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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