Erythroderma; exfoliative dermatitis; L53.92

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Erythrodermy

History
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Hebra, 1868

Definition
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Erythroderma is a descriptive term for a universal redness (dermatitis) of the skin (affection of > 90% of the skin organ), mostly with pronounced scaling, intense itching (> 90% of the patients), rarely with weeping. Erythroderma is a severe inflammation of the skin with serious effects on the whole organism. A conclusion on an underlying disease cannot be deduced from the erythrodermal condition per se.

Patients with neonatal erythrodermia must be regarded as special clinical cases, as this condition is potentially life-threatening in newborns and young infants due to heat loss, transepidermal water loss, danger of transcutaneous infection.

Classification
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Erythrodermias are distinguished into primary (development de novo) and secondary erythrodermias (development at the bottom of a pre-existing dermatological disease).

Occurrence/Epidemiology
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The epidemiological data on erythroderma are unreliable. They vary between 0.9/100,000 for Europe and 35/100,000 in India.

Manifestation
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Gender distribution: Women are affected twice as often as men. Average age of the disease: 50 - 60 years.

Histology
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The diagnostic value of a histological examination must be considered in a differentiated way. Often the histological result is uncharacteristic. In the case of congenital erythroderma, the histological examination may be diagnostically groundbreaking. Lymphomas of the skin can be clearly diagnosed. In the case of secondary erythroderma, indications of the underlying disease may be found.

Important: an important prerequisite for a histological examination is a long-term discontinuation of any therapy with glucocorticoids (external as well as internal).

Complication(s)
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For the skin and the entire organism erythroderma is a considerable burden, independent of the underlying disease, especially due to:
  • Significantly increased skin circulation with consecutive cardiovascular stress.
  • Excessively increased heat radiation (constant freezing of the patient).
  • Disruption of the skin barrier with increased loss of fluid.
  • Increased desquamation with increased loss of albumin and proteins.
  • Non-specific disturbance of the immunological defence with increased tendency to infections.

Therapy
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According to the underlying disease.

Literature
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  1. Borrás-Blasco J et al (2001) Erythrodermia induced by omeprazole. Int J Clin Pharmacol Ther 39:219 w23.
  2. Iliescu V et al.(1997) Erythrodermia sézary with immunological deficiency and antibodies against human albumin. Acta Med Scand 197(1-2):141-144. Kiessling W et al.(1959) Melano-erythrodermia with cachexia. Arch Klin Exp Dermatol 208:579-591.
  3. Mori S et al (1988) Postoperative erythrodermia (POED), a type of graft-versus-host reaction (GVHR)? Pathol Res Pract 184:53-59.
  4. O'DONOVAN WJ (1950)Exfoliative erythrodermia with lymphadenopathy. Proc R Soc Med. 43:563-564.
  5. Oztas P et al (2006) Imatinib-induced erythrodermia in a patient with chronic myeloid leukemia. Acta Derm Venereol 86:174-175.
  6. Sequeira JH (1919) Case of Erythrodermia with Lymphatic Leukaemia. Proc R Soc Med.12(Dermatol Sect):54-56.
  7. Wigley JE (10947) Exfoliative erythrodermia with marked pigmentation. Proc R Soc Med 40:246-247.

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Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020