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exfoliative erythroderma
A generalized dermatitis (eczema); chronic cutaneous failure.
Etiology:
1) all forms of dermatitis (eczema)
a) contact dermatitis
b) atopic dermatitis
c) seborrheic dermatitis
d) stasis dermatitis
2) psoriasis
3) hypersensitivity reactions
4) cutaneous T-cell lymphoma (Sezary syndrome)
5) other lymphomas
6) other malignancies
Epidemiology:
1) generally occurs in adults over 50 years of age
2) more common in men
Pathology:
1) arteriovenous shunting of blood to the skin
2) loss of body heat
3) non-specific thickening of the epidermis with some spongiosis
Clinical manifestations:
1) diffuse desquamative erythema (often scaling) interspersed with lesions of underlying condition
2) fever/chills (difficulties with thermoregulation)
3) lymphadenopathy
Complications:
1) difficulty regulating body temperature
2) systemic sequelae
a) high-output cardiac failure
b) anemia of chronic disease
c) general debilitation
Management:
1) aggressive topical & systemic corticosteroids
2) systemic therapy of underlying etiology
3) underlying etiology may become apparent after some improvement in the dermatitis
General
dermatitis
syndrome
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 94