Erythroderma: Epidemiology, Clinical Profile and Clinicopathological Correlation in 47 Patients

Abstract

Erythroderma, or generalized exfoliative dermatitis, is a disease characterized by erythema and scaling of greater
than 90% of the body’s surface. There is paucity of Indian studies over the etiology, clinical profile and its histopathological
correlation. Aims and objectives: To assess the demographic profile, clinical features and histopathological correlation in
erythroderma patients. Material and methods: We registered all patients of erythroderma consecutively from January 2013 to
December 2013. After a thorough history and clinical examination, a provisional clinical diagnosis was made. We performed
biopsy from two representative sites of patient and it was sent for histopathological examination. The slides were examined by
two pathologists and one dermatologist without any relevant clinical information. The clinical diagnosis was matched with the
blinded microscopical diagnosis. Results: The mean age of onset was 54.1 years with a male-to-female ratio of 3.3:1. The most
common causes were airborne contact dermatitis (53.2%) followed by psoriasis (21.2%), drug-induced erythroderma (12.7%),
chronic actinic dermatitis (2.1%), atopic dermatitis (2.1%), endogenous dermatitis (2.1%), mycosis fungoides (2.1%), lichenoid
dermatitis (2.1%) and idiopathic (2.1%). Histopathology was able to provide diagnosis in 32 (68%) patients. Out of these
32 patients, microscopical diagnosis was in accordance with clinical diagnosis in 28 patients. Conclusion: Most of the clinical
features of erythroderma are overlapping. Specific and diagnostic features of disease are seen only in a few patients. Repeated
evaluations, close follow-up and skin biopsy are recommended for a better clinical diagnosis and patient care.