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Dermatology
Erythroderma
Built from Dermatology, 5th Edition
What’s inside
12 sections · 95 slides
Overview
- What this topic covers
Definition and Key Features
What counts as erythroderma, and why it is hard to diagnose
- What is erythroderma
- Key features to remember
- Historical perspective
- Erythroderma with desquamation
- Systemic complications overview
Epidemiology and Causes
How common erythroderma is, and what usually causes it
- How common is erythroderma
- Most common causes in adults
- Causes: additional detail
- Uncommon and rare adult causes
- Full differential: causes in adults
- Causes of erythroderma in adults
- Causes of erythroderma in adults (continued)
- Causes of erythroderma in adults (continued)
- Causes of erythroderma in adults (continued)
- Causes of erythroderma in adults (continued)
- Causes of erythroderma in adults (continued)
- Erythroderma in neonates and infants
Pathogenesis
What happens inside erythrodermic skin
- Why the skin sheds so much
- Consequences of protein loss
- Other contributing factors
Cutaneous Manifestations
How erythroderma looks, and how it evolves over time
- Primary vs secondary erythroderma
- How erythema and scaling evolve
- Scale character can hint at the cause
- Additional hand and forearm exfoliation
- Pruritus (itch)
- Pigment, keratoderma, and skin infection
- Nail and hair changes
- Nail pitting and onycholysis
- Other skin findings and eye complications
- Eruptive seborrheic keratoses
Systemic Manifestations
What erythroderma does beyond the skin
- Fluid, heart, and temperature effects
- Chronic systemic effects
- Lymphadenopathy: the key extracutaneous sign
- Working up an enlarged lymph node
Specific Underlying Diseases
The clinical picture of each major cause of erythroderma
- Psoriatic erythroderma
- Psoriatic erythroderma: clinical clues
- Psoriatic erythroderma: clinical appearance
- Psoriatic erythroderma after a drug trigger
- Atopic dermatitis (eczema)
- Atopic erythroderma: clinical appearance
- Drug-induced erythroderma
- Drug reactions: special situations
- Drug reaction is always in the differential
- Drugs associated with erythroderma
- Drugs associated with erythroderma (continued)
- Idiopathic erythroderma
- Idiopathic erythroderma: appearance
- What eventually explains 'idiopathic' cases
- Cutaneous T cell lymphoma (CTCL)
- Sézary syndrome: clinical appearance
- Sézary syndrome: diagnostic criteria
- Erythrodermic mycosis fungoides vs Sézary syndrome
- Pityriasis rubra pilaris (PRP)
- Pityriasis rubra pilaris: appearance
- PRP: islands of sparing (nappes claires)
- Papuloerythroderma of Ofuji
- Paraneoplastic erythroderma
- Bullous dermatoses
- Pemphigus foliaceus: clinical appearance
Erythroderma in Neonates and Infants
A different set of causes, often with a genetic basis
- Inherited ichthyoses
- Netherton syndrome
- Staphylococcal scalded skin syndrome (SSSS)
- Omenn syndrome
- Full differential: causes in neonates and infants
- Causes of erythroderma in neonates and infants
- Causes of erythroderma in neonates and infants (continued)
- Causes of erythroderma in neonates and infants (continued)
- Causes of erythroderma in neonates and infants (continued)
- Causes of erythroderma in neonates and infants (continued)
- Causes of erythroderma in neonates and infants (continued)
- Causes of erythroderma in neonates and infants (continued)
Pathology
What the skin biopsy can, and cannot, tell you
- Value and limits of skin biopsy
- Why repeated biopsies matter
- Histopathology across five causes of erythroderma
Differential Diagnosis
A structured approach to finding the cause
- How to approach the work-up
- Approach to the differential diagnosis of adult erythroderma
- Reading the adult algorithm
- Approach to the differential diagnosis of infantile erythroderma
- Reading the infantile algorithm
Treatment
General supportive care, plus disease-specific management
- Erythroderma is a medical emergency
- Systemic corticosteroids: when and how
- Topical treatment principles
- Treating psoriatic erythroderma specifically
- Treating drug-induced erythroderma
- Treating idiopathic erythroderma
- Treating neonates and children
- Key takeaways
- Diagnostic clues worth remembering
References
Sources cited in this chapter
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Dermatology, 5th Edition (2-Volume Set)