Post on 01-Jun-2018
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ERHYTRODERMA
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Name : Tn. M
Age : 70 years old
Address : Pokko village, Polmas
!a!"s : Married
Da!e o# Admi!!ed : $7 may $0%&
'den!i#y o# Pa!ien!
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His!ory o# medi*ine !aking /1 His!ory o# +os)i!ali2a!ion/31 i!+*ys!os!omy $ mon!+ ago,
His!ory o# allergi* /1,
His!ory o# !+e same disease /1,
His!ory o# DM/1, HT/1,
His!ory o# !+e same disease in #amily /1
His!ory Taking
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Anemi* /1, '*!er"s /1, (yanosis /1
Di4"se ery!+ema i!+ overlying s*ale
*overing 560 !+e -ody s"r#a*e area *or8)"lmonal : normal
Peris!al!ik : /31 normal
P+ysi*al e9amina!ion
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eneral s!a!"s : *om)os men!is,
ade;"a!e n"!ri!ion
eneral (ondi!ion : Modera!eHygiene : Modera!e
>98min"!e
RR : %>98min"!e
Tem)era!"re : &?,>o(
Presen! !a!"s
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@o*a!ion : regio eneralisa!a
Eores*en*y : ery!+em, erosion, e9*oria!ion,
*r"s!a@o*a!ion : Regio a-domen
Eores*en*y : ery!+em, e9*oria!ion
Derma!ovenerology
!a!"s
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@a-ora!ori"m
Ro"!ine =lood
B=( : %C.7% 9 %0& 8"l
R=( : .0C 9 %0?8"l H= : %$.? g8dl
H(T : &>.>
P@T : &? 9 %0& 8"l
M(< : 6C.>
M(H : &%.% )g
M(H( : &$.C gr8dl
Fesan : @e"kosi!osis
RDBD : &.
PDB : 6.0
MP< : >.? P@(R: %.?
P(T : 0,&0
NEGT : C.6$ 9 %0&
@YM : .0> 9 %0
&
EO : . C6 9 %0&
=AO : 0.0 9 %0&
MONO :%.0> 9 %0&
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D : 6C mg8dl
Gre"m : &%
(rea!inin : %.%
OT : $C
PT : $%
Pro! To! : &,C
Al-"min : $
lo-"lin : 0,$
Hi)oal-"minemia
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Diagnosis
Eri!roderma
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Di4eren!ial Diagnosis
Psoriasis e--or+oi* Derma!i!is
Dr"g Er")!ion
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T+era)y
=e!+ame!asone 3 "son (ream/!i*e a day, +ole -ody1
(e!iri2ine %9%
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Gniversal redness and s*aling o# !+eskin
a4e*!ing 60%00 o# !+e -ody
ERYTHRODERMA
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'dio)a!+i* &0
Dr"g allergy I $>
e-orr+ei* derma!i!is I $0
(on!a*! derma!i!is I &
A!o)i* derma!i!is I %0
@ym)+oma and le"kimia I %
Psoriasis I >
E!iology
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T+e ery!+ema e9!ends ra)idly and may
-e "niversal in %$> +r. *aling
a))ears a#!er $? days, o#!en rs! in !+ee9"res.
T+e s*ales may -e large, or ne and
-ran like. A! !+is s!age !+e skin is -rig+!red,+o! and dry and )al)a-ly !+i*kened.
Pr"ri!"s is o#!en *a"se -y e*2ema.
(lini*al Mani#es!a!ion
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B+en !+e ery!+roderma +as -een
)resen! #or some eeks, !+e s*al) and
-ody may -e s+ed and !+e nails-e*ome ridged and !+i*kened,and mayalso -e s+ed.
T+e )erior-i!al skin is inamed andoedema!o"s, res"l!ing in e*!ro)ion,i!+*onse;"en! e)i)+ora.
(lini*al Mani#es!a!ion
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T+e re*ogni!ion o# ery!+roderma is easy, -"!
!+e diagnosis o# "nderlying *a"se may -e
very diJ*"l!. T+e +is!ory is o#!en +el)#"l in iden!i#ying !+e
+eredi!ary disorders, dr"g rea*!ions and
)soriasis, -"! in some *ases !+eery!+roderma is o# s"dden onse! and !+e+is!ory may no! -e +el)#"l, and !+ee*2ema!o"s ery!+rodermas and !+ose
asso*ia!ed i!+ lym)+oma may no! s+o any
Diagnosis
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'ni!ial !rea!men! o# any e!iology involves "idand ele*!roly!e re)la*emen!.
To)i*al : oa!mel -a!+s
e! dressings
emollien!s /lanolin %08"rea *ream %01
ys!emi* :
An!i+is!amines
(or!i*os!eroid
sys!emi* an!i-io!i*s i# se*ondary in#e*!ion
Trea!men!
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di"re!i*s #or )eri)+eral edema
*or!i*os!eroid #or dr"g +y)ersensi!ivi!y
rea*!ions,imm"no-"llo"s disease,a!o)i*derma!i!is /%$ mg8kg8day i!+ !a)er 1
*y*los)orine #or )soriasis, a!o)i* derma!i!is /C mg8kg8day1
me!+o!re9a!e #or )soriasis, a!o)i* derma!i!is,)i!yriasis r"-ra )ilaris /C$C mg ;k de)end.on renal #"n*. and res)onse !o !rea!men!1
*on!in"eK
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a*i!re!in /soria!ane1 #or )soriasis, )i!yriasis
r"-ra )ilaris /$CC0 mg ;d 1
my*o)+enola!e mo#e!il #or )soriasis, a!o)i*derma!i!is, imm"no-"llo"s disease /%& g ;d 1
ini9ima- #or )soriasis /C%0 mg8kg1
*on!in"eK
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Mos! likely
L )ongio!i* derma!i!is / a!o)i*,6 *on!a*!
derma!i!is, ? se-orr+ei* derma!i!is, *+roni* a*!ini* derma!i!is, &1
L Psoriasis /$& 1
L Dr"g +y)ersensi!ivi!y rea*!ion /%C1
L ("!aneo"s T*ell lym)+oma /C1L 'dio)a!+i* /a))ro9ima!ely $01
Di4eren!ial Diagnosis
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(onsider
L (on!a*! derma!i!is
L 'mm"no-"llo"s disease
L 'n#e*!ion /s*a-ies,derma!o)+y!osis1
L To9in media!ed
L (+roni* a*!ini* derma!i!is
L Pi!yriasis r"-ra )ilaris
L (ollagen vas*"lar disease
L Primary imm"node*ien*y
*on!in"eK
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