Exfoliative Dermatitis, (Erythroderma) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

by Kenneth Kee

Overview

This book describes Exfoliative Dermatitis, Diagnosis and Treatment and Related Diseases
Exfoliative dermatitis (Erythroderma) is the medical disorder where there is intense and normally widespread scaling, peeling, and flaking of the skin due to inflammatory skin disease.
It often occurs before or is linked with exfoliation (skin peeling off in scales or layers), when it may also be called exfoliative dermatitis (ED).
Idiopathic exfoliative dermatitis is occasionally called the ‘red man syndrome’.
It is often followed by, itching, skin redness (exfoliative dermatitis), and hair loss.
The most frequent skin disorders to cause exfoliative dermatitis are:
1. Drug eruption — with numerous diverse drugs implicated
2. Dermatitis especially atopic dermatitis
3. Psoriasis, especially after withdrawal of systemic steroids or other treatment
4. Pityriasis rubra pilaris
Other skin diseases that less often cause exfoliative dermatitis are:
1. Other forms of dermatitis:
a. contact dermatitis (allergic or irritant),
b. stasis dermatitis (venous eczema) and
c. in babies, seborrhoeic dermatitis or staphylococcal scalded skin syndrome
2. Blistering diseases such as pemphigus and bullous pemphigoid
3. Sezary syndrome (the erythrodermic form of cutaneous T-cell lymphoma)
Exfoliative dermatitis may also be a symptom or sign of a systemic disease.
1. Hematological malignancies, e.g. lymphoma, leukemia
2. Internal malignancies, e.g. carcinoma of rectum, lung, fallopian tubes, colon
3. Graft-versus-host disease
4. HIV infection
It is not known why some skin diseases in some people progress to exfoliative dermatitis.
The pathogenesis is complicated, with involvement of keratinocytes and lymphocytes, and their interaction with adhesion molecules and cytokines
Symptoms
Exfoliative dermatitis occurs often after morbilliform eruption, dermatitis, or plaque psoriasis.
Generalized erythema can form quite quickly in acute exfoliative dermatitis, or more slowly over weeks to months in chronic exfoliative dermatitis.
Generalized edema and erythema affects 90% or more of the skin surface.
The skin feels warm on contact.
Itch is normally worrisome, and is occasionally not tolerable.
Rubbing and scratching results in lichenification
Eyelid swelling may lead to ectropion
Scaling starts 2-6 days after the onset of erythema (red skin), as fine flakes or large sheets.
Thick scaling may form on the scalp with differing degrees of hair loss and ending in complete baldness.
Palms and soles may form yellowish, diffuse keratoderma
Nails become dull, thickened and ridged or form onycholysis and may break off
Lymph nodes become enlarged
Diagnosis:
Blood count may reveal anemia, white cell count abnormalities, and eosinophilia.
Marked eosinophilia should be suspicious for lymphoma.
>20% circulating Sezary cells indicates Sezary syndrome
Skin biopsies from several locations may be taken if the cause is not known.
They are likely to reveal non-specific inflammation on histopathology
Direct immunofluorescence is of use if an autoimmune blistering disease or connective tissue disease is indicated
Treatment:
Exfoliative dermatitis is possibly serious, even life-threatening
Most patients need hospitalization for monitoring of circulatory status and body temperature and to replace fluid and electrolyte balance.
These general measures apply:
1.Stop all medicines that are not needed
2.Check fluid balance and body temperature
3.Retain skin moisture with:
a.Wet wraps,
b.Other wet dressings,
c.Emollients and
d.Mild topical steroids
4.Antibiotics are given for bacterial infection
5.Antihistamines may decrease severe itch
6.Specific treatment for psoriasis and skin atopy

TABLE OF CONTENT
Introduction
Chapter 1 Exfoliative Dermatitis
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Steven Johnson Syndrome
Chapter 8 Erythema Multiforme
Epilogue

Product Details

BN ID:	2940155341291
Publisher:	Kenneth Kee
Publication date:	07/17/2018
Sold by:	Smashwords
Format:	eBook
File size:	147 KB

About the Author

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 65. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical conditions seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog afamilydoctorstale.blogspot.com. This autobiolographical account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Conditions” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 550 amazon kindle books and some into Smashwords.com eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical conditions. The first chapter of all my ebooks is always taken from my blog A Simple Guide to Medical Conditions which was started in 2007 as a simple educational help to my patients on my first blog http://kennethkee.blogspot.com. The medical condition was described simply and direct to the point. Because the simple guide as taken from the blog was described as too simple, I have increased the other chapters to include more detailed description of the illness, symptoms, diagnosis and treatment. As a result there are the complaints by some readers of constant repetitions of the same contents but in detail and fairly up to date. He has published 550 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health conditions and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Bouna Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. All the PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"