Clinicopathological Correlation of Erythroderma Cases - A Study of 60 Cases

Abstract

Background: Erythroderma or exfoliative dermatitis is an inflammatory disorder characterized by erythema and scaling in the body involving more than 90% of the body surface. Underlying etiologies which lead to erythroderma are commonly psoriasis (23%), spongiotic dermatitis (16%), drug hypersensitivity reactions (15%) and cutaneous T cell lymphoma (16%). Aims: The aim of our study was to find out the histopathologically erythroderma cases and to evaluate the clinicopathological correlation of such cases. Methods: Skin biopsies of 60 erythroderma cases were received in the department of Pathology. The samples were processed, stained and examined under light microscope. Results: Erythroderma was more common in males (60%) with male to female ratio 1.5:1. Mean age of incidence was 43.3 years. Majority of the cases were acute in onset (51.67%) with shortest duration of 5 days. Pre-existing dermatoses was responsible in 68.33% cases with maximum cases being psoriasis in 33.33% and eczema in 31.67%. Drug induced erythroderma was seen in 16.67% cases. Winter was the aggravating season in 48.14% patients especially in psoriasis. Systemic features such as fever, tachycardia, etc were reported in 76.67% cases. Scales were seen in 83.33% cases and nail changes in 68.33%. Out of 60 cases, 49 cases (81.67%) had positive clinicopathological correlation with best correlation seen in psoriatic erythroderma. P value is<0.001 with strong clinical significance. Conclusion: Erythroderma has many overlapping features which made the identification of underlying disease quiet challenging sometimes. Therefore thorough clinical examination and patients' detailed history along with microscopic findings is essential to rule out all the differential diagnosis.