Exfoliative Dermatitis (Erythroderma)

The widespread involvement of the skin by a scaly, erythematous dermatitis occurring either as a secondary or reactive process to an underlying cutaneous disorder (e.g., atopic dermatitis, psoriasis, etc.), or as a primary or idiopathic disease. It is often associated with the loss of hair and nails, hyperkeratosis of the palms and soles, and pruritus. (From Dorland, 27th ed)

Also Known As:

Networked: 692 relevant articles (21 outcomes, 18 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Psoriasis (Pustulosis Palmaris et Plantaris)
2.	Psoriatic Arthritis
3.	Infection
4.	Mycosis Fungoides
5.	Bullous Pemphigoid (Pemphigoid)

Experts

1.	Traupe, Heiko: 4 articles (09/2013 - 10/2005)
2.	Barbaud, A: 4 articles (11/2010 - 01/2004)
3.	Rook, Alain H: 3 articles (10/2015 - 12/2004)
4.	Oji, Vinzenz: 3 articles (09/2013 - 07/2006)
5.	Elias, Peter M: 3 articles (05/2012 - 09/2006)
6.	Villa, Anna: 3 articles (12/2011 - 08/2007)
7.	Porter, Forbes D: 3 articles (01/2011 - 12/2003)
8.	Schmutz, J-L: 3 articles (11/2010 - 04/2008)
9.	Duvic, Madeleine: 2 articles (10/2015 - 04/2009)
10.	Kim, Ellen J: 2 articles (10/2015 - 03/2012)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Exfoliative Dermatitis:

1.	infliximab (Remicade)FDA Link 05/01/2002 - "A single infusion of infliximab at 5 to 10 mg/kg resulted in the rapid and complete clearing of recalcitrant psoriatic plaques and erythroderma with a disease-free interval of 3 to 4 months in these 2 patients and improved the symptoms of psoriatic arthritis." 04/01/2011 - "In patients with plaque psoriasis, psoriatic arthritis, pustular psoriasis and psoriatic erythroderma, infliximab was well tolerated, regardless of prior treatment, and also showed superior efficacy over a period of approximately 1 year." 04/01/2011 - "Long-term study of infliximab in Japanese patients with plaque psoriasis, psoriatic arthritis, pustular psoriasis and psoriatic erythroderma." 04/01/2011 - "The efficacy and safety of infliximab in patients with plaque psoriasis, psoriatic arthritis, pustular psoriasis (excluding localized type) and psoriatic erythroderma were assessed in clinical practice. " 03/01/2004 - "Case number 29: hitting three with one strike: rapid improvement of psoriatic arthritis, psoriatic erythroderma, and secondary renal amyloidosis by treatment with infliximab (Remicade)."
2.	EtretinateFDA Link 01/01/2015 - "Her pustules improved with additional etretinate 20 mg/day, but the erythroderma persisted and she consulted us. " 04/01/2010 - "We treated a patient who received continuous treatment of psoriatic erythroderma with etretinate for 7 years, and who had an osseous bridge that extended across the acetabulum over the femur on both sides. " 01/01/2001 - "One patient developed erythroderma responding eventually to etretinate. " 01/01/1986 - "[Unusual side effects in patients with psoriatic erythroderma treated with etretinate (RO 10-9359)]." 03/01/1985 - "Erythroderma due to etretinate."
3.	Carbamazepine (Tegretol)FDA LinkGeneric 11/01/1997 - "Therapeutic efficacy of carbamazepine in a HIV-1-positive patient with psoriatic erythroderma." 04/01/2014 - "To identify risk factors other than genetic for severe carbamazepine-induced mucocutaneous reactions, that is, SJS, TEN, and exfoliative dermatitis (ED). " 09/01/2004 - "We report a 62-year-old patient suffering from epilepsia presenting erythroderma following carbamazepine intake. " 07/01/2002 - "Carbamazepine induced exfoliative dermatitis." 05/01/1999 - "This case report describes a severe multisystemic reaction, characterized by generalized erythroderma; and renal, hepatic, and bone marrow failure in a patient who started carbamazepine therapy 50 days beforehand."
4.	SteroidsIBA 02/01/2002 - "Case 2. A 58 year-old man suffered from congestive and pruriginous erythroderma for 2 1/2 months, which responded well to topical steroids. " 11/01/1997 - "Although early inpatient treatment with weak topical steroids and PUVA produced initial improvement, the patient's clinical condition fluctuated, with the subsequent development of erythroderma. " 12/01/1996 - "A 68-year-old female diagnosed as having Sézary syndrome because of generalized erythroderma and increased lymphocytes with convoluted nuclei in 1988 was treated with steroids. " 01/01/1994 - "Other rIL-2-related toxicities forcing exclusion from the study were severe thrombocytopenia (1 case), and generalised exfoliative dermatitis requiring steroids (1 case). " 09/01/1994 - "The erythroderma and photodermatitis responded to systemic steroids and psoralen/ultraviolet A therapy (total dose: 90 J/cm2). "
5.	AntibodiesIBA 12/01/1995 - "Several studies have shown that pemphigoid nodularis, pemphigoid vegetans, localized BP and vesicular pemphigoid are true variants of BP as the circulating antibodies in these patients recognize the same 230 kDa BP antigen as found in patients with generalized BP. Erythrodermic BP is a very unusual variant characterized by an erythroderma along with blister formation. " 05/01/2012 - "We present two patients, to our dermatology department, with a previous diagnosis of psoriasis, with an exfoliative erythroderma, which ultimately proved to be because of PF based on histopathological features, direct immunofluorescence results and levels of antibodies against desmoglein 1. Both patients responded well to oral prednisone and rituximab. "
6.	Cyclosporine (Ciclosporin)FDA LinkGeneric 03/01/2015 - "Cyclosporin treatment up to 10 mg/kg effectively resolved erythroderma and lowered total eosinophil counts, and she gained weight during treatment. " 09/01/1998 - "[Ofuji's papulo-erythroderma: treatment with cyclosporin A]." 09/01/1996 - "Psoriatic erythroderma and arthropathy also respond rapidly to oral cyclosporin. " 03/01/1996 - "This protocol causes a more widely distributed cutaneous eruption, including erythroderma (50%), than autologous bone marrow transplantation and cyclosporine administration alone (3%). " 01/01/2015 - "Two weeks after a dose reduction of cyclosporine to 100 mg/day, erythroderma with widespread generalized pustules and fever developed. "
7.	Methotrexate (Mexate)FDA LinkGeneric 05/01/1971 - "[Unusual micromaculous melanoderma developing in patients with psoriatic erythroderma during methotrexate therapy]." 03/01/2008 - "Indication for the institution of methotrexate therapy was severe disease, viz., extensive recalcitrant plaque type psoriasis in 17 patients, erythroderma and generalized pustular psoriasis of von-Zumbusch type in three patients each and severe disabling palmo-plantar involvement along with chronic plaque lesions in one patient. " 09/01/1999 - "Exfoliative dermatitis after long-term methotrexate treatment of severe psoriasis." 01/01/1999 - "The patient with pemphigus foliaceus presented with exfoliative dermatitis, and was treated with oral corticosteroid; methotrexate was added later for steroid-sparing purposes The patients were followed up for 1-4 years; the prognosis of childhood pemphigus is good. " 05/01/1983 - "The combination of aromatic retinoid with methotrexate was successfully used in the treatment of two patients with a particularly severe course of psoriasis, one having psoriatic erythroderma coupled with psoriatic arthritis and the other psoriatic erythroderma. "
8.	AcitretinFDA Link 05/01/2007 - "Treatment with acitretin resulted in gradual resolution of the erythroderma. " 10/01/2006 - "Acitretin-induced erythroderma in a psoriatic patient." 01/01/2005 - "His erythroderma slowly resolved over 6 months, at which time the acitretin dose was tapered. " 04/01/2008 - "Erythroderma in a patient taking acitretin for plaque psoriasis." 11/01/2011 - "We present the case in which erythroderma was most likely triggered by acitretin combined with ceftriaxone. "
9.	RetinoidsIBA 07/01/2015 - "The child with ichthyosiform erythroderma developed features of rickets within months of initiation of systemic retinoids. " 11/01/2011 - "Psoriatic erythroderma coexisting with erythema multiforme-like lesions induced by retinoids or retinoids combined with an antibiotic: case report." 07/01/2000 - "The prognosis of erythroderma has improved with the advent of innovative dermatologic therapies (e.g., cyclosporine and synthetic retinoids) and advances in the management of systemic manifestations. " 01/01/2009 - "Patients with lamellar ichthyosis or ichthyosiform erythroderma in particular profit from oral therapy with retinoids or retinoic acid metabolism-blocking agents." 01/01/2009 - "He had been treated with oral retinoids, steroids, and phototherapy for the diagnoses of drug eruption, pityriasis rubra pilaris, and exfoliative dermatitis at other hospitals. "
10.	Tretinoin (Retinoic Acid)FDA LinkGeneric 03/01/1975 - "Oral retinoic acid has been therapeutically beneficial for three patients with congenital ichthyosiform erythroderma and one with congenital bullous ichthyosifrom erythroderma. " 03/01/1974 - "[Experiences with vitamin A acid treatment in Ichthyosis congenita larvata and Erythroderma ichthyosiforme congenitum]." 06/01/2011 - "Fourteen percent of participants reported dry skin, 8% skin burning sensation, 5% erythema, and 5% dermatitis exfoliative with tretinoin gel 0.05% compared with 32%, 11%, 23%, and 23%, respectively, with tretinoin gel microsphere 0.1% (all P<.001, except skin burning sensation). " 01/01/1998 - "[Scrotum exfoliative dermatitis with ulcers associated with treatment of acute promyelocytic leukemia with all-trans retinoic acid]." 01/01/2009 - "Patients with lamellar ichthyosis or ichthyosiform erythroderma in particular profit from oral therapy with retinoids or retinoic acid metabolism-blocking agents."

Therapies and Procedures

1.	Drug Therapy (Chemotherapy) 01/01/1996 - "Our results suggest that DCF is beneficial for chemotherapy-resistant generalized erythroderma in CTCL." 11/01/2011 - " may prevent or extenuate palmar plantar erythroderma in many cases, enabling regular chemotherapy as planned. " 01/01/1998 - "We report three patients with APL treated with ATRA in combination with chemotherapy, who developed scrotum exfoliative dermatitis with ulceration. " 01/01/1995 - "However, because of subsequent aggravation of the generalized erythroderma, we administered chemotherapy. " 02/05/1987 - "The responding group included 8 of 10 patients with lymph-node involvement, 24 of 29 with exfoliative erythroderma, and 20 of 28 whose disease was resistant to standard chemotherapy. "
2.	Blood Transfusion (Blood Transfusions) 03/01/1992 - "It is therefore strongly suggested that postoperative erythroderma of this case was induced by graft-versus-host reaction due to blood transfusion given during the operation." 03/01/1992 - "[An autopsy case of postoperative erythroderma after nephroureterectomy possibly induced by graft-versus-host reaction following blood transfusion]." 09/01/1990 - ""Postoperative erythroderma", the pathogenesis of this disease have solved as graft-versus-host disease (GVHD) due to blood transfusion, is fatal and impossible to cure for the time being. " 04/01/1993 - "All patients received homologous blood transfusion during and after surgery and erythroderma associated hyperthermia occurred approximately 10 days after operation. " 09/01/1992 - "Erythroderma as a manifestation of graft-versus-host disease after cardiac operations with blood transfusion may occur more frequently in Japan than in other countries. "
3.	Combination Drug Therapy (Combination Chemotherapy) 05/01/2006 - "Treatment with combination chemotherapy could not completely control both the erythroderma and Sézary cells. " 11/01/1997 - "Combination chemotherapy was not effective for erythroderma and organomegaly, and deoxycoformycin revealed a transient effect. " 01/01/1996 - "Combination chemotherapy, utilizing vincristine, etoposide and cyclophosphamide, was effective against organomegaly but not against generalized erythroderma. "
4.	Injections 12/01/1932 - "Lupus Erythematosus cured by Injections of Solganol B which resulted in Generalized Exfoliative Dermatitis from which the patient nearly died." 05/01/1987 - "The incidence of severe reactions such as thrombocytopenia, aplastic anaemia and exfoliative dermatitis is lower with oral gold than injectable preparations, and contributes to a superior risk-benefit ratio. "
5.	Coronary Artery Bypass (Coronary Artery Bypass Surgery) 11/01/1986 - "[Studies on postoperative erythroderma following coronary artery bypass grafting operations]." 10/01/1991 - "[A case of "postoperative erythroderma" following coronary artery bypass grafting operation]." 06/01/1989 - "An immunologically normal 70-year-old male developed fever and disturbance of consciousness after aortocoronary bypass; this was followed by diarrhea, systemic erythroderma and granulocytopenia. "