tailieunhanh - Chapter 054. Skin Manifestations of Internal Disease (Part 2)

Erythroderma (Table 54-2) Erythroderma is the term used when the majority of the skin surface is erythematous (red in color). There may be associated scale, erosions, or pustules as well as shedding of the hair and nails. Potential systemic manifestations include fever, chills, hypothermia, reactive lymphadenopathy, peripheral edema, hypoalbuminemia, and high-output cardiac failure. The major etiologies of erythroderma are (1) cutaneous diseases such as psoriasis and dermatitis (Table 54-3); (2) drugs; (3) systemic diseases, most commonly CTCL; and (4) idiopathic. In the first three groups, the location and description of the initial lesions, prior to the development of the. | Chapter 054. Skin Manifestations of Internal Disease Part 2 Erythroderma Table 54-2 Erythroderma is the term used when the majority of the skin surface is erythematous red in color . There may be associated scale erosions or pustules as well as shedding of the hair and nails. Potential systemic manifestations include fever chills hypothermia reactive lymphadenopathy peripheral edema hypoalbuminemia and high-output cardiac failure. The major etiologies of erythroderma are 1 cutaneous diseases such as psoriasis and dermatitis Table 54-3 2 drugs 3 systemic diseases most commonly CTCL and 4 idiopathic. In the first three groups the location and description of the initial lesions prior to the development of the erythroderma aid in the diagnosis. For example a history of red scaly plaques on the elbows and knees would point to psoriasis. It is also important to examine the skin carefully for a migration of the erythema and associated secondary changes such as pustules or erosions. Migratory waves of erythema studded with superficial pustules are seen in pustular psoriasis. Table 54-2 Causes of Erythroderma 1. Primary cutaneous disorders a. Psoriasisa b. Dermatitis atopic contact seborrheic or stasis with autosensitization a c. Pityriasis rubra pilaris 2. Drugs 3. Systemic diseases a. Cutaneous T cell lymphoma b. Lymphoma 4. Idiopathic Discussed in detail in Chap. 53. Table 54-3 Erythroderma Primary Cutaneous Disorders Initial Lesions Locati on of Initial Lesions Othe r Findings Diag nostic Aids Treat ment Psori asis Pink- red silvery scale sharply demarcated Elbow s knees scalp presacral area Nail dystrophy arthritis pustules Skin biopsy Topic al glucocortico ids vitamin D .