Exfoliative Dermatitis

Carcinoma of the Rectum Presenting with Exfoliative Erythrodermia

“…They concluded that skin biopsy is of little value in the study of exfoliative dermatitis unless a lymphoma infiltrate is present, though the absence of such specific change did not, of course, preclude the eventual demonstration of lymphoma. In particular they were unable to confirm the opinion of Wilson (1954), Montgomery (1933) and Andrews (1954) that the characteristic histological appearances of such diseases as psoriasis and pityriasis rubra pilaris continue to be found even after the disease becomes generalised and exfoliative. Lymph node biopsy was even less reliable than that of the skin.…”

Erythroderma and its management*

“…Reports of five series of cases of erythroderma give the number of deaths that occurred as ranging from 8-64"" (Table i) (Jarrett & Kellett, 1951;Wilson, 1954;Abrahams, McCarthy & Sanders, 1963;Marks, 1971;Nicolis & Helwig, 1973). Some of these differences are explicable on the basis of the date of the study, e.g.…”

“…the psoriatics in the series of Abrahams et al (1963). Jarrett & Kellett (1951) 19",, Wilson (1954) 38% Abrahams et al (1963) 19% Marks (1971) 8% Nicolis & Helwig (1973) 64% Table I (for further details of key see text).…”

“…The relationship of erythroderma to lymphoma is a controversial subject and there was apparently in the minds of the authors uncertainty about the diagnosis in some cases as the following quotations indicate: 'Of the two patients whose lymph glands gave an appearance of Hodgkin's disease ... the diagnosis was not established in either case' (Wilson, 1954); 'Skin from patients with drug allergy may show histologic features simulating those of mycosis fungoides' (Nicolis & Helwig, 1973). It is not possible to lay down absolute criteria for diagnosis of malignant lymphoma in erythroderma and some of the relevant findings which can cause confusion are shown for our own patients (Table 3) none of whom had developed a lymphoma when last seen, and in the majority the lymphadenopathy, hepatomegaly, leucocytosis, eosinophilia and raised ESR regressed once the skin had cleared.…”

Skin Disorders in Relation to Malabsorption

“…For example, Wilson (1954) reported on 50 patients with exfoliative dermatitis in whom no evidence of gastrointevt'nal disease came to light. He did mention, howexer, that a few of these patients " suffered from a severe macrocytic anaemia for which no cause could be found."…”