Eritroderma
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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
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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
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ETIOLOGY Drug eruption Wide range of cutaneous
disease Systemic disease
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PATOPHISIOLOGYUnclearThe mechanisms by which an underlying
disease manifests as erytrodermaRecent research on the immunopathogenesis
of toxin-mediated infection demonstrates staphylococcal pathogenicity islands encoding superamigens
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CLINICAL FINDINGSWide range of cutaneous disease
Eritroderma psoriasis
seborrhoic dermatitis
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Continue…
Ptryasis rubra pilaris
Pemfigus Foliasius
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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
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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
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DIFFERINTIAL DIAGNOSTICAtopic dermatitisPsoriasisSebhorroic dermatitis
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TREATMENTfluid and electrolyte replacementAntihistaminesEmollientStop all drugsThe environment should be warm and humidSystemic corticosteroidsTreat underlying disease
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COMPLICATIONSHigh-output cardiac failure, cardiogenic
shockCardiac renHipotermia central
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PROGNOSISdepending on the underlying etiologyDrug-induced Erytroderma improves with
discontinuation of the offending drug
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THANK YOU