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At least 19 recordsLinked to original sources
PubMed1999

Exfoliative dermatitis.

Exfoliative dermatitis, also known as erythroderma, is an uncommon but serious skin disorder that family physicians must be able to recognize and treat appropriately. Although the etiology is often unknown, exfoliative dermatitis may be the result of a drug reaction or an underlying malignancy. The approach to treatment should include discontinuation of any potentially causative medications and a search for any underlying malignancy. One of the most common malignancies associated with exfoliative dermatitis is cutaneous T-cell lymphoma, which may not manifest for months or even years after the onset of the skin condition. Hospitalization is usually necessary for initial evaluation and treatment. In the hospital, special attention must be given to maintaining temperature control, replacing lost fluids and electrolytes, and preventing and treating infection. The long-term prognosis is good in patients with drug-induced disease, although the course tends to be remitting and relapsing in idiopathic cases. The prognosis of cases associated with malignancy typically depends on the outcome of the underlying malignancy.

Dermatitis, Exfoliative↗
PubMed1994

Exfoliative dermatitis.

Exfoliative dermatitis or erythroderma is a clinical syndrome characterized by widespread erythema, fine or large scales, and desquamation of a significant portion of the body surface. Appropriate management of the patient during the acute phase of erythroderma requires a firm understanding of the pathophysiology and consequences of this clinical syndrome.

Dermatitis, Exfoliative↗
PubMed1999

Quantitative estimation and recommendations for supplementation of protein lost through scaling in exfoliative dermatitis.

BACKGROUND: Exfoliative dermatitis (ED) can result in protein loss due to scaling causing a negative nitrogen balance. Freedberg and Baden (J Invest Dermatol 1962; 38: 277-284) estimated the amount of scale lost in ED by collecting it in an occlusive suit. Subsequently, the nitrogen content was determined by the Kjeldahl method. The exact amount of protein supplementation in ED, dependent on scale loss, is not well established. As occlusion and hyperthermia caused by the suit can inhibit scaling, the objectives of the present study were to design an alternative method to measure the amount of scale lost, to estimate the protein content of the scale, and to propose suitable recommendations for protein supplementation. METHODS: In 40 patients with ED, the total protein content lost through scaling per day (P) was determined by the following equation: P = TxIxYxX/25x10(4) g, where T is the total body surface area in square meters, I is the percentage area involved in scaling, estimated using computer-aided design (CAD graph), Y is the amount of scale lost per unit area (0.0025 m2) in milligrams, and X is the quantity of protein present in 1 g of scale in milligrams estimated by a spectrophotometer. RESULTS: It was observed that patients with ED secondary to drug reactions, eczema, and psoriasis lost 7.2, 9.6, and 22.6 g of scale with a protein content of 4.2, 5.6, and 12.8 g respectively. The difference in the amount of protein lost in ED secondary to drug reactions and eczema was not statistically significant; however, the protein lost in psoriasis was significant (p < 0.01 to p < 0.05). CONCLUSIONS: ED may increase the daily protein loss by approximately 25-30% in psoriasis and 10-15% in other causes. Standard treatment for ED and protein supplementation based on our recommendations can minimize the adverse effects of a negative nitrogen balance.

Albumins↗
PubMed1980

Sulphone induced exfoliative dermatitis and hepatitis.

Exfoliative dermatitis associated with hepatitis has been reported in leprosy patients taking dapsone in daily dosage of 200 mg daily or more previously. This report concerns a 40 year-old-female who developed exfoliative dermatitis and hepatitis six weeks after starting dapsone in daily dosage of 100 mg for treatment of leprosy. She responded dramatically to administration of corticosteroids.

Adrenal Cortex Hormones↗
PubMed2005

Gallbladder carcinoma presenting as exfoliative dermatitis (erythroderma).

Although exfoliative dermatitis (erythroderma) secondary to malignancy is commonly associated with lymphomas or leukemias, coincident gastrointestinal (GI) malignancy and erythroderma is rare. The authors recently encountered a patient with gallbladder carcinoma presenting as erythroderma. A 77-yr-old Japanese man presented with a 3-mo history of erythematous eruptions with pruritus over almost the entire body. After confirming the diagnosis of erythroderma, asymptomatic gallbladder carcinoma was found. Further investigations detected no malignancies in other organs. An extended cholecystectomy was performed. Histologic examination of resected specimens revealed poorly differentiated adenocarcinoma with negative resection margins. The eruptions with pruritus resolved within 1 wk after the operation. This is the first report, to our knowledge, of coincident biliary malignancy and erythroderma. The experience of the current patient suggests that erythroderma secondary to GI malignancy may resolve spontaneously after curative resection of the tumor.

Aged↗
PubMed1979

Exfoliative dermatitis: presenting sign of internal malignancy.

Exfoliative dermatitis is most commonly associated with antecedent cutaneous disorders, medications, and lymphoreticular malignancies. Three patients with exfoliative dermatitis associated with internal carcinoma are described. The importance of thorough evaluation of all patients who present with exfoliative dermatitis is stressed.

Adenocarcinoma↗
PubMed1997

Exfoliative dermatitis associated with diltiazem.

BACKGROUND: Exfoliative dermatitis due to calcium channel blockers is a known but infrequent response. CASE REPORT: A 77-year-old woman began treatment with diltiazem for angina pectoris. Three days later, severe exfoliative dermatitis developed. CONCLUSION: The present case and the others previously reported emphasize the need for greater awareness of the occurrence of adverse cutaneous reactions including toxic epidermal necrolysis, Stevens-Johnson syndrome and cutaneous vasculitis due to calcium channel blockers including diltiazem.

Aged↗
PubMed1991

Lichenoid histopathologic changes in patients with clinical diagnoses of exfoliative dermatitis.

Among 30 patients who received a clinical diagnosis of exfoliative dermatitis and were biopsied between 1982 and 1990, nine showed microscopic features of lichenoid dermatitis. Clinical information was available in eight of these cases. Possible etiologic factors included lymphoma, herpes simplex infection, connective tissue disease, and (in five cases) reactions to drugs. In each instance, microscopic features included a superficial perivascular lymphocytic infiltrate involving the dermal-epidermal interface, vacuolar alteration of the basilar layer, and individually necrotic keratinocytes at all levels of the epidermis. Such microscopic changes are not usually described in connection with exfoliative dermatitis, with the possible exception of those cases related to lichen planus or lupus erythematosus. Disseminated lichenoid drug eruption is one possible interpretation of the drug-induced cases. Erythema multiforme is another condition that has similar microscopic features and has been associated with drugs (many of which also cause exfoliative dermatitis), infectious agents, neoplasms, and connective tissue diseases. Lichenoid dermatitis can become generalized and clinically mimic and exfoliative dermatitis. Many, but not all, of these eruptions may be triggered by drugs.

Adult↗
PubMed1980

Cimetidine-induced exfoliative dermatitis.

A 68-year-old woman developed exfoliative dermatitis while taking cimetidine for gastritis. She had no history of previous drug reactions, allergies, or skin disorders and had taken no other medications for three months. Although cimetidine is a relatively safe drug, severe reactions such as exfoliative dermatitis can occur.

Aged↗
PubMed2004

Thymoma-associated exfoliative dermatitis in cats.

Five cases of exfoliative dermatitis in cats were presented from 1996 to 2002 in which a feline thymoma was found by postmortem or postsurgical examination. Besides abundant exfoliation of keratin squames and layers, the histologic picture of the skin revealed a similar pattern of interface dermatitis with predominantly CD3+ lymphocytes and fewer mast cells and plasma cells. In the epidermal basal layer a hydropic degeneration of keratinocytes was present. In all cases an infundibular lymphocytic mural folliculitis and absence of or drastic decrease in the number of sebaceous glands occurred. In addition to the so far described cell-poor type, we also found examples of a cell-rich skin lesion. Together with the clinical observation of generalized exfoliative dermatitis, the histologic pattern of this dermatitis was suggestive of an underlying thymoma. The pathogenesis of this skin disease in association with thymic neoplasia remains obscure, and our results contradict the hypothesis of production of autoantibodies that cross-react with epithelial antigens. The morphology of the thymomas and CD3 expression of the thymocytes varied and did not seem to have an impact on the dermal lesions.

Animals↗
PubMed1976

Drug induced interstitial nephritis, hepatitis and exfoliative dermatitis.

Acute interstitial nephritis associated with hepatitis, exfoliative dermatitis, fever and eosinophilia is uncommon. The syndrome has been described previously in association with phenindione administration, leptospirosis and heavy metal poisoning. Four cases are described, two of which were due to phenindione sensitivity. The other two patients had been exposed to a number of toxins including allopurinol, frusemide, chlorothiazide and methyldopa so that the exact aetiological agent is unclear. Interstitial nephritis should be considered as a cause of acute renal failure in patients with other features of drug hypersensitivity.

Acute Disease↗