Erythroderma: A clinical study of 97 cases

We reviewed the clinical, laboratory and biopsy material of 97 patients diagnosed with erythroderma who were treated in our department over a 6-year period (1996 through 2002).The male-female ratio was 1.85:1. The mean age at diagnosis was 46.2 years. The most common causative factors were dermatoses (59.7%), followed by drug reactions (21.6%), malignancies (11.3%) and idiopathic causes (7.2%). Carbamazepine was the most common drug (57.1%). The best clinicopathologic correlation was found in cutaneous T-cell lymphoma and pityriasis rubra pilaris related erythroderma. Apart from scaling and erythema that were present in all patients, pruritus was the most common finding (97.5%), followed by fever (33.6%), lymphadenopathy (21.3%), edema (14.4%) and hyperkeratosis (7.2%).This study outlines that underlying etiologic factors of erythroderma may show geographic variations. Our series had a high percentage of erythroderma secondary to preexisting dermatoses and a low percentage of idiopathic cases. There was no HIV-infected patient among our series based on multiple serum antibody tests. The clinical features of erythroderma were identical, irrespective of the etiology. The onset of the disease was usually insidious except in drug-induced erythroderma, where it was acute. The group associated with the best prognosis was that related to drugs.Erythroderma or exfoliative dermatitis is a rare skin disorder that may be the result of many different causes. It represents an extreme state of skin irritation involving the whole or most of the skin surface. Because most patients are elderly and skin involvement is widespread, the disease implies an important risk to the life of the patient [1]. Hasan and Jansen estimated the annual incidence of erythroderma to be 1 to 2 per 100,000 patients [2].Sehgal and Strivasta recorded the incidence of erythroderma in a large prospective study from the Indian subcontinent as 35 per 100,000 dermatologic outpatients [3]. The causative factors