Erythroderma: A Manifestation of Cutaneous and Systemic Diseases

Abstract

Introduction: Erythroderma, or generalised exfoliative dermatitis, is a rare inflammatory disorder characterised by generalised erythema, involving more than 90% body surface area accompanied by a variable degree of scaling. Objectives: This retrospective study aimed to determine characteristics of erythroderma as a marker of cutaneous and systemic disease and to identify the underlying causes of this condition. Materials and methods: Hospitalised patients diagnosed with erythroderma at the dermatology and venereology department of UHC ‘Mother Teresa’ from 2012–2017 were selected for this study. Epidemiological, clinical, laboratory, and histological data of these patients were electronically compiled and analysed using SPSS© software (IBM, Armonk, New York, USA). Results: 116 patients were diagnosed with erythroderma. Of these, 43.1% were female and 56.9% were male. The average age of onset was 55.1 years. A variable hospitalisation period was observed from 1–49 days. Previous episodes of erythroderma were indicated in 11.2% of cases, and 29.3% of cases appeared as emergencies. The most common cause of erythroderma was exacerbation of pre-existing dermatoses, namely psoriasis (53.4%), eczema (3.4%), and dermatitis (10.3%). Drug hypersensitivity reactions were evidenced in 4.3% of cases. In 16.4% of cases, the cause of erythroderma was undetermined. This study demonstrated a high percentage of secondary erythroderma to a pre-existing cutaneous pathology, psoriasis in 53.4% of cases, and a low percentage of primary erythroderma. Conclusions: Erythroderma can be a manifestation of systemic and cutaneous diseases, but mostly erythrodermic psoriasis. Often it presents as a life-threatening emergency. The condition masks the primary pathology lesions, making it difficult to establish the correct diagnosis of the underlying aetiology. However, biopsy provides a positive correlation between clinical findings and anatomopathological diagnosis.