Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
Short Communication
1997:63:1;38-39
PMID: 20944257

Erythroderma: a study of incidence and aetiopathogenesis

Ajay Chaudhary, Pushpa D Gupte
 Department of Dermatology, Seth GS Medical College and KEM Hospital, Parel, Bombay-400012, India

Correspondence Address:
Ajay Chaudhary
5/A Sham Dham, Sion, Bombay-400022
India
How to cite this article:
Chaudhary A, Gupte PD. Erythroderma: a study of incidence and aetiopathogenesis. Indian J Dermatol Venereol Leprol 1997;63:38-39
Copyright: (C)1997 Indian Journal of Dermatology, Venereology, and Leprology

Abstract

Thirty cases of exfoliative dermatitis (22 male and 8 female) were selected at random for study. In addition to routine history and clinical examination, investigations like histopathology of skin and lymph nodes, peripheral blood smear for abnormal cells and bone marrow examinations were done. Aetiologically, the cases could be classified into 4 categories namely exfoliation in per existing dermatoses, drug-induced exfoliation, idiopathic exfoliation and exfoliation secondary to internal malignancy. Two cases showed abnormal monocytoid cells (sezary cells) in peripheral blood smear.
Keywords: Exfoliative dermatitis, Psoriatic erythroderma

Introduction

Exfoliative dermatitis is a symptom complex characterized by generalised or universal exfoliation of the skin in response to various factors, internal or external, known or unknown. It either represents reflection on the skin of severe systemic disease or extension of pre existing cutaneous disease. The term erythroderma is applied when erythema is a conspicuous clinical feature, but distinction from exfoliative dermatitis is arbitary and these two terms are regarded as synonyms. Some of the recognized aetiological factors are exacerbation of an existing dermatoses, drugs and reticulosis. Incidence of exfoliative dermatitis in this country appears to be on the increase, but very little work has been done particularly with regard to aetiology of the disease. Hence, most of the cases of exfoliative dermatitis which are labeled as idiopathic, may at a later stage manifest certain reticulosis. The present study was undertaken to find out the causes which lead to this disorder.

Material and Methods

Thirty patients (22 male and 8 female) with erythroderma were taken up for the study. All the patinets were hospitalized. A detailed history was taken and following investigations were performed Complete haemogram, serum proteins, total and differential, liver and renal function tests, routine and microscopic urine tests, peripheral blood smear for abnormal cells, X-ray chest, skin and lymph node biopsies. Bonemarrow examination by sternal puncture was done in 2 cases.

Results

The disease was observed maximally in the 5th decade followed by 6th decade of life. Mean age of incidence is 51.5 years. [Table - 1] Incidence of exfoliative dermatitis was more in males than females.

In the present series, the cases could be classified according to the causative factors as shown in [Table - 2].

Nail changes like pitting, subungual hyperkeratosis were noted in most of the cases of Psoriatic Erythroderma. Psoriatic Erythroderma (40%) accounted for the bulk of exfoliative dermatitis. None of the 12 cases of psoriatic erythroderma had a known precipitating factor. The exfoliative dermatitis secondary to eczema was seen in 6 cases (20%). Ingestion of drugs was responsible for exfoliative dermatitis in 5 patients (16.6%). Malignancy (mycosis fungoides) as a cause of exfoliative dermatitis was found in 2 (6.6%) of our patients.

Oedema of varying severity was seen in 25 cases (83.3%). Hypoalbuminemai, anaemia and inflammation of the skin accounted for oedema. Enlargement of superficial lymph nodes was observed in 19 cases. The involvement was maximum in the inguinal group of glands. Laboratory investigations revealed no significant abnormality excepting in 2 cases in which the peripheral blood revealed presence of a typical lymphocytes (Sezary cells). Histopathology of the skin was helpful in the diagnosis of 25 patients. In 12 patients with psoriatic erythroderma, histopathology was consisten with psoriasis. Six patients of erythroderma showed features consistnet with that of an eczema, while drug-induced erythroderma showed psoriasiform presentation. Presence of Pautrier′s microabscesses in 2 cases implied that the occurrence of exfoliative dermatitis was secondary to mycosis fungoides. Lymph node biopsy in 10 cases was consistent with a diagnosis of dermatopathic lymphadenitis.

Discussion

In detemining the aetiology of the present series of cases of exfoliative dermatitis, history and the physical examination were of great help. Histopathology of skin was of maximum benefit in cases suspected to be related to pre existing dermatosis and internal malignancy. In our series, Commonest cause of exfoliative dermatitis was psoriasis, while internal malignancy constituted the least common cause Similar findings have been reported in other studies[4].

References
1.
Abraham I, McGarthy IT, Saunders IL. One hundred and one cases of exfoliative dermatitis. Arch Dermatol 1963.87:96-101.
[Google Scholar]
2.
Wilson HTH. Exfoliative dermatitis:its etiology and prognosis. Arch Dermatol. Syphilol. 1954,69:577-588.
[Google Scholar]
3.
Sehgal VN, Rege VL. A retrospective study of exfoliative dermatitis. Ind J Dermatol Venerol 1974,40:36.
[Google Scholar]
4.
Singh R, Garg BR. A clinical study of exfoliative dermatitis. Ind J Dermatol 1970,16:11
[Google Scholar]
Show Sections