Mar 31, 2016 erythroderma is an uncommon and severe dermatological manifestation of a variety of diseases. In severe cases of erythrodermic prp supportive care is indicated to prevent hypothermia, electrolyte imbalance and. It is commonly challenging to find the underlying cause. Secondary erythrodermas develop along with existing skin diseases, such as eczema and psoriasis. Gonzalez, md, university of miami miller school of medicine. The extent of the skin changes can obscure the primary lesion making it difficult to. Conditions listing erythroderma as a symptom may also be potential underlying causes of erythroderma. Erythroderma is a rare skin disorder that may be caused by a variety of underlying dermatoses, infections, systemic diseases and drugs. Erythroderma is an uncommon and severe dermatological manifestation of a variety of diseases. Erythroderma the name for any of a group of diseases of humans manifested chiefly by an inflammatory reaction of the entire skin, including redness, edema, scaling, and itching. Because of erythroderma, he was admitted to the hospital and was treated with mtx 15 mgweek. In a retrospective study, erythroderma accounted for in 100,000 patients presenting with skin diseases in china 2.
It may complicate a preexisting dermatosis, follow the ingestion of a drug or be associated with. Leprosy is a chronic infectious disease that is endemic in brazil. Since erythroderma can quickly lead to serious complications, the provider will start treatment right away. It is characterized by inflammations, erythema and scaling. This usually involves strong doses of cortisone medicines to reduce inflammation. Exfoliative dermatitis is characterized by erythema and scaling involving the skins surface and often obscures the primary lesions that are important clues to understanding the evolution of the disease. Erythroderma is erythema that covers at least 90% of the body surface area. In erythrodermic psoriasis, the immune system causes the body to produce too many skin cells, leaving a flaky rash. A preexisting dermatosis is the single most common cause of adult erythroderma. Erythroderma is a rare but serious condition of the skin that affects almost the whole cutaneous surface. Hypereosinophilia as a rare side effect of methotrexate in a patient. Psoriatic erythroderma represents a form of psoriasis that affects all body sites, including the face, hands, feet, nails, trunk, and extremities. Erythroderma is a term used to describe erythema affecting more than 90% of the body surface. Pdf causes and features of erythroderma researchgate.
Erythrodermic psoriasis national psoriasis foundation. Exfoliative dermatitis exfoliative erythroderma current medical. Erythroderma is conventionally defined as inflammation of at least 90% of the. Because of the patients recent history of an upper respiratory tract infection, the rash might be a consequence of the infective organism a toxic erythema or related to its treatment. Erythroderma is an intense generalized redness of the skin. Some of the drug eruptions may sometimes present as erythroderma. During the month of january, 1954, four cases of erythroderma desquamativum came under my observation at the air force hospital in wiesbaden, germany. Erythroderma is generalized exfoliative dermatitis, which involves 90% or more of the patients skin. Syllable counter is now available for text and documents. The widespread involvement of the skin by a scaly, erythematous dermatitis occurring either as a secondary or reactive process to an underlying cutaneous disorder e. Erythroderma usually evolves slowly over months to years. It is a rare type of psoriasis, occurring once or more during the lifetime of 3 percent of people who have psoriasis.
Inappropriate treatment may cause more harm to patients. A major challenge lies in establishing the underlying cause of erythroderma. The most common cause of erythroderma is exacerbation of an underlying skin disease, such as psoriasis, contact dermatitis, seborrheic dermatitis, lichen planus, pityriasis rubra pilaris or a drug reaction, such as the use of topical steroids. Exfoliative dermatitis may occur in response to drug therapy, systemic disease, or an idiopathic entity box 3. Diagnosis of the underlying disorder is therefore crucial to institute the appropriate therapy. If the inline pdf is not rendering correctly, you can download the pdf file here. Erythroderma free download as powerpoint presentation. Word unscambler has been renamed and will be altered to a complete anagram solver.
More than half of all cases are due to aggravation. Methotrexate mtx has been approved for the treatment of psoriasis and is considered to be effective and. Exfoliative dermatitis ed is a definitive term that refers to a scaling erythematous dermatitis involving 90% or more of the cutaneous surface. The course of an erythroderma may be acute, subacute, or chronic.
A practical approach to the diagnosis and treatment of adult. Idscalp idiopathic drug allergy seborrheic dermatitis contact dermatitis atopic dermatitis lymphoma and leukemia psoriasis. Erythroderma is a condition caused by several etiologies that result in red inflamed skin on 90% or more of the body surface. In the american literature, case reports have been scarce. Successful treatment of recalcitrant, erythroderma. Doctors will try to stop the flareup as quickly as possible and.
The incidence of neonatal and infantile erythroderma was 0. Erythroderma exfoliative dermatitis is a cutaneous reaction pattern characterized by erythema, edema and scaling of all or most of the skin surface, often accompanied by pruritus see p. Patil medical college and research centre, vijayapura 1 2. A case report of erythroderma in a patient with borderline leprosy on. Erythroderma article about erythroderma by the free dictionary. Erythrodermic psoriasis ep is a rare and severe variant of psoriasis vulgaris, with an estimated. Thermoregulatory disturbance, 31 malaise, fatigue, and pruritus are prominent symptoms in erythroderma. Erythroderma generalized exfoliative dermatitis treatment. Erythroderma related to the administration of 99mtcsestamibi. Drugs reported to cause erythroderma codes and concepts open. Erythroderma is characterized by erythema and scaling affecting more than 90% of the body surface area. Erythroderma can occur at any age and in both sexes, but is more frequent in older. Primary erythrodermas occur as disease entities, for example, ritters disease. Gehgal and srivastava performed a large prospective study in the indian subcontinent, where they determined the incidence to be 35 per 100,000 dermatologic outpatients.
Medicines to treat the underlying cause of erythroderma, such as psoriasis. Drugs reported to cause erythroderma codes and concepts open ace inhibitors. Summarize treatment and management recommendations for erythroderma. Drug reactions also tend to regress more quickly than other forms of erythroderma. Erythroderma in a patient taking acitretin for plaque psoriasis. Our products are designed to not only help you pass exams, but retain your medical knowledge for life. The aim of this study was to analyze the causes of the disease in patients with erythroderma. Mar 26, 2018 in erythrodermic psoriasis, the immune system causes the body to produce too many skin cells, leaving a flaky rash. Home treatment is with cool to tepid baths and application of midpotency corticosteroids under wet dressings or with. Firstline treatments for psoriatic erythroderma include immunosuppressive. The extent of the skin changes can obscure the primary lesion making it difficult to diagnose the underlying cause. Exfoliative dermatitis is characterized by erythema and scaling involving the skins surface and often obscures the primary lesions that are important clues to understanding the evolution of the dis. Wed like to understand how you use our websites in order to improve them.
Patients with erythroderma often experience severe and highly debilitating pruritus. Erythrodermic psoriasis is a rare type of psoriasis, but it can be quite serious. Prognosis of erythroderma depends on the underlying disease process. Prognosis sigurdsson et al 1996 found a mortality rate of 43% in 102 patients with erythroderma, although only 18% of these deaths occurred as a direct result of the patients erythroderma. Most published series reveal that the majority of patients are diagnosed with psoriasis, spongiotic dermatitis, drug reactions or cutaneous t cell lymphoma ctcl. Secondary erythrodermas develop along with existing skin diseases, such as eczema and psoriasis, or systemic diseases, for example, mycosis fungoides and blood diseases. Erythema is remarkable and, when significant scaling is present, the term exfoliative erythroderma is often used. Early diagnosis and supportive treatment of exfoliative dermatitis are important in preventing infection from developing in the affected skin and in keeping fluid and protein loss from becoming life threatening. Sigurdsson recorded the annual incidence in the netherlands to be 0.
If you have any concerns with your skin or its treatment, see a dermatologist for advice. Erythroderma definition of erythroderma by medical dictionary. If erythroderma is the result of a generalised spread of a primary skin disorder such as psoriasis or dermatitis, it usually clears with appropriate treatment of the skin disease but may recur at any time. Although the underlying etiology is frequently unknown, the condition mostly occurs as a result of some drug reaction or a malignant disorder. If the cause can be removed or corrected, the prognosis is generally good. Inflammatory, neoplastic and, more rarely, infectious diseases may culminate with erythroderma. It is an inflammatory disorder characterized by an extreme state of skin dysmetabolism that gives rise to extensive erythema and scaling all over the body. Aug 12, 2019 exfoliative dermatitis ed is a definitive term that refers to a scaling erythematous dermatitis involving 90% or more of the cutaneous surface. Because of erythroderma, he was admitted to the hospital and was treated with mtx 15 mg week.
Erythroderma and exfoliative dermatitis springerlink. Exfoliative dermatitis msd manual consumer version. Erythroderma definition of erythroderma by medical. Management of erythroderma requires a combination of general supportive measures and treatment directed at the underlying cause. A case series of dermatological emergencies erythroderma. If you have symptoms of erythrodermic psoriasis, dont wait to get help. The causes of erythroderma fall into four broad categories. Erythroderma symptoms, diagnosis, treatments and causes. Management of adverse events of angiogenetic inhibitors in the treatment of renal cell carcinoma.
Pdf erythrodermic psoriasis ep is a rare and severe variant of psoriasis vulgaris, with an estimated. The annual incidence has been estimated to be approximately 1 per 100,000 in the adult population 1. Jun, 20 erythroderma is erythema that covers at least 90% of the body surface area. Searching two syllable words with qu in the middle, ab in the center. As with all medical conditions, there may be many causal. In general, studies have shown a male predominance, with the maletofemale ratio. Introduction erythroderma is defined as the scaling erythematous dermatitis involving 90% or more of the cutaneous surface. Recent studies of pruritus hypothesize a local origin caused by several proinflammatory cytokines and neuroinflammatory mediators.
Erythroderma is the term applied to any inflammatory skin disease affecting more than 90% of the body surface. To optimize the diagnosis and management of the erythrodermic patient, healthcare professionals. David weedon ao md frcpa fcaphon, in weedons skin pathology third edition, 2010. Treatment with cyclosporin a always demands carefull evaluation of the course of the disorder. Jan 27, 2016 prognosis sigurdsson et al 1996 found a mortality rate of 43% in 102 patients with erythroderma, although only 18% of these deaths occurred as a direct result of the patients erythroderma. Acute cases need hospital management with intensive monitoring and support. Erythroderma is a generalized, inflammatory skin condition involving more than 90% of the skin surface area fig. Doctors will try to stop the flareup as quickly as possible and protect you from. Erythrodermic ehreethrodermik psoriasis is a particularly inflammatory form of psoriasis that often affects most of the body surface. Identify erythroderma causes, symptoms, and diagnostic testing. The commonest causes of acute erythroderma are psoriasis, atopic and other varieties of eczema, cutaneous tcell lymphoma and drug reactions. Patients with erythroderma attributed to psoriasis or spongiotic dermatitis are likely to have a prior history of more localized disease before the onset of erythroderma, 33 although in some cases, erythroderma is the first manifestation of the dermatosis. Despite numerous treatment options, control of pruritus is difficult. The term exfoliative dermatitis is also used, and describes the exfoliation skin peeling found in erythroderma.