Papuloerythroderma 2009: Two New Cases and Systematic Review of the Worldwide Literature 25 Years after Its Identification by Ofuji et al.

Abstract

Background: Even after the description of papuloerythroderma of Ofuji (PEO) in 1984, little is known about this clinical entity. Objective:To report on 2 new cases of PEO and review of the worldwide literature on this topic. Methods: Article citations were searched on several biomedical search engines (PubMed, EMBASE, SCOPUS, Google Scholar). Papers were retrieved either online or in print. Results: A grand total of 170 PEO cases were identified. Most patients were older than 55 years and of Asian or white descent, with an overall male/female ratio of 4.0. Itch and the deck-chair sign were observed in all patients. Peripheral eosinophilia, lymphocytopenia and increased serum IgE were common findings. Histopathology mostly showed aspecific inflammation, while 17 showed histological features of cutaneous T-cell lymphoma (CTCL). Atopy, malignancies, infections and drugs were rarely linked to PEO. Conclusion: PEO represents a rather monomorphous entity both clinically and, with the remarkable exception of CTCL, also histologically. Nonetheless, no causative factor could be identified in the vast majority of cases. An etiological classification and diagnostic criteria are proposed in the attempt to contribute framing this puzzling clinical entity.

High Incidence of Internal Malignancy in Papuloerythroderma of Ofuji: A Case Series from Japan

“…Torchia et al [3] recently reviewed the worldwide literature on PEO for the 25 years since its identification by Ofuji et al [1] and reported that associated malignancies were found in 37 (21.8%) of 170 cases. However, they commented that the data probably reflect overreporting, because, in several instances, the association between PEO and a given cancer was the main reason for publication.…”

“…The diagnosis was based on the diagnostic criteria for PEO described by Torchia et al [3], which includes an erythroderma-like eruption formed by the coalescence of flat-topped, red-to-brown papules with a cobblestone-like appearance, the deck chair sign, itch and histopathological exclusion of cutaneous T cell lymphoma. The standard screening investigations included full blood count, renal and liver function tests, serum IgE levels, some tumor markers, urinalysis and stool examinations.…”

“…The clinical features are characterized by pruritic, erythroderma-like lesions formed by the coalescence of solid, red-to-brown papules with little scaling [1,2,3]. There is sparing of the skin folds, which is the so-called deck chair sign.…”

Case of papuloerythroderma of Ofuji‐like eruption during the course of bullous pemphigoid

“…The major criteria for PEO are as follows: (i) erythroderma‐like eruptions formed by coalescence of flat‐topped, red‐to‐brown papules with cobblestone‐like appearance; (ii) itch; (iii) deck‐chair sign; (iv) histopathological exclusion of other skin diseases; and (v) absence of causative factors 4. Because the present case showed no characteristic papular eruptions, the criteria were not fulfilled.…”

Papuloerythroderma of Ofuji: clinical case

“…В доступной нам отече-ственной литературе случаев описания ПО мы не встретили. По имеющимся данным [2,3], большин-ство больных этим заболеванием являются лицами азиатского происхождения. Однако в последние го-ды случаи ПО отмечаются и среди европейцев [4,5].…”