ERITRODERMAPresented by:

Nadira Wulandari LasimpalaMukhisal Aqni

Asnita

Advisor:dr.Shinta Novianti Barnas

Supervisor:dr.Sri Ramayani,Sp.KK

Dermatology and Venerology DepartmentFaculty of Medicine

Hasanuddin University2011

INTRODUCTIONErythroderma is a generalized deep

redness of the skin involving more than 90 percent of the body surface

The incidence: 0.9 to 71.0 per 100,000 outpatients

Males > females (Ratio= 2-4:1 )The average age of disease onset varies

from 41 to 61 years old

ETIOLOGY Drug eruption Wide range of cutaneous

disease Systemic disease

PATOPHISIOLOGYUnclearThe mechanisms by which an underlying

disease manifests as erytrodermaRecent research on the immunopathogenesis

of toxin-mediated infection demonstrates staphylococcal pathogenicity islands encoding superamigens

CLINICAL FINDINGSWide range of cutaneous disease

Eritroderma psoriasis

seborrhoic dermatitis

Continue…

Ptryasis rubra pilaris

Pemfigus Foliasius

WORKUPLaboratory Tests

The most common laboratory abnormalities hypoproteinemia, increased gammaglobulin, leuchositosis, decreased anemia

HistopathologyClinical evaluation in conjunction with multiple skin punch biopsies over timeare required

DIAGNOSIS

Approach to the patient with exfoliative dermatitis. CBC = complete blood cell count; CXR =chest x-ray: PCP =primary care physician

Look for clues to on etiology history and physical examination

Perform multiple punch biopsies; consider multi repeat biopsies in 3-6 months for

increased diagnostic yield

Consider additional tests such as:biopsies for direct immunofluorescence, gene rearrangement, CBC, CD4:CD8 ratio, gene CXR, lymph node

Refer to PCP to rule out systemic disease

Likely diagnosisestablished andtreatment initiated

DIFFERINTIAL DIAGNOSTICAtopic dermatitisPsoriasisSebhorroic dermatitis

TREATMENTfluid and electrolyte replacementAntihistaminesEmollientStop all drugsThe environment should be warm and humidSystemic corticosteroidsTreat underlying disease

COMPLICATIONSHigh-output cardiac failure, cardiogenic

shockCardiac renHipotermia central

PROGNOSISdepending on the underlying etiologyDrug-induced Erytroderma improves with

discontinuation of the offending drug

THANK YOU