Erythroderma

Erythroderma in advanced stage

Erythroderma, also known as dermatitis exfoliativa, is a diffuse inflammation of the skin covering more than 90% of the entire body surface. The skin is red with massive peeling. Occurrence is more common between 40 and 60 years of age and slightly more often affects men. The mortality of this disease without timely intervention by doctors reaches up to 40%.

Etiopathogenesis

They contribute to the development of erythroderma

• dermatoses - emergence of generalizations of some dermatoses - psoriasis, eczema, lichen ruber, pemphigus...
• chemical substances - created by the action of drugs and toxic substances - mercury, gold, antibiotics, sulfonamides, lithium, hydantoin...
• infection - scabies, TB, congenital syphilis,
• paraneoplastic phenomenon - a non-specific manifestation of cancer - in the terminal stage was found in solid tumors of the lungs, liver, prostate and GIT,
• specific manifestations of cancer - lymphomas, leukemia, Sézary syndrome (T-lymphoma with erythroderma)...
• idiopathic causes - in up to 20% of cases the cause cannot be found, in the English literature this type is referred to as red man syndrome.

Clinical picture

The clinical picture differs according to the course of the disease, with a division into acute and chronic form of the disease.

The acute form of the disease is characterized by bright red edematous skin with peeling lamellae. The skin sometimes oozes locally and is covered with crusts.

Chronic form is manifested by skin of a dark red color, sometimes stiff with pityriasis-like desquamation.

Complications

Complications can be divided into local and systemic.

Local complications are

• hyperkeratosis of the palms and soles,
• trophic changes on the nails,
• swelling of the eyelids can result in ectropion,
• long-term erythroderma can cause changes in skin pigmentation (brown or white spots),
• itching or burning of the skin,
• secondary infection at the site of urination.

Systemic complications are

• lymphadenopathy,
• anemia, leukocytosis, eosinophilia,
• fever,
• coldness,
• malaise,
• tachycardia,
• fluid loss through broken skin.

Systemic complications can lead to metabolic breakdown of the organism and ultimately to death.

Therapy

Treatment is based on knowledge of the disease causing it. In case of systemic complications, hospitalization with possible symptomatic treatment is necessary - analgesics, antihistamines (against itching), ATB (against secondary infection), corticoids, etc.

Links

Related Articles

• Hyperkeratosis
• Analgesics
• Antihistamines
• Ectropium
• Eczema
• Lichen ruber
• Pemphigus
• Psoriasis
• Scabies
• Sézary Syndrome

References

• Lectures Dermatovenerology 1. Faculty of Medicine, Charles University in Prague
• BURNS, – BREATHNACH, – COX,. Rook's textbook of dermatology. 8. edition. Wiley Blackwell, 2010. 4432 pp. ISBN 9781405161695.

• PIZINGER, Charles. Dermatovenereology. 1. edition. Euroverlag s.r.o., 2012. ISBN 978-80-7177-985-8.

• Erythroderma. DermNet NZ [online]. [feeling. 2015-10-23]. Available from: https://www.dermnetnz.org/topics/erythroderma/
• [online]. [feeling. 2015-10-23]. Available from: https://emedicine.medscape.com/article/1106906-overview
• [online]. [feeling. 2015-10-23]. Available from: https://emedicine.medscape.com/article/1106906-treatment