Exfoliative dermatitis: A 7-year retrospective study in Ramathibodi Hospital
Keywords:
exfoliative dermatitis, erythroderma, clinicopathological, prognosisAbstract
Background: Exfoliative dermatitis or erythroderma is an inflammatory skin disorder that may be caused by various diseases and medications.
Objectives: To determine the cause, clinicopathological features and prognosis of these patients in Ramathibodi Hospital.
Materials and Methods: We reviewed the clinical, laboratory, biopsy materials and follow-up data of 38 patients diagnosed with exfoliative dermatitis in Ramathibodi hospital over 7-year periods (2004 through 2010).
Results: The male to female ratio was 3:1. The mean age at diagnosis was 65 years. The two most common etiologies were drug eruption (47.3%), followed by pre-existing dermatosis (36.8%). Cutaneous T-cell lymphoma was found in one case. The cause of the erythroderma could not be determined in 13% of the cases. The onset of the disease was usually insidious except in drug-induced exfoliative dermatitis. In the drug-induced group, anti-tuberculosis drug was the most offending drug (27.8%). In the pre-existing dermatosis group, psoriasis is the most common etiology (64%). Scaling, erythema and pruritus were found in all patients. Nail involvement was found mostly in cases with pre-existing dermatosis. Eosinophilia and hypoalbuminemia were common findings, which presented in more than 50% of the patients.
Abnormal liver function tests occurred more commonly in the drug-induced group. Histopathology was mostly unrewarding. A clinicopathologic correlation was present only in psoriasis, eczema and cutaneous T-cell lymphoma. Follow-up data was obtained in 26 patients. Most of the patients improved after treatment (69%). Small group of the patients were still unchanged (15%) and 4 patients died from another causes unrelated to the erythroderma.
Conclusion: This study outlines the underlying etiology of exfoliative dermatitis, which had a high percentage of drugs and pre-existing dermatosis. Histopathology were non-specific in most of the cases. The prognosis of most patients is relatively good.
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เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใดๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นลิขสิทธิ์ของวารสารฯ หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใดๆ จะต้องได้รับอนุญาตเป็นลายลักอักษรจากบรรณาธิการวารสารโรคผิวหนังก่อนเท่านั้น
