly also after withdrawing the medication being used. 10 One 11,12,13 The effect of exfoliative dermatitis on the organism depends on the intensity and duration of the process. 13 Complications from erythroderma may be seen in chart 3. Common laboratory findings in the erythrodermic state include light anemia, leukocytosis with eosinophil, high IgE, an increase of the hemosedimentation process, a drop in seric albumin and rise in uric acid.…”