EXFOLIATIVE ERYTHRODERMA SYNDROME

1
EXFOLIATIVE ERYTHRODERMA SYNDROME

2
New words 1

• exfoliative the loss of epidermis
• erythroderma the desease is a serious, at times
  life-threatening reaction pattern of the skin
  characterized by generalized and uniform redness
  and scaling
• onycholysis the nails become thickened and
  separated from the nail bed
• branny adj,like bran
• Scalpn,??
• pityriasis rubra pilaris
• pathognomonic corresponding
• Leukemia???????
• silvery sth has the same colour with silver
• Seborrheic????
• Pemphigus???
• Dilatationenlarege
• Capillarie????
• cardiac
• Parakeratosis
• acanthosis
• elongation
• rete ridges
• Emollientsone kind of drug that make your skiin
  sof

3
New words 2

• Seborrheic????
• Pemphigus???
• Dilatationenlarege
• Capillary????
• Cardiacheart
• Parakeratosis????
• acanthosis???
• elongation??,??
• Emollientsone kind of drug that make your skin
  soft

4
EPIDEMIOLOGY

• Age of Onset
• gt 50 years in children, EES usually results
  from pityriasis rubra pilaris or atopic
  dermatitis.
• Sex
• Males gt females.

5
Cause

• Undetermined or unclassified 23
• Psoriasis
  23
• Atopic dermatitis, eczema 16
• Drug allergy
  15
• Lymphoma, leukemia 11
• Allergic contact dermatitis 5
• Seborrheic dermatitis 5
• Stasis dermatitis with id reaction 3
• Pityriasis rubra pilaris
  2
• Pemphigus
  1

6
PATHOGENESIS

• Large amounts of warm blood are present in the
  skin due to the dilatation of capillaries, and
  there is considerable heat convection. Also,
  there may be high output cardiac failure the
  loss of scales through exfoliation

7
cardiac failure.
warm blood
dilatation of capillary
Heat convection
the loss of proteinum

• the loss of scales through exfoliation

reduction in serum albumin and the edema of the
lower extremities
8
Clinical Manifestation

• Skin Symptoms
• red, thickened, scaly.
• Dermatitis is uniform involving the entire body
• surface
• Palms and Soles
• Hair
• Nails

9
Dermatopathology

• Depends on type of underlying disease.
  Parakeratosis, inter- and intracellular edema,
  acanthosis with elongation of the rete ridges,
  and exocytosis of cells. There is edema of the
  dermis and a chronic inflammatory infiltrate.

10

• Acute EES
• generalized vivid red erythema
• fine branny scales
• feels hot and cold, shivers, and has fever

11
Chronic ees

• The skin thickens
• The nail
• Maybe hyperpigmentation or patchy loss of
  pigment

12
Erythroderma
13
Erythroderma cutaneous T cell lymphoma
14

• Chronic EES
• the skin thickens
• scaling continues and becomes lamellar
• loss of scalp and body hair
• the nails become thickened and separated

15
DIAGNOSIS

• the history of the preexisting dermatosis
• pathognomonic signs and symptoms of the
  preexisting dermatosis may help
• psoriasis dusky-red
  
• Pityriasis rubra pilaris yellowish-red
  
• in atopic dermatitis and eczema

16
MANAGEMENT

• Topical
• Water bath with added bath oils, followed by
  application of bland emollients.

17
Systemic

• Oral glucocorticoids for remission
• induction and for maintenance systemic and
  topical therapy as required by underlying
  condition.

18
Supportive

• Supportive cardiac, fluid,
• protein replacement therapy as required.
• Electrolyte balance

19
CASE

• Chief Complaint
• The patient had erythroderma With universal
  redness, a fine brawny scaling universal for 3
  weeks

20
present disease

• 3 weeks ago ,the patient had injected gold salts.
  One week later , there was universal redness, a
  fine brawny scaling in his face,arms,trunk,with
  itch ,however ,he had ignored it.1weeks ago ,the
  patients had generalized erythroderma ,
  thickening of the skin, and heavy scaling.felling
  fatigue, weakness, malaise and shivering.

21

22
Dermatopathology

• Parakeratosis, intracellular edema,and
  acanthosis with elongation of the rete ridges
• There is edema of the dermis and a chronic
  inflammatory infiltrate

23
consideration

• ?

24

• Erythroderma drug-induced

25
Thanks