Papuloerythroderma L30.8

Ofuji et al., 1984

Rare, large-surface, maculo-papular, considerably pruritic, exanthematous skin manifestation with a tendency to confluence and possibly erythroderma, with blood eosinophilia, leukopenia and IgE elevation. Entity of the clinical picture was controversial for a long time.

Unknown.

Types of eosinophilic dermatitis.

Associations with underlying malignancies such as cutaneous T-cell lymphoma, leukemias (Wick MR et al. 2019), and gastrointestinal tumors as well as infections(strongyloidosis) have been described.

Mainly occurring in Asians, rarely in Caucasians. It is particularly pronounced in adults and is preferred in older men (mean age of the disease: approx. 72 years).

Mainly localized in lateral parts of the trunk and extremities. Face, palmae and plantae are free.

Appearance of intensely itchy, flat, smooth (typically non-scaly), bright red to brownish-red papules that coalesce into large nummular plaques. The development of erythroderma is typical as the disease progresses. In cases with a nearly erythrodermic presentation, the absence of erythema in the transverse skin folds of the abdomen is described as a key diagnostic feature (“deck-chair sign”).

Less common are psoriasiform skin lesions, which may primarily be interpreted as an exacerbation of pre-existing psoriasis (Hauptman M et al. 2026). 

Note! The“deck-chair sign” is meant to resemble solar dermatitis on the abdomen, as it occurs in the typical deck-chair position (skin folds remain skin-colored and do not turn red).

(No uniform pattern is expected): superficial perivascular dermatitis with acanthosis, spongiosis, parakeratosis, and marked histoeosinophilia.

Hypereosinophilic Dermatitis

Exacerbated Psoriasis  

If necessary, therapy of the underlying disease.

Good results have been achieved with methotrexate (Qureshi F et al. 2020).

Try PUVA therapy.

Otherwise caring external measures.

1. Aste N et al. (2000) Ofuji papuloerythroderma. J Eur Acad Dermatol Venereol 14: 55-57
2. Desai K et al. (2021) Ofuji's papuloerythroderma. Clin Dermatol 39:248-255. Desai K et al. (2021) Papuloerythroderma of Ofuji. Clin Dermatol 39:248–255.
3. de Vries HJ et al. (2002) Ofuji papuloerythroderma associated with Hodgkin’s lymphoma. Br J Dermatol 147: 186–187
4. Hauptman M et al. (2026) Paraneoplastic Papuloerythroderma of Ofuji Masquerading as Worsening Psoriasis. Psoriasis (Auckl) 16:608704.
5. Michel S et al. (1999) Ofuji papuloerythroderma: Bath PUVA therapy. Hautarzt 50: 360–362
6. Ofuji S, Furukawa F, Miyachi Y, Ohno S (1984) Papuloerythroderma. Dermatologica 169: 125–130
7. Qureshi F et al. (2020) Methotrexate for Ofuji’s papuloerythroderma. Clin Exp Dermatol 45:241–243.
8. Wick MR et al. (2019) Cutaneous paraneoplastic syndromes. Semin Diagn Pathol 36:211–228.
9. Wong C et al. (2003) Papuloerythroderma of Ofuji associated with acute myeloid leukemia. Clin Exp Dermatol 28: 277–279