Erythroderma

Question 1

Age of onset and M/F predominance?

Answer 1

• M>F, average age=50

Question 2

Clinical features:

Answer 2

• erythema and scale involving >90% BSA!!!
• pruritus (>90% of its)
• lichenification (>30%)
• dyspigmentation (>50%)
• nail changes (40%)- shiny nails

Question 3

Other skin findings in erythroderma besides erythema?

Answer 3

• S. aureus colonization
• eruptive SK’s
• ectropion
• conjunctivitis

Question 4

Number 1 systemic finding?

Answer 4

• Peripheral LAD

Question 5

which other systemic findings can be present besides peripheral LAD?

Answer 5

• hepatomegaly (20%)
• pedal/pretibial edema (50%)
• tachycardia (40%)
• thermoregulatory disturbances
• anemia

Question 6

Most common cause of erythroderma in healthy patients?

Answer 6

psoriasis

Question 7

In psoriasis patients, erythroderma is usually due to ____

Answer 7

• drug withdrawal (rapid d/c of CS, MTX, or CSA)

Question 8

Atopic dermatitis patients with erythroderma have these clinical symptoms

Answer 8

• severe pruritus and lichenification

Question 9

Atopic dermatitis patients with erythroderma have increased _____

Answer 9

• serum IgE and eosinophilia

Question 10

Most common cause of erythroderma in HIV patients?

Answer 10

Drugs (HAART)

Question 11

Drug induced erythroderma has _____ duration lasting ____ long after withdrawal of drug

Answer 11

• shorter

- 2-6 weeks

Question 12

Most common drugs causing erythroderma?

Answer 12

• allopurinol
• anti epileptics
• sulfa
• HAART
• these drugs turn patients to AASH

Question 13

What are the causes of erythroderma?

Answer 13

• psoriasis (most common)
• atopic derm
• drugs
• idiopathic (elderly men w/ relapsing course)
• CTCL (sezary and erythrodermic MF)- see pg 66 for more
• PRP
• GVHD

Question 14

Idiopathic erythroderma occurs in which population? and has a clinical course that is ____

Answer 14

• elderly men

- relapsing course

Question 15

Treatment for erythroderma

Answer 15

• nutritional assessment, fluid and electrolyte correction, prevention of hypothermia, treatment of secondary infections
• tailor treatment to underlying condition (sedating antihistamines, topical or systemic CS, wet dressings, emollients)

Question 16

Difference between erythroderma from sezary syndrome vs erythrodermic MF?

Answer 16

• Sezary syndrome is primary erythroderma whereas MF is secondary simply due to progression of classic MF patches.