A Clinico-epidemiologic Study of 75 Cases of Erythroderma

Bae, You In; Yun, Sook Jung; Lee, Jee Bum; Kim, Seong Jin; Lee, Seung Chul; Won, Young Ho

Abstract

BACKGROUND: Erythroderma, a generalized exfoliative dermatitis, is a rare but easily recognized skin condition with the potential for serious outcomes. Various conditions may be associated with the development of erythroderma.
OBJECTIVE
The purpose of this study was to evaluate the prevalence, clinical, laboratory, histopathological findings and evolution of erythroderma and classify the various causes of the disease.
METHODS
We reviewed medical records, skin biopsy results and clinical photos of 75 patients diagnosed with erythroderma from 1984 to 2006.
RESULTS
The male-female ratio was 2.4:1. The mean age at diagnosis was 57 years. 26 out of 75 patients (34.7%) had a history of drug ingestion and a preexisting dermatosis. Nineteen patients (25.3%) remained undetermined. Four patients (5.3%) had concomitant malignancies. In the dermatosis induced group, 10 patients (38.4%) had psoriasis as a possible causative dermatologic disease. Fever (> or =38degrees C) was seen in 28% of patients. Laboratory abnormalities were seen in the order of leukocytosis, eosinophilia, elevated IgE level (>500 IU/ml), elevated erythrocyte sedimentation rate (ESR), elevated lactate dehydrogenase (LDH). There was a significant difference in the proportion of patients showing complete remission to treatment among the groups. In the group of patients who had a recent history of drug ingestion, 42% of patients showed complete remission, whereas the remaining groups, especially the group with preexisting dermatosis displayed only 8% of cases resulting in complete remission (p<0.05).
CONCLUSION
In our view, drug use or pre-existing dermatosis induced erythroderma compose the majority of cases. The differences in response rates among groups may give a more realistic estimation of clinical outcome and provide appropriate guidance to clinicians.