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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↗
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↗
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↗
PubMed1992

A case of tubulo-interstitial nephritis with exfoliative dermatitis and hepatitis due to phenobarbital hypersensitivity.

Severe exfoliative dermatitis and liver dysfunction developed in a 5-year-old girl 3 weeks after initiation of phenobarbital therapy. Liver function improved gradually after discontinuation of phenobarbital. During the convalescent stage an initially mild renal dysfunction was exacerbated by episodes of post-transfusion haemolysis. Liver biopsy revealed moderate parenchymal damage with subacute cellular infiltration. Renal biopsy demonstrated the cardinal findings of interstitial nephritis, excluding the possibility of acute tubular necrosis caused by haemolysis. Serial lymphocyte transformation studies and skin patch tests gave positive results for phenobarbital, supporting the view that these were unusual complications of phenobarbital hypersensitivity.

Chemical and Drug Induced Liver Injury↗
PubMed1986

Exfoliative dermatitis. A prospective study of 80 patients.

A prospective study in 80 exfoliative dermatitis patients over a period of 5 years establishes 41.9 years as its mean age at onset. The disease affected both males and females, with a preponderance of the former. The clinical features were identical, irrespective of the etiology. The onset of the disease was usually insidious except in staphylococcal scalled skin syndrome and drug-induced erythroderma, where it was abrupt and florid. Microcytic hypochromic anemia, elevated erythrocyte sedimentation rate, eosinophilia, low serum proteins and electrolytes were salient laboratory features. Histopathology was largely unrewarding; only in 12 patients, a good clinicohistologic correlation was present. Preexisting dermatoses, namely psoriasis, air-borne contact dermatitis, phytophotodermatitis, photosensitive and seborrheic dermatitis, and other dermatoses constituted the major etiology. Antituberculous drugs were responsible for a substantial proportion of drug-induced erythroderma. No lymphomas were found. This study outlines that some salient features of exfoliative dermatitis may show geographic variations.

Adult↗
PubMed1998

[Scrotum exfoliative dermatitis with ulcers associated with treatment of acute promyelocytic leukemia with all-trans retinoic acid].

All-trans retinoic acid (ATRA) induces complete remission (CR) in most cases of acute promyelocytic leukemia (APL). Toxicity of ATRA has been shown to be mild and consist of headache, dry skin, dermatitis, gastrointestinal disorders, and hypertriglyceridemia. We report three patients with APL treated with ATRA in combination with chemotherapy, who developed scrotum exfoliative dermatitis with ulceration. Their age was 33 years (range, 25 to 37). All three cases developed scrotum erosions, and many small ulcers after 9 to 17 days of ATRA treatment. The scrotum exfoliative dermatitis with ulceration occurred repeatedly, but gradually resolved in about 8 weeks time. They developed no dryness of the lip or skin apart from the scrotum. All three cases continued to receive 45 mg/m2 of ATRA daily throughout induction therapy, and achieved CR. We suspected the scrotum exfoliative dermatitis with ulceration to be a side effect of ATRA. The scrotum lesions, which have been already reported may be common in patients receiving ATRA.

Adult↗
PubMed1990

Vancomycin-associated exfoliative dermatitis.

We describe a 51-year-old patient with endstage renal disease who developed vancomycin-associated exfoliative dermatitis. After four weeks of vancomycin hydrochloride treatment for staphylococcal pericarditis this patient developed a hypersensitivity reaction characterized by intermittent fevers, lymphadenopathy, peripheral eosinophilia, and exfoliative dermatitis. The reaction persisted for five weeks, probably because of inability to rapidly eliminate vancomycin secondary to underlying renal failure. Maculopapular rashes have been reported in two to six percent of patients who receive this drug, with severe skin reactions rarely reported. In addition to this case report, a review of the literature including 11 Eli Lilly/Food and Drug Administration case reports is presented. Although severe skin reactions to vancomycin rarely occur, they prolong morbidity, particularly in patients with renal failure.

Dermatitis, Exfoliative↗
PubMed1988

Generalised exfoliative dermatitis--a clinical study of 108 patients.

This study was to investigate the epidermiological, etiological, clinical and prognostic aspects of patients with Generalised Exfoliative Dermatitis in Singapore. From 1981 to 1985, all patients with exfoliative dermatitis or erythroderma admitted to our dermatology wards were included into this study. A standard protocol was filled in for each patient, and they were subsequently followed up at our out-patient clinics. There were 79 male and 29 female patients (sex ratio 2.7:1). The average age was 61.5 years. Most of the patients were from low social income groups. Apart from scaling and erythema, peripherial oedema was the most common finding (44%), followed by hair loss (25%) and lymphadenopathy (22%), 15% of patients had haemoglobin level 10G/dl. The main etiological groups were eczema/dermatitis, psoriasis, drug reactions and those with unknown causes. Two patients were suffering from congenital dermatoses. None of our patients was casually related to malignancy. This study suggested that GED was not a fatal disease among our patients, and they often had a good prognosis.

Adolescent↗