Exfoliative erythroderma syndrome

Question 1

age sex

Answer 1

AGEOFONSET Usually>50years;inchildren, EESusuallyresults romatopicdermatitis. SEX Males > emales

Question 2

50% have a prior existing dermatosis most frequent are

Answer 2

Some50%o patientshaveahistoryo preex- istingdermatosis.Most requentarepsoriasis, atopic dermatitis, adverse cutaneous drug reactions, cutaneous -cell lymphoma (C CL), allergic contact dermatitis, seborrheic derma- titis and pityriasis rubra pilaris.

Question 3

manif

Answer 3

ever, pruritus, atigue, weakness, anorexia, weight loss, malaise, eeling cold, and shivers. APPEARANCEOFPATIENT Frightened,red,“toxic,” maybemalodorous.
SKINLESIONS Skinisred,thickened,andscaly
T ickening leadstoexaggeratedskin olds(Figs.8-2and 8-3); scaling may be ne and branny, and may be barely perceptible (Fig. 8-2) or large, up to 0.5 cm, and lamellar
Palms and Soles. Usually involved, with mas- sive hyperkeratosis and deep ssures
HAIR elogen e uvium, even alopecia
nails NAILS T ickeningo nailplates,onycholysis, andsheddingo nails

PIGMENTATION InchronicEES,theremaybe hyperpigmentationorpatchylosso pigmentin

Question 4

general examination

Answer 4

Lymph nodes generalized, rubbery, and usually small; enlarged in Sézary syndrome. Edema o lower legs and ankles.

Question 5

labs

Answer 5

CHEMISTRY Low serum albumin and increase in gammaglobulins; electrolyte imbalance; acute- phase proteins increased.
HEMATOLOGY Leukocytosis.
BACTERIALCULTURE Skin: Rule out secondary Staphylococcus aureus in ection. Blood: Rule out sepsis.
DERMATOPATHOLOGY Depends on the type o underlying disease. In all, there is parakeratosis, inter- and intra-cellular edema, acanthosis with elongation o the rete ridges, exocytosis o cells, edema o the dermis, and an in ammatory
in ltrate.
IMAGING C scans or MRI should be used to
ndevidenceo lymphoma. LYMPHNODEBIOPSYWhenthereissuspiciono lymphoma.

Question 6

tx

Answer 6

hospitalized in a single room where conditions (hot and cold) should be adjusted to the patient’s needs; most of en, these patients need a warm room with many blankets. TOPICAL Water baths with added bath oils,
ollowed by application o bland emollients. SYSTEMIC Oral glucocorticoids or remission

Antibioticsi thereisbacteremiaor septicemia.
SUPPORTIVE Supportive cardiac, uid, elec- trolyte, and protein replacement therapy as required.