Erythroderma: a clinico etiological study of 77 patients in a tertiary care centre in Kerala

Authors

  • Abin Abraham Itty Department of Dermatology, Venereology and Leprosy, Kannur Govt Medical College, Pariyaram, Kannur, Kerala, India. Department of Dermatology, Venereology and Leprosy, VPS Lakeshore hospital, Panangad, Kochi, Kerala, India
  • Rajiv Sridharan Department of Dermatology, Venereology and Leprosy, Kannur Govt Medical College, Pariyaram, Kannur, Kerala, India
  • Anoop Thyvalappil Department of Dermatology, Venereology and Leprosy, Kannur Govt Medical College, Pariyaram, Kannur, Kerala, India.
  • Bindurani Sudhamani Department of Dermatology, Venereology and Leprosy, Kannur Govt Medical College, Pariyaram, Kannur, Kerala, India. Department of Dermatology, Venereology and Leprosy, Institute of Integrated Medical Sciences (Government Medical College), Palakkad, Kerala, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20205599

Keywords:

Erythroderma, Histopathology, Psoriasis, Eczema

Abstract

Background: Erythroderma is defined as generalized erythema and scaling of the skin affecting more than 90% of body surface area. Identification of the underlying disease process represents one of the most complex challenges in proper patient care.

Methods: A retrospective study was done in Department of Dermatology in a Tertiary Care Centre. History, clinical findings and investigations of erythroderma patients were recorded and clinic-histopathological correlation was analyzed by kappa coefficient (К).

Results: Erythroderma was more prevalent in elderly males with a mean age of 64.56 years and a male to female ratio of 3:1. A clinical evidence of pre-existing dermatoses was found in 65 patients, commonest being eczema (41.3%) followed by psoriasis (40.3%). Evidence of a trigger was seen in 54.54% patients, commonest being the use of ayurvedic medications (42.8%). Clinico-histopathological correlation was seen in 53.9% cases.

Conclusions: Although the clinical presentation of erythroderma is similar, etiological factors are varied and it depends largely on the population studied. Most commonly, erythroderma is due to generalization of pre-existing dermatoses as seen in our study. Hence careful evaluation of clinical clues and histopathological correlation plays a pivotal role in diagnosis of the primary cause and the effective management of erythroderma.

Metrics

Metrics Loading ...

Author Biographies

Rajiv Sridharan, Department of Dermatology, Venereology and Leprosy, Kannur Govt Medical College, Pariyaram, Kannur, Kerala, India

Professor &HOD, Department of Dermatology, Venereology & Leprosy

Anoop Thyvalappil, Department of Dermatology, Venereology and Leprosy, Kannur Govt Medical College, Pariyaram, Kannur, Kerala, India.

Professor , Department of Dermatology, Venereology & Leprosy

Bindurani Sudhamani, Department of Dermatology, Venereology and Leprosy, Kannur Govt Medical College, Pariyaram, Kannur, Kerala, India. Department of Dermatology, Venereology and Leprosy, Institute of Integrated Medical Sciences (Government Medical College), Palakkad, Kerala, India

Associate Professor, Department of Dermatology,  Venereology and Leprosy

References

Whittaker S. Erythroderma. In: Bolognia JL, Schaffer JV, Cerroni L: Dermatology. 4th edition. Philadelphia: Elsevier Saunders; 2018:213-227.

César A, Cruz M, Mota A, Azevedo F. Erythroderma. A clinical and etiological study of 103 patients. J Dermatol Case Rep. 2016;10:1-9.

Banerjee S, Ghosh S, Mandal RK. A study of correlation between clinical and histopathological findings of erythroderma in North Bengal population. Indian J Dermatol. 2015;60:549-55.

Kalsy J, Puri K. Erythroderma in children: Clinicoetiological study from Punjab. Indian J Paediatr Dermatol. 2013;14:9-12.

Akhyani M, Ghodsi SZ, Toosi S, Dabbaghian H. Erythroderma: A clinical study of 97 cases. BMC Dermatol. 2005;5:5.

Rym BM, Mourad M, Bechir Z, Dalenda E, Faika C, Iadh AM, et al. Erythroderma in adults: A report of 80 cases. Int J Dermatol. 2005;44:731-5.

Hulmani M, Kishore NB, Bhat MR, Sukumar D, Martis J, Kamath G, et al. Clinico-etiological study of 30 erythroderma cases from tertiary center in South India. Indian Dermatol Online J. 2014;5:25-9.

Miyashiro D, Sanches JA. Erythroderma: a prospective study of 309 patients followed for 12 years in a tertiary center. Sci Rep. 2020;10:9774.

Khaled A, Sellami A, Fazaa B, Kharfi M, Zeglaoui F, Kamoun MR. Acquired erythroderma in adults: a clinical and prognostic study. J Eur Acad Dermatol Venereol. 2010;24:781-8.

Mathew R, Sreedevan V. Erythroderma: A clinicopathological study of 370 cases from a tertiary care center in Kerala. Indian J Dermatol Venereol Leprol. 2017;83:625.

Bandyaopadhyay D, Chowdhury S, Roy A. Seventy-five cases of exfoliative dermatitis. Ind J Dermatol. 1999;44:55-7.

Kondo RN, Gon AD, Minelli L, Mendes MF, Pontello R. Exfoliative dermatitis: clinical and etiological study of 58 cases. An Bras Dermatol. 2006;81:233-7.

Pal S, Haroon TS. Erythroderma: a clinico-etiologic study of 90 cases. Int J Dermatol. 1998;37:104-7.

Morar N, Dlova N, Gupta AK, Naidoo DK, Aboobaker J, Ramdial PK. Erythroderma: a comparison between HIV positive and negative patients. Int J Dermatol. 1999;38:895-900.

Bharatiya PR, Joshi PB. Study of exfoliative dermatitis. Indian J Dermatol Venereol Leprol. 1995;61:81-3.

Tan GF, Kong YL, Tan AS, Tey HL. Causes and features of erythroderma. Ann Acad Med Singapore. 2014;43:391-4.

Thatte UM, Rege NN, Phatak SD, Dahanukar SA. The flip side of Ayurveda. J Postgrad Med. 1993;39:179-82.

Downloads

Published

2020-12-24

How to Cite

Itty, A. A., Sridharan, R., Thyvalappil, A., & Sudhamani, B. (2020). Erythroderma: a clinico etiological study of 77 patients in a tertiary care centre in Kerala. International Journal of Research in Dermatology, 7(1), 73–77. https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20205599

Issue

Section

Original Research Articles