Erythroderma: Epidemiology, Clinical Profile and Clinicopathological Correlation in 47 Patients

Abstract

Erythroderma, or generalized exfoliative dermatitis, is a disease characterized by erythema and scaling of greaterthan 90% of the body’s surface. There is paucity of Indian studies over the etiology, clinical profile and its histopathologicalcorrelation. Aims and objectives: To assess the demographic profile, clinical features and histopathological correlation inerythroderma patients. Material and methods: We registered all patients of erythroderma consecutively from January 2013 toDecember 2013. After a thorough history and clinical examination, a provisional clinical diagnosis was made. We performedbiopsy from two representative sites of patient and it was sent for histopathological examination. The slides were examined bytwo pathologists and one dermatologist without any relevant clinical information. The clinical diagnosis was matched with theblinded microscopical diagnosis. Results: The mean age of onset was 54.1 years with a male-to-female ratio of 3.3:1. The mostcommon causes were airborne contact dermatitis (53.2%) followed by psoriasis (21.2%), drug-induced erythroderma (12.7%),chronic actinic dermatitis (2.1%), atopic dermatitis (2.1%), endogenous dermatitis (2.1%), mycosis fungoides (2.1%), lichenoiddermatitis (2.1%) and idiopathic (2.1%). Histopathology was able to provide diagnosis in 32 (68%) patients. Out of these32 patients, microscopical diagnosis was in accordance with clinical diagnosis in 28 patients. Conclusion: Most of the clinicalfeatures of erythroderma are overlapping. Specific and diagnostic features of disease are seen only in a few patients. Repeatedevaluations, close follow-up and skin biopsy are recommended for a better clinical diagnosis and patient care