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Drug Eruptions and Erythroderma

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Cutaneous Drug Eruptions

Abstract

Erythroderma, also known as generalized exfoliative dermatitis, manifests as widespread scaling and erythema of most of the body’s cutaneous surface. Other than an apparent predilection for males, the disease occurs no more or less commonly in any other specific subsets of the population. Its etiology is highly variable, although the most common cause is a drug eruption, flare of a pre-existing dermatologic condition or lymphoma or other cancer. It may occur secondary to systemic use or topical application of the medication. Other causes may include infections, particularly in immunocompromised patients, excessive exposure to solar radiation while taking photosensitive drugs, and malignancy. Erythroderma is potentially life threatening, due to the severe associated hemodynamic and metabolic complications. The diagnosis of this disease is made clinically. Histological findings tend to be non-specific. Treatment of hemodynamic instability should be given precedence to reduce mortality, followed by rapid identification of the underlying cause of disease, as this relates directly to the prognosis of the condition as well as the likelihood of resolution from cessation of the offending agent or treatment of the underlying disease.

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Suggested Reading

  • Akhyani M, Ghodsi ZS, Toosi S, Dabbaghian H. Erythroderma: a clinical study of 97 cases. BMC Dermatol. 2005;5(1):5.

    Article  PubMed Central  PubMed  Google Scholar 

  • Botella-Estrada R, Sanmartin O, Oliver V, Febrer I, Aliaga A. Erythroderma: a clinicopathological study of 56 cases. Arch Dermatol. 1994;130(12):1503–7.

    Article  CAS  PubMed  Google Scholar 

  • Grant-Kels JM, Bernstein M, Rothe MJ. Exfoliative dermatitis. In: Wolff K, Goldsmith S, Gilchrest B, Paller A, Leffell D, editors. Fitzpatricks dermatology in general medicine. New York: McGraw Hill; 2008. p. 1068–87.

    Google Scholar 

  • Hasan T, Jansén CT. Erythroderma: a follow-up of fifty cases. J Am Acad Dermatol. 1983;8(6):836–40.

    Article  CAS  PubMed  Google Scholar 

  • Hengee UR, Ruzicka T, Schwartz RA, Cork MJ. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006;54:1–16.

    Google Scholar 

  • Husain Z, Reddy BY, Schwartz RA. DRESS syndrome: part I. Clinical perspectives. J Am Acad Dermatol. 2013;68:693–705.

    Google Scholar 

  • Husain Z, Reddy BY, Schwartz RA. DRESS syndrome: part II. Management and therapeutics. J Am Acad Dermatol. 68:709–717.

    Google Scholar 

  • Janniger CK, Gascón P, Schwartz RA, Hennessey PN, Lambert WC. Erythroderma as the initial presentation of the acquired immunodeficiency syndrome. Dermatologica (Basel) 1991;183:143–5.

    Google Scholar 

  • King Jr LE, Dufresne Jr RG, Lovett GL, Rosin MA. Erythroderma: review of 82 cases. South Med J. 1986;79(10):1210–5.

    Article  PubMed  Google Scholar 

  • Krasowska D, Szymanek M, Schwartz RA, Myśliński W. Cutaneous effects of the most commonly used antidepressant medication, the selective serotonin reuptake inhibitors. J Am Acad Dermatol. 2007;65(6):848–53.

    Article  Google Scholar 

  • Okoduwa C, Lambert W, Schwartz R, Kubeyinje E, Eitokpah A, Sinha S, et al. Erythroderma: review of a potentially life-threatening dermatosis. Indian J Dermatol. 2009;54(1):1–6.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pal S, Haroon TS. Erythroderma: a clinico‐etiologic study of 90 cases. Int J Dermatol. 1998;37(2):104–7.

    Article  CAS  PubMed  Google Scholar 

  • Rothe MJ, Bialy TL, Grant-Kels JM. Erythroderma. Dermatol Clin. 2000;18(3):405–15.

    Article  CAS  PubMed  Google Scholar 

  • Rubins A, Hartmane I, Lielbriedis Y, Schwartz R. Therapeutic options for erythroderma. Cutis. 1992;49(6):424–6.

    CAS  PubMed  Google Scholar 

  • 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(9):731–5.

    Article  PubMed  Google Scholar 

  • Schwartz RA, Leevy CM, Cohen PJ, Lambert WC. Erythroderma and fulminant hepatitis: a possible association. Cutis 1986;37:56–8.

    Google Scholar 

  • Schwartz RA, McDonough PH, Lee BW. Toxic epidermal necrolysis: part I. Introduction, history, classification, clinical features, systemic manifestations, etiology, and immunopathogenesis. J Am Acad Dermatol. 2013;69:173–84.

    Google Scholar 

  • Schwartz RA, McDonough PH, Lee BW. Toxic epidermal necrolysis: part II. Prognosis, sequelae, diagnosis, differential diagnosis, prevention, and treatment. J Am Acad Dermatol. 201369: 187-202;69:187–202.

    Google Scholar 

  • Sehgal V, Srivastava G. Exfoliative dermatitis: a prospective study of 80 patients. Dermatologica. 1986;173(6):278–84.

    Article  CAS  PubMed  Google Scholar 

  • Sehgal VN, Srivastava G, Sardana K. Erythroderma/exfoliative dermatitis: a synopsis. Int J Dermatol. 2004;43(1):39–47.

    Article  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Sigurdsson V, Toonstra J, Hezemans-Boer M, van Vloten WA. Erythroderma: a clinical and follow-up study of 102 patients, with special emphasis on survival. J Am Acad Dermatol. 1996;35(1):53–7.

    Article  CAS  PubMed  Google Scholar 

  • Sigurdsson V, Toonstra J, van Vloten W. Idiopathic erythroderma: a follow-up study of 28 patients. Dermatology. 1997;194(2):98–101.

    Article  CAS  PubMed  Google Scholar 

  • Thestrup-Pedersen K, Halkier-Sørensen L, Søgaard H, Zachariae H. The red man syndrome: exfoliative dermatitis of unknown etiology: a description and follow-up of 38 patients. J Am Acad Dermatol. 1988;18(6):1307–12.

    Article  CAS  PubMed  Google Scholar 

  • Wilson DC, Jester JD, King Jr LE. Erythroderma and exfoliative dermatitis. Clin Dermatol. 1993;11(1):67–72.

    Article  CAS  PubMed  Google Scholar 

  • Wilson HT. Exfoliative dermatitis: its etiology and prognosis. AMA Arch Derm Syphilol. 1954;69(5):577–88.

    Article  CAS  PubMed  Google Scholar 

  • Zip C, Murray S, Walsh NM. The specificity of histopathology in erythroderma. J Cutan Pathol. 1993;20(5):393–8.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Yuri T. Jadotte MD .

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Jadotte, Y.T., Schwartz, R.A., Karimkhani, C., Boyers, L.N., Patel, S.S. (2015). Drug Eruptions and Erythroderma. In: Hall, J., Hall, B. (eds) Cutaneous Drug Eruptions. Springer, London. https://doi.org/10.1007/978-1-4471-6729-7_23

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  • DOI: https://doi.org/10.1007/978-1-4471-6729-7_23

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6728-0

  • Online ISBN: 978-1-4471-6729-7

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