Erythroderma. A clinicopathological study of 56 cases

Botella‐Estrada, Rafael

doi:10.1001/archderm.130.12.1503

Cited by 61 publications

(103 citation statements)

References 7 publications

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“…This was in accordance with the study done by Botella-Estrada, Martin which found the ratio to be 4:1. 4 In our study, 83% of patients (30/36) presented within 1 month of onset of disease, whereas 17% (6/36) presented after 1 month. All the patients with drug induced erythroderma and malignancy presented within 1 month of onset In the study by Sigurdsson and Toonstra, the mean duration of the erythroderma before admission was 8 months (range, up to 96 months).…”

Section: 3mentioning

confidence: 43%

Clinical profile, etiology and histopathology of patients with erythroderma in South India

Snigdha¹,

George²,

Binitha³

et al. 2017

Int J Res Dermatol

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Background: Erythroderma is a generalised inflammatory disorder of skin manifesting with erythema and scaling affecting more than 90% of the skin surface. Several studies have highlighted the importance of biopsy in the diagnosis and management of erythroderma, while some others have found it to be of limited use.Methods: Thirty-six patients with erythroderma were enrolled in the study and a detailed history, clinical examination and relevant investigations including skin biopsy was done to find out the etiology.Results: Pre-existing dermatoses were the predominant cause (84%) contributed equally by psoriasis (42%) and eczemas (42%) and clinicopathologic correlation could be obtained in 30.55% of cases.Conclusions: Our study showed that skin biopsy remains a valuable tool in the diagnosis of erythroderma.

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Section: 3mentioning

confidence: 43%

Clinical profile, etiology and histopathology of patients with erythroderma in South India

Snigdha¹,

George²,

Binitha³

et al. 2017

Int J Res Dermatol

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“…The patient was treated with systemic corticosteroids and should be followed-up. In cases with idiopathic erythroderma, cutaneous T-cell lymphoma, atopic dermatitis and drug reactions were found to be the most common causes, during the follow up, in one study, and in the other, CTCL was the most common diagnosis during the follow-up of patients with idiopathic erythroderma (11,16).…”

Section: Patients With Idiopathic Erythroderma and Clinical Suspicionmentioning

confidence: 85%

“…The causative factors are previous dermatoses, drug reactions, malignancy, infections and idiopathic erythroderma. The 4 most common causes are: adult atopic dermatitis, drug reactions, cutaneous T-cell lymphoma (CTCL) and paraneoplastic erythroderma (12,13,16,18,19). In our study, drug reactions and previous dermatoses were excluded, and there were 9 patients with erythrodermic CTCL, 3 with idiopathic erythroderma (and probable prelymphomatous eruption), 8 with adult onset atopic dermatitis and disseminated eczema, 2 patients with senile erythroderma, 1 patient with pityriasis rubra pilaris, and 1 with paraneoplastic erythroderma.…”

Section: Discussionmentioning

confidence: 99%

“…Search for internal malignancy, bone marrow biopsy, and lymph node biopsy, among other investiagations, did not reveal any signs of malignant disease, and the patient was diagnosed to have senile erythroderma. Senile erythroderma is most commonly manifested by previous eczema or atopic dermatitis, with persistent course and nonspecific features by histopathological analysis, elevated IgE and LDH and variable presence of eosinophils in the skin biopsy (16). In the other patient, aged 65, a dominant T-cell clone was found only in the peripheral blood, while a dominant B-cell clone was found in the bone found that finding of a dominant clone was specific for lymphomatous erythroderma (11).…”

Section: Discussionmentioning

confidence: 99%

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T-Cell Receptor-G Gene Rearrangement Analysis in the Diagnosis of Patients with Erythroderma / Dijagnostički Značaj Analize Preuređenja Gena Gama Lanca T-Ćelijskog Receptora Kod Pacijenata Sa Eritrodermijom

Kandolf-Sekulović¹,

Cikota²,

Dinić³

et al. 2009

Serbian Journal of Dermatology and Venerology

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The diagnosis of erythroderma is challenging, since clinical, histopathological and immunophenotypic findings are insufficient to differentiate between inflammatory and lymphomatous erythroderma. Thus, multiplex PCR was used for T-cell receptor-g gene rearrangement analysis, in the skin and peripheral blood samples of 24 patients (20 men and 4 women) with erythroderma of varying origin, in order to estimate its diagnostic value. Cutaneous T-cell lymphoma was confirmed in 9, benign inflammatory dermatosis in 12, and idiopathic erythroderma and clonal dermatitis in 3 patients. In the group of patients with erythrodermic cutaneous T-cell lymphoma, the dominant clone was detected in the skin of 8/9, and in none of the patients with inflammatory dermatoses. A dominant clone was found in peripheral blood of 5/6 samples of patients with erythrodermic cutaneous T-cell lymphoma, and in 2/12 patients with inflammatory dermatosis. T-cell receptor-g gene rearrangement analysis is valuable in differentiation between inflammatory and lymphomatous erythroderma, thus substantially improving the diagnosis of patients with erythroderma.

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“…Other manifestations include diffuse alopecia, keratoderma, nail dystrophy, ectropion, peripheral edema and lymphadenopathy. 3 Symptoms generally include fevers, malaise, fatigue and pruritus. Significant systemic complications include fluid and electrolyte abnormalities, hypoalbuminemia, thermoregulatory disturbance, cardiac failure, capillary leak syndrome, infection and possibly even death.…”

Section: Discussionmentioning

confidence: 99%

Erythroderma: a dermatologic emergency

Bruno

Grewal

2009

CJEM

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Erythroderma is a potentially fatal dermatologic emergency that is often mistaken for infection. Indeed, the fact that it is difficult to diagnosis is the main contributor to its significant mortality rate, as treatment is readily available. We present a case of a 36-year-old man who was incorrectly diagnosed and treated for 2 months. We review the etiologies, initial work-up and management of this disease. In our case, the patient was ill, had lost 11.3 kg and developed systemic inflammatory response syndrome. Without proper treatment he was at risk of developing full-blown sepsis. Although there are many causes of erythroderma, prompt initial treatment directed at the underlying etiology typically results in a rapid remission. RÉSUMÉL'érythrodermie constitue une urgence dermatologique potentiellement fatale qui peut souvent être confondue avec une infection. De fait, on attribue principalement l'important taux de mortalité associé à la maladie au fait qu'elle est difficile à diagnostiquer, alors qu'en soi, elle se traite facilement. Nous présentons ici le cas d'un homme de 36 ans qui a reçu un traitement inadéquat pendant deux mois pour un diagnostic erroné. Nous passons en revue les étiologies, les analyses et la prise en charge initiales de cette maladie. Dans ce cas-ci, le patient était mal en point, il avait perdu 11,3 kg et présentait un syndrome de réponse inflammatoire systémique. Faute de traitement approprié, il se trouvait exposé à un risque de sepsis avéré. Bien qu'il y ait de nombreuses causes de l'érythrodermie, un traitement initial instauré sans délai et selon l'étiologie sous-jacente procure généralement une rémission rapide.(e.g., cutaneous T-cell lymphoma and paraneoplastic phenomena), pre-existing dermatoses (e.g., atopic dermatitis, psoriasis, seborrheic dermatitis and pityriasis rubra pilaris), drug reactions, bullous disorders and allergic contact dermatitis. In up to 25% of cases, no underlying cause is found, and so it is termed idiopathic erythroderma. 1Erythroderma accounts for 1% of all dermatologic admissions to hospital and is more commonly seen in male patients. The importance of this disease is highlighted by the consequences of losing the cutaneous barrier: those affected are prone to lose heat, water, protein and electrolytes, and they are more susceptible to cutaneous infections.2 The disease can be mistaken as an infectious process and treated as such. The purpose of this case report is to highlight the pertinent clinical findings of erythroderma and its differentiation from infectious or malignant etiologies. CASE REPORTA 36-year-old man presented to our emergency department (ED). His chief complaint was a generalized pruritic rash ongoing for approximately 2 months. He also complained of concomitant fevers, night sweats and generalized malaise. Over the course of the previous 2 months he had seen his general practitioner and been to a walk-in clinic. Both times, he was given diphenhydramine hydrochloride and a topical corticosteroid without much relief. Ten days bef...

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Erythroderma. A clinicopathological study of 56 cases

Cited by 61 publications

References 7 publications

Clinical profile, etiology and histopathology of patients with erythroderma in South India

Clinical profile, etiology and histopathology of patients with erythroderma in South India

T-Cell Receptor-G Gene Rearrangement Analysis in the Diagnosis of Patients with Erythroderma / Dijagnostički Značaj Analize Preuređenja Gena Gama Lanca T-Ćelijskog Receptora Kod Pacijenata Sa Eritrodermijom

Erythroderma: a dermatologic emergency

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