Exfoliative Dermatitis: A Clinico-etiological Study

ABSTRACT

Background: Exfoliative dermatitis or erythroderma is a symptom complex characterized by universal desquamation and erythema of the skin in response to various internal or external, known or unknown factors. Largely it is a secondary process and therefore it is mandatory to establish its etiopathology to facilitate the precise management. We attempted to establish the different causes of exfoliative dermatitis. Methods: We reviewed the clinical, laboratory and histopathological findings of 50 patients diagnosed with exfoliative dermatitis. Results: The frequency of exfoliative dermatitis was found to be 0.1 percent. The male-female ratio was 2.51 and majority of patients were in their 5th & 6th decade of life (mean age at diagnosis being 45.2 years). The total duration of disease ranged from 2 months to 1 year. The common causative factors were preexisting dermatomes (64%), followed by idiopathic (18%), drug induced (16%) and malignancy (2%). The most common dermatoses were psoriasis (24%) and eczema (24%). Carbamazepine (6%) and antitubercular drugs (6%) were the most frequent drugs which induced exfoliative dermatitis. Apart from scaling with erythema, pruritus and thickening of skin were found in all patients. Anemia was the most common finding (90%), followed by fever (42%), lymphadenopathy (38%) and edema (32%). The best Clinicopathological correlation was found in psoriasis and pemphigus foliaceous. Conclusions: This study outlined that the underlying etiologic factors of exfoliative dermatitis may show geographic variations. In this study preexisting dermatoses was most common cause of exfoliative dermatitis followed by idiopathic causes. Clinical features were identical irrespective of the etiology.