What Is Erythroderma?

Red skin disease, also known as exfoliative dermatitis, is a serious systemic disease. It is generally believed that erythroderma and exfoliative dermatitis are the same disease. The former is characterized by extensive erythema infiltration accompanied by pityriasis desquamation, while the latter Extensive edema erythema, accompanied by a large amount of desquamation. Skin involvement area 90% is a prerequisite for the diagnosis of this disease.

Basic Information

nickname

Exfoliative dermatitis

English name

Erythroderma

Visiting department

dermatology

Common locations

whole body

Common causes

Caused by the deterioration of psoriasis, eczema, seborrheic dermatitis, pityriasis furuncle, lichen planus and lymphoma, and other malignant tumors, etc.

Common symptoms

Diffuse flushing, infiltration, swelling, desquamation, etc.

Causes of erythroderma

Common reasons may be:

1. Psoriasis, eczema, seborrheic dermatitis, red pityriasis, and lichen planus are caused by deterioration.

2. Lymphoma and other malignant tumors, such as mycosis fungoides, Hodgkin's disease, malignant lymphoma, and leukemia, can cause erythroderma, with a severe prognosis.

3. Caused by drug allergy.

4. Other causes, including pemphigoid pemphigus, Norwegian tincture, dermatomyositis, or sarcoidosis.

5. Unexplained.

Clinical manifestations of erythroderma

According to the onset and course of disease are divided into acute and chronic erythroderma.

Most of the patients caused by drug allergies are acute, and their condition is more serious. The initial rash can be scarlet fever-like or measles-like. The rash rapidly expands, fuses, and spreads throughout the body to form exfoliative dermatitis.

The typical manifestation of erythroderma is diffuse flushing, infiltration, swelling, and desquamation of the skin throughout the body, and the affected area of skin lesions has reached more than 90% of the entire skin. Even the internal organs are affected.

Mucosal symptoms

It is more obvious that ocular conjunctivitis, blepharitis, keratitis, corneal ulcers, oral swelling, ulcers, pain, and symptoms worsen when swallowed. The mucous membranes of the vulva, urethra, and anus are often eroded with secretions.

2. Skin appendages

Hair loss, sparse hair in the light, and extensive shedding in the heavy. The more severe the condition, the more obvious hair loss, and the hair can regenerate when the condition recovers. Finger (toe) nails can appear atrophy, turbidity, depression, etc., especially the most significant changes in nails caused by psoriasis erythroderma.

3. Lymph node enlargement

Two-thirds of erythrodermic patients have varying degrees of lymphadenopathy, with groin and axillary lymph nodes most likely to be affected, followed by the neck.

4. Hepatosplenomegaly

One-third to two-thirds of patients are accompanied by hepatosplenomegaly. Red skin disease caused by drug allergy and lymphoma, liver and spleen enlargement are more likely. If there is significant hepatosplenomegaly, malignant lymphoma should be considered.

5. Increased body temperature

Under normal circumstances, the body's heat production and heat dissipation process maintains a dynamic balance. Patients with erythrodermic disease can cause fever to varying degrees due to absorption of toxins and dysfunction of skin heat dissipation. The temperature of most patients is between 38 ° C and 39 ° C. If the fever is high, symptoms of poisoning are obvious, and concurrent infections should be considered.

6. Hemodynamic changes

Patients with erythrodermic disease may have elevated jugular vein pressure, hepatomegaly, depressed edema of the lower limbs, and increased heart rate. These symptoms worsen as the skin lesions worsen, and they alleviate as the skin symptoms improve. If it is an elderly patient, or a patient with hypertension or coronary heart disease, the heart function is poor and hemodynamic changes occur, which can cause heart failure and even death.

7. Endocrine changes

There are a few male patients with feminization of the breast, testicular atrophy, and reduced sperm. Women can cause menstrual disorders, breast tissue hyperplasia, and abnormal sex hormones and their metabolites.

Red skin disease diagnosis

Diagnosis is mainly based on typical clinical manifestations, medical history, histopathological examination, and response to treatment. A skin biopsy can help exclude Sézary syndrome (systemic pruritus, paroxysmal sweating, skin thickening, psoriasis-like or eczema-like skin lesions), and other malignant lesions. When the lymphadenopathy is obvious, it indicates the possibility of lymphatic malignancy.

Red skin disease treatment

Systemic treatment

(1) Etiology treatment Try to find the cause and conduct appropriate treatment for different causes.

(2) Supportive treatment Give a high-protein diet, supplement a variety of vitamins, and maintain water and electrolyte balance. Antibiotics should be applied promptly when infected.

(3) Hormonal therapy can relieve symptoms and shorten the course of disease. Prednisone can be used orally, and dexamethasone can be used intravenously in severe cases.

(4) Avi A, methotrexate, tripterygium can be used for psoriasis and erythroderma caused by pityriasis hair, in order to reduce the amount of hormones and benefit the treatment of the primary disease.

(5) Antihistamines have sedative and antipruritic effects. Those with obvious itching can be used. The principle of local treatment is to stop itching and protect the skin from infection.

Local treatment

(1) Those with obvious erosion and exudation should be wet-packed with 3% boric acid.

(2) Powders, lotions, creams and ointments can be used for dry parts, such as calamine lotion, zinc oxide oil and various corticosteroid ointments.

(3) Eye, mouth and vulva damage should be given corresponding care.

3. Causes of drug allergies

Give large doses of corticosteroids as early as possible to control the condition as soon as possible, and external medicine should be as simple as possible, and avoid using high concentration or irritating drugs.

4. Prevention of infection

Strengthen care to prevent secondary infections.

5. Topical medication

Decide on topical treatments based on skin conditions.

Erythrodermic prevention

1. Avoid drug abuse, do not use strong drugs for patients with other skin diseases in the acute stage.

2. Eat high protein foods, eat more fruits and vegetables, avoid alcohol and spicy spicy food.

3. For dermatosis caused by drug allergy, care should be taken in the selection of medication during treatment to avoid cross-allergic reactions.

4. Pay attention to the cleanliness of the skin and maintain a good environment, such as air circulation, regular space disinfection, cleaning of bedding, etc., especially the care of the mouth, eyes, and vulva.