Papuloerythroderma – A further Case with the ‘Deck Chair Sign’

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

“…Seventy papers belonged to the English literature, 25 to the Asian literature and 17 to the non-English/non-Asian Western literature. One hundred twenty-five [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51], 25 [52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73], and 18 cases of PEO [74,75,76,77,78,79,80,81,82,83,84,85,86,87] were identified, respectively, for a grand total of 170 cases (including the present 2) as of July 31, 2009. Six case reports were excluded as redundancy with later articles was suspected [88,89<...>…”

“…Nail and buttock infarcts [2], hypothyroidism [7], depression [10], coronary artery disease [11,15,21,50], Quincke’s edema [11], thrombocytopenia [12], arterial hypertension [12,21,74], chronic obstructive pulmonary disease [15,16,21], diabetes mellitus [15,64], benign prostatic hyperplasia [15], cholesteatoma [19], hypercholesterolemia [19], hepatic cysts [21], arthritis [3,21], atrial fibrillation [21], duodenal ulcer [21], goiter [41] and gallstones [26,50] were not considered significant. Seven cases of drug-induced PEO have been reported (4.11%) [23,40,45,47,48,58,67,69], including one in which the name of the medication could not be obtained [58].…”

“…‘papuloerythroderma’, by describing 4 otherwise healthy elderly male patients affected by erythroderma which featured flat-topped papules and a characteristic sparing of the skin folds (a finding later defined as ‘deck-chair sign’ [2]). Palmoplantar keratoderma and dermatopathic lymphoadenopathy were present in 2 patients.…”

Circumstances that Led to the Definition of Papuloerythroderma (Ofuji) as an Individual Entity

“…In intertriginous areas, such as axillary, cubital, and popliteal fossas and the inguinal region, as well as the abdomen, the eruption is absent, showing a clear boundary in accordance with major wrinkle lines (Figures 1a and 1b). Such a zebra or belt-shaped skin eruption distribution is called a 'deckchair sign' in Western countries [2]. The skin eruption does not appear, or it is mild, if any, on the face.…”

“…When such reporting began to be made from Europe [2,7], the clinical individuality of this disorder was established [6,8].…”