Erythroderma. A clinical and etiological study of 103 patients.
BACKGROUND
Erythroderma is an uncommon and severe dermatological manifestation of a variety of diseases. It is commonly challenging to find the underlying cause.


OBJECTIVE
The aim of this study was to analyze the causes of the disease in patients with erythroderma.


METHODS
Data including the clinical symptoms, laboratory examinations, histopathology and follow-up information were collected from patients with erythroderma admitted to our department between 2000 and 2010.


RESULTS
One-hundred and three patients diagnosed with erythroderma were identified during this period (11.9% of all hospitalized patients; hospital incidence = 9.4 cases/year). The mean age of onset was 54.4 years (range: 17-89 years) with a male:female ratio of 1.5:1. The most frequent cause of erythroderma was exacerbation of preexisting dermatoses (65.0%), including psoriasis (44.7%) and eczema (16.5%). Drugs (18.4%) and cutaneous T-cell lymphomas (11.7%) induced most of the remaining cases. No cause could be identified in four cases (3.9%). Apart from erythema and scaling, that were present in all patients, clinical findings were dominated by pruritus (97.1%), followed by edema (56.3%), fever (54.4%), palmoplantar keratoderma (50.5%), nail changes (42.7%), liver or spleen enlargement (41.7%) and lymphadenopathy (40.8%).


CONCLUSIONS
Although numerous clinical features and laboratory values were abnormal, most findings were non-specific. The skin biopsy yielded a positive clinical correlation in most cases. Our study had a high percentage of erythroderma secondary to preexisting skin disease and a relatively low percentage of idiopathic erythroderma.
Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Porto, Portugal; ; Faculty of Medicine, University of Porto, Portugal.
Artur
A
César
Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Porto, Portugal; ; Faculty of Medicine, University of Porto, Portugal.
Maria
M
Cruz
Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Porto, Portugal; ; Faculty of Medicine, University of Porto, Portugal.
Alberto
A
Mota
Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Porto, Portugal;
Filomena
F
Azevedo
dermatitis; erythroderma; exfoliative; psoriasis