Niña A. Gabaton, MD, DPDS, Daisy K. Ismael, MD, FPDS
Introduction: Exfoliative dermatitis is a potentially life- threatening inflammatory reaction that poses a significant risk for morbidity and mortality. Several underlying etiologies of this dermatologic condition include pre-existing dermatoses, drugs and malignancy. Although it is a common disease entity, local studies on exfoliative dermatitis published in literature are very limited.
Objective: The primary objective of this study is to determine the epidemiological profile of patients with exfoliative dermatitis diagnosed at University of Santo Tomas Hospital Dermatology department from January 2008 to December 2012.
Methods: Inpatient and outpatient clinical records of patients diagnosed and treated as exfoliative dermatitis were retrieved. The prevalence, clinical presentation, history of previous dermatoses or use of any drugs/topical medications, family history and accompanying systemic symptoms were reviewed and analyzed.
Results: A total of 67 patients were included in this retrospective study. The prevalence among patients with exfoliative dermatitis in this study was computed at 1 per 1000 dermatologic patients. The highest number of cases belonged to the group aged seventy-one to seventy-nine (25.4%) with a mean age of 56.62 years. There was a male predilection (65.7%). Clinical presentation of patients included pruritus, generalized scaling and erythema, accompanied by bipedal edema (41.8%), chills (22.4%), fever (T ≥ 38 °C), lymphadenopathies (6%) and joint pains (4.5%). Several etiologic factors of exfoliative dermatitis recorded were: pre-existing dermatosis (67.2%), idiopathic or undetermined causes (19.4%), drug-induced (10.4%) and malignancy (3%).
Conclusion: Exfoliative dermatitis is a condition more commonly found in the older age group. Pre-existing dermatoses, drugs and malignancy are etiologic factors. The most common pre-existing dermatosis causing exfoliative dermatitis in this study is psoriasis while the most implicated drug is allopurinol.
Key words: exfoliative dermatitis, erythroderma, epidemiology
1. Okudawa,C, Lambert WC, Schwartz RA, Kubeyinje E, Eitokpah A. Sinha S, Chen W. Erythroderma: review of a potentially life-threatening dermatosis. Indian J Dermatol 2009;54 (1):1-6.
2. Sehgal V, Srivastava G, Sardana K. Erythroderma/exfoliative dermatitis:a synopsis. Int J of Dermatol 2004; 43(1):39-47.
3. Burton JL, Holden CA.Eczema, lichenification and prurigo. In Text book of Dermatology. Volume 1. 6th ed. Edited by Champion RH, Burton JL, Burns DA, Breathnach SM. Oxford: Blackwell Scientific Publications; 1998:673-8.
4. Valerie G, Nenita A.Cutaneous drug reactions and their causative agents as seen at the Philippine General Hospital Section of Dermatology from January 2001 to March 2003. J Phil Dermatol Soc 2005; 14(1): 49-56.
5. Encarnación LA, Celis-Versoza M. Contact allergy presenting as erythroderma. Dermatitis 2006; 17(1): 45-47.
6. Hortaleza MA, Salta-Ramos N, Barcelona-Tan J,Abad-Venida MLDapsone syndrome in a Filipino man. Lepr Rev 1995;66: 307-313
7. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EZ, et al. A method for estimating the probability of adverse drug reactions. Clinical Pharmacology & Therapeutics 1981; 30(2): 239-245.
8. Botella-Estradas R, Sanmartin O, Oeiver V, Febrer I, Aliaga A. Erythroderma – a clinical pathological study of 56 cases. Arch Dermatol 1994; 130: 1503-1507.
9. Sigurdsson V, Steegmans PH, van Vloten WA. The incidence of erythroderma: a survey among all dermatologists in the Netherlands. J Am Acad Dermatol 2001;45(5):675-8.
10. Pal S, Haroon TS: Erythroderma: a clinico-etiologic study of 90 cases. Int J Dermatol 1998; 37:104-7.
11. Morar N, Dlova N, Gupta AK, Naidoo DK, Aboobaker J, Ramdial PK: Erythroderma: a comparison between HIV positive and negative patients. Int J Dermato 1999; 38(12):895-900.
12. Pruszkowski A, Bodemer C, Fraitag S, Teillac-Hamel D, Amoric JC, de Prost Y. Neonatal and infantile erythrodermas: a retrospective study of 51 patients. Arch Dermatol 2000;136(7):875-80.
13. Yuan X, Guo JY, Dang YP, Qiao L, Liu W. Erythroderma: a clinico-etiological study of 82 cases. Eur J Dermatol 2010; 20 (3): 373-7.
14. Akhayani M. Eythroderma: A clinical study of 97 cases. BMC Dermatol 2005; 5:5.
15. Mathew R, Sreedevan V. Erythroderma: A clinicopathological study of 370 cases from a tertiary care center in Kerala. Indian J Dermatol Venereol Leprol 2017;83:625-625
Authors: Katrina Carmela M. Belen, MD, DPDS, Jasmin J.Jamora, MD, FPDS , Ma. Cecilia P. Ingente MD, DPDSAbstractBackground: Dermoscopy, a non-invasive diagnostic tool, has been proven to improve the diagnostic accuracy of vascular tumors since it can aid in...
A randomized, double-blind, comparative study on the safety and efficacy of virgin coconut (Cocos nucifera l.) oil against 1% hydrocortisone lotion as an anti-inflammatory and antipruritic preparation for mosquito reactions
Authors: Uy, Veronica S, MD; Gracia B. Teodosio, MD, FPDS; Ma. Teresita G. Gabriel, MD, FPDS; Mary Catherine T. Galang, MD; Mohammad Yoga A. Waskito, MD; Johannes F. Dayrit, MD, FPDS Abstract Background: Virgin coconut oil (VCO) has been reported...
Primary Cutaneous Anaplastic Large Cell Lymphoma (PC-ALCL) is a rare Non-Hodgkin lymphoma (NHL) representing approximately 9% of all cutaneous lymphomas.3 It usually manifests as a slow-growing, solitary tumor which has a tendency to regress spontaneously. However, metastasis is reported in 5-10% of cases.