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Me > (Ch10) Erythroderma > Flashcards

(Ch10) Erythroderma Flashcards

1
Q

Average age for Erythroderma?

A

52y M>F

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2
Q

Erythroderma BSA?

A

> 80%
1. Primary: erythema and scaling
2. 2ndry: generalization of pre-existing rash

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3
Q

Most common cause Erythroderma?

A

Idiopathic 25%

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4
Q

What could exacerbate Erythroderma?

A

UV radiation or drug ingestion

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5
Q

Causes of Erythroderma in order

A
  1. idiopathic (25%)
  2. dermatitis (24%)
  3. psoriasis (20%)
  4. drug reaction (19%)
  5. CTCL (8%),
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6
Q

Causes of Erythroderma in paediatrics

A

INHERITED ICHTHYOSES
- BCIE/NBCIE
- Netheron syndrome
- Chondrodysplasia punctate (XLD)
- KID, Sjogren-Larsson, trichothiodystrophy
IMMUNODEFICIENCIES
- Omenn syndromen (severe form SCID)
- SCID (eg, complement deficiences)
- Wiskott-Aldrich syndrome
PRIMARY DERMATOSES
- Atopic dermatitis
- Seborrheic dermatitis
- Psoriasis
DRUG REACTION

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7
Q

Causes of Erythroderma
SCALPID

A

S – scabies, seborrheic dermatitis
C – contact dermatitis, CTCL
A – atopic dermatitis; actinic dermatitis
L – lupus, lymphoproliferative
P – psoriasis, pityriasis rubra pilaris
I – immunodeficiency, icthyosis
D – drug, dermatophyte

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8
Q

Pathogenesis of Erythroderma

A

Underlying diseases responsible for various pathogenesis, but, overall:

-↑germinative cells
- ↑mitotic rate

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9
Q

Most common cutaneous and systemic sx of Erythroderma

A

Most common cutaneous sx: Pruritus (90%)

Most common extraxutanous/systemic sx: LAD (50%)

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10
Q

Mention few systemic sx of erythroderma?

A
  1. Lymphadenopathy (50%)
  2. Fluid/electrolyte imbalance
  3. tachycardia
  4. high output cardiac failure
  5. hyponatremic dehydration (esp pediatrics)
  6. Thermoregulation: hyper (37%) > hypo (4%)
  7. Hypermetabolism:cachexia
  8. Anemia (chronic disease)
  9. Acute respiratory distress syndrome
  10. Hepatomegaly
  11. Splenomegaly (rare – seen in lymphoma
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11
Q

Meds causing erythroderma?

A

SPAAAN

ABC GPPS
Allopurinol
Beta-lactams
Carbamazepine
Gold
Phenytoin
Phenobarbitol
Sulfa

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12
Q

Which type of patient are at higher risk of drug induced Erythroderma

A

HIV

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13
Q

Psoriatic erythroderma Rx

A

Cyclosporine
methotrexate
acitretin,
targeted immunomodulators (biologic agents)
AVOID systemic steroids

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14
Q

Drug induced erythroderma Rx

A

Resolve within 2-6 weeks (except some patients with DRESS/DIHS)
prednisone, IVIg

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15
Q

Idiopathic erythroderma Rx

A

low-potency topical corticosteroids
oral antihistamines

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16
Q

Refractory erythroderma Rx

A

CsA 5mg/kg/d  reduced to 1-3mg/kg/d
Methotrexate, azathioprine
Mycophenolate mofetil
Etanercept

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