Abstract

AN AETIOPATHOLOGICAL STUDY OF EXFOLIATIVE DERMATITIS

Author(s): Sadeep Melathil Sadanandan, Celine Machiyanickal Issac, Sobhanakumari Kunjumoni, Anuj Kumar

BACKGROUND Erythroderma or exfoliative dermatitis is an inflammatory disorder in which erythema and scaling occur in a generalized distribution involving more than 90% of body surface. It is a reaction pattern of skin due to various pre-existing dermatoses, malignancy– cutaneous or internal. 100 clinically diagnosed cases of exfoliative dermatitis were included in this study. The objectives of this study were- to evaluate clinical profile and aetiology of exfoliative dermatitis and to correlate histopathological findings with clinical diagnosis. MATERIALS AND METHODS 100 clinically diagnosed cases of exfoliative dermatitis were included for this cross-sectional study, during a period of 18 months (from March 2014 to August 2015). A detailed history and clinical examination were done. Investigations including complete blood count, peripheral smear, urine routine examination, LFT, RFT, chest X-Ray, ECG, blood sugar, FNAC lymph node and skin biopsy were done in all patients. An approval from institutional review board for ethics committee and informed consent from all patients were obtained. All data was collected in a proforma and evaluated by using epidemiological investigative software SPSS. RESULTS Male to female ratio was 5:1:1. Mean age of patients was 57.7 years. 57% of patients were manual labourers. 82% of patients develop exfoliative dermatitis from pre-existing skin diseases and psoriasis was present in 42%. The interval between pre-existing skin disease and Erythroderma was 1 week to 1 year in 61% of patients. Drugs caused exfoliative dermatitis in 11% of patients. Lymphadenopathy was seen in 80% of cases. Anaemia was found in 61% of patients. LFT abnormality was noted in 48% of cases. Histopathology of skin correlated with clinical diagnosis in 51% of patients. CONCLUSION Erythroderma mainly a disease affecting persons of 40-70 yrs. Psoriasis is the common single disease causing exfoliative dermatitis. Histopathology helps in diagnosis only in 50% of cases.