BACKGROUND Norwegian scabies(NS)is a serious parasitic skin condition.Although NS is one of the causes of erythroderma,it is frequently overlooked.Therefore,it is essential to raise awareness regarding NS presenting a...BACKGROUND Norwegian scabies(NS)is a serious parasitic skin condition.Although NS is one of the causes of erythroderma,it is frequently overlooked.Therefore,it is essential to raise awareness regarding NS presenting as erythroderma.CASE SUMMARY We present a case of NS that persisted for more than 3 years.After following nonstandard treatment,the patient’s rash worsened and gradually progressed into erythroderma.Finally,NS was diagnosed by skin microscopy and pathology.CONCLUSION When patients with pruritic dermatosis have high-risk factors such as prolonged bed rest and immunodeficiency,clinicians need to enhance their awareness of NS and ensure prompt diagnosis and treatment.展开更多
Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality, of which the incidence was 0.5‰–1.5‰ in skin diseases. Erythrodermic psoriasis（EP） is the commonest type of erythr...Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality, of which the incidence was 0.5‰–1.5‰ in skin diseases. Erythrodermic psoriasis（EP） is the commonest type of erythroderma. In addition, there are drug-induced erythroderma, erythroderma secondary to preexisting dermatoses, malignancy-related erythroderma, and idiopathic erythroderma of unknown etiology. Erythroderma of different etiologies has various clinical manifestations, resulting in relevant curative effects and outcomes. In this article, we retrospectively investigated 205 erythroderma patients about clinical symptoms, auxiliary examination and treatments, and evaluated the efficacy and prognosis. There were 84 cases of EP among 205 patients, 10 cases of erythroderma caused by specific drugs, 77 cases of erythroderma secondary to preexisting dermatoses（excluding psoriasis）, 7 cases of erythroderma patients suffering from malignancy and 27 cases with unknown causes. We concluded that the etiology of male patients in different age groups had significant difference. The incidence of EP was the highest among all types. The EP was commonly accompanied with hypoproteinemia, and changed into psoriasis vulgaris after treatment. Drug-induced erythroderma was commonly accompanied with fever, and mostly cured by systematic steroid therapy. For erythroderma secondary to preexisting dermatoses, the original dermatoses must be actively treated to achieve a satisfying prognosis. Erythroderma with malignancy or unknown causes had long-term duration, poor response to the treatment, and high potential to relapse. Therefore, clarifying the etiology, providing an appropiate and individual regimen, and regular follow-up are crucial for the successful treatment of erythroderma with unknown causes.展开更多
BACKGROUND: To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodeficiency syndrome(AIDS) complicated with drug-induced erythroderma.METHODS: The clinical data of 12 AIDS p...BACKGROUND: To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodeficiency syndrome(AIDS) complicated with drug-induced erythroderma.METHODS: The clinical data of 12 AIDS patients with drug-induced erythroderma in our hospital were retrospectively analyzed. The general information, offending medications, complications, modified severity-of-illness score for toxic epidermal necrolysis(SCORTEN) scores, and disease outcome spectrums were analyzed.RESULTS: Drug-induced erythroderma was mostly caused by antiviral drugs, antituberculosis drugs, antibiotics, traditional Chinese medicine, and immune checkpoint inhibitors. The spectrum of sensitizing drugs was broad, the clinical situation was complex, and infections were common. The affected areas were greater than 40% body surface area in all patients. The modified SCOTERN score averaged 3.01±0.99. All patients were treated with glucocorticoids, and nine patients were treated with intravenous immunoglobulin(IVIG) pulse therapy at the same time. The average time to effectiveness was 7.08±2.23 days, and the average hospital stay was 17.92±8.46 days. Eleven patients were cured, and one patient died of secondary multiple infections, who had a modified SCORTEN score of 5 points. The mortality rate in this study was 8.3%.CONCLUSIONS: The clinical situation of AIDS patients with drug-induced erythroderma in hospitalized patients is complex and the co-infection rate is high. The use of modified SCORTEN score may objectively and accurately assess the conditions, and the use of glucocorticoid combined with IVIG therapy may improve the prognosis.展开更多
Objective:Erythroderma is an uncommon and severe skin disorder with many underlying causes and identifying its etiology can facilitate further treatments.This study was performed to evaluate the clinical profile and e...Objective:Erythroderma is an uncommon and severe skin disorder with many underlying causes and identifying its etiology can facilitate further treatments.This study was performed to evaluate the clinical profile and etiology of erythroderma.Methods:We collected the data on 136 patients diagnosed with erythroderma with respect to the epidemiological,clinical,biological,and histological data,treatments,and outcomes in The First Affiliated Hospital of Ningbo University from 2011 to 2021.The analyses of qualitative data were performed with the chi-square test or Fisher’s exact test.The groups of quantitative data were compared using a t-test or analysis of variance.Results:The patients’mean age in this study was 65.00±16.51 years,with a male:female ratio of 5.8:1.0.Acute onset occurred in 27 patients(19.9%)and was associated with drug reactions(P=0.002).The mean length of stay was 19.18±9.75 days.Clinical characteristics were dominated by pruritus(135,99.3%),fever(44,32.4%),edema(82,60.3%),nail changes(14,10.3%),arrhythmia(16,11.8%),and superficial lymphadenopathy(57,41.9%).Combined with biopsy,history inquiry and laboratory testing,this study found that most common causative factor was pre-existing dermatoses(107,78.7%),followed by drug reactions(15,11.0%),malignancies(8,5.9%),and undetermined etiology(6,4.4%).Among the pre-existing dermatoses,eczema was the most common etiology(33.9%).We also found that psoriasis,solar dermatitis,hypereosinophilic syndrome,atopic dermatitis,scabies,pemphigus foliaceus,and pityriasis rubra pilaris were causes of erythroderma.In the drug-induced group,anticonvulsants were the most frequently implicated drug.Compared to other cause diseases,patients with psoriasis had a significant higher rate of fever(P=0.022),nail changes(P<0.001),arthralgia(P<0.001),and infection(P=0.007).Eosinophilia and an increased immunoglobulin E concentration were associated with hypereosinophilic syndrome(P=0.005)and eczema(P=0.032),respectively compared to other cause diseases.The infection rate was significantly higher in patients with abnormal liver function compared to the patients with normal liver function(P<0.001).Conclusion:Most of the clinical features of erythroderma are unspecific with the exception of fever,nail changes,and arthralgia,which were mostly found in patients with psoriasis.Clinicohistopathological examination helps to establish the etiology of erythroderma and reminder doctors to focus on high-risk populations.展开更多
Introduction:Congenital ichthyosiform erythroderma(CIE)is characterized by fine,whitish scales on a background of erythematous skin over the whole body;it is reportedly caused by mutations inABCA12,ALOX12B,ALOXE3,CERS...Introduction:Congenital ichthyosiform erythroderma(CIE)is characterized by fine,whitish scales on a background of erythematous skin over the whole body;it is reportedly caused by mutations inABCA12,ALOX12B,ALOXE3,CERS3,CYP4F22,NIPAL4,PNPLA1,andTGM1 genes.Case presentation:A 15-month-old girl presented with CIE associated with compound heterozygousABCA12 mutations,a known missense mutation c.4139A>G(p.Asn1380Ser)from her father,and a novel missense mutation c.4300A>G(p.Thr1434Ala)from her mother.Conclusion:This is the first report to indicate that compound heterozygous missense mutations in the first ATP-binding cassette ofABCA12 could contribute to the onset of CIE.展开更多
文摘BACKGROUND Norwegian scabies(NS)is a serious parasitic skin condition.Although NS is one of the causes of erythroderma,it is frequently overlooked.Therefore,it is essential to raise awareness regarding NS presenting as erythroderma.CASE SUMMARY We present a case of NS that persisted for more than 3 years.After following nonstandard treatment,the patient’s rash worsened and gradually progressed into erythroderma.Finally,NS was diagnosed by skin microscopy and pathology.CONCLUSION When patients with pruritic dermatosis have high-risk factors such as prolonged bed rest and immunodeficiency,clinicians need to enhance their awareness of NS and ensure prompt diagnosis and treatment.
基金supported by the National Natural Science Foundation of China(No.81673057 and No.81502735)
文摘Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality, of which the incidence was 0.5‰–1.5‰ in skin diseases. Erythrodermic psoriasis（EP） is the commonest type of erythroderma. In addition, there are drug-induced erythroderma, erythroderma secondary to preexisting dermatoses, malignancy-related erythroderma, and idiopathic erythroderma of unknown etiology. Erythroderma of different etiologies has various clinical manifestations, resulting in relevant curative effects and outcomes. In this article, we retrospectively investigated 205 erythroderma patients about clinical symptoms, auxiliary examination and treatments, and evaluated the efficacy and prognosis. There were 84 cases of EP among 205 patients, 10 cases of erythroderma caused by specific drugs, 77 cases of erythroderma secondary to preexisting dermatoses（excluding psoriasis）, 7 cases of erythroderma patients suffering from malignancy and 27 cases with unknown causes. We concluded that the etiology of male patients in different age groups had significant difference. The incidence of EP was the highest among all types. The EP was commonly accompanied with hypoproteinemia, and changed into psoriasis vulgaris after treatment. Drug-induced erythroderma was commonly accompanied with fever, and mostly cured by systematic steroid therapy. For erythroderma secondary to preexisting dermatoses, the original dermatoses must be actively treated to achieve a satisfying prognosis. Erythroderma with malignancy or unknown causes had long-term duration, poor response to the treatment, and high potential to relapse. Therefore, clarifying the etiology, providing an appropiate and individual regimen, and regular follow-up are crucial for the successful treatment of erythroderma with unknown causes.
基金supported by National Natural Science Foundation of China (81972931)。
文摘BACKGROUND: To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodeficiency syndrome(AIDS) complicated with drug-induced erythroderma.METHODS: The clinical data of 12 AIDS patients with drug-induced erythroderma in our hospital were retrospectively analyzed. The general information, offending medications, complications, modified severity-of-illness score for toxic epidermal necrolysis(SCORTEN) scores, and disease outcome spectrums were analyzed.RESULTS: Drug-induced erythroderma was mostly caused by antiviral drugs, antituberculosis drugs, antibiotics, traditional Chinese medicine, and immune checkpoint inhibitors. The spectrum of sensitizing drugs was broad, the clinical situation was complex, and infections were common. The affected areas were greater than 40% body surface area in all patients. The modified SCOTERN score averaged 3.01±0.99. All patients were treated with glucocorticoids, and nine patients were treated with intravenous immunoglobulin(IVIG) pulse therapy at the same time. The average time to effectiveness was 7.08±2.23 days, and the average hospital stay was 17.92±8.46 days. Eleven patients were cured, and one patient died of secondary multiple infections, who had a modified SCORTEN score of 5 points. The mortality rate in this study was 8.3%.CONCLUSIONS: The clinical situation of AIDS patients with drug-induced erythroderma in hospitalized patients is complex and the co-infection rate is high. The use of modified SCORTEN score may objectively and accurately assess the conditions, and the use of glucocorticoid combined with IVIG therapy may improve the prognosis.
基金the Medical Health Science and Technology Project of Zhejiang Province(No.2022PY022)We thank the patients in this study。
文摘Objective:Erythroderma is an uncommon and severe skin disorder with many underlying causes and identifying its etiology can facilitate further treatments.This study was performed to evaluate the clinical profile and etiology of erythroderma.Methods:We collected the data on 136 patients diagnosed with erythroderma with respect to the epidemiological,clinical,biological,and histological data,treatments,and outcomes in The First Affiliated Hospital of Ningbo University from 2011 to 2021.The analyses of qualitative data were performed with the chi-square test or Fisher’s exact test.The groups of quantitative data were compared using a t-test or analysis of variance.Results:The patients’mean age in this study was 65.00±16.51 years,with a male:female ratio of 5.8:1.0.Acute onset occurred in 27 patients(19.9%)and was associated with drug reactions(P=0.002).The mean length of stay was 19.18±9.75 days.Clinical characteristics were dominated by pruritus(135,99.3%),fever(44,32.4%),edema(82,60.3%),nail changes(14,10.3%),arrhythmia(16,11.8%),and superficial lymphadenopathy(57,41.9%).Combined with biopsy,history inquiry and laboratory testing,this study found that most common causative factor was pre-existing dermatoses(107,78.7%),followed by drug reactions(15,11.0%),malignancies(8,5.9%),and undetermined etiology(6,4.4%).Among the pre-existing dermatoses,eczema was the most common etiology(33.9%).We also found that psoriasis,solar dermatitis,hypereosinophilic syndrome,atopic dermatitis,scabies,pemphigus foliaceus,and pityriasis rubra pilaris were causes of erythroderma.In the drug-induced group,anticonvulsants were the most frequently implicated drug.Compared to other cause diseases,patients with psoriasis had a significant higher rate of fever(P=0.022),nail changes(P<0.001),arthralgia(P<0.001),and infection(P=0.007).Eosinophilia and an increased immunoglobulin E concentration were associated with hypereosinophilic syndrome(P=0.005)and eczema(P=0.032),respectively compared to other cause diseases.The infection rate was significantly higher in patients with abnormal liver function compared to the patients with normal liver function(P<0.001).Conclusion:Most of the clinical features of erythroderma are unspecific with the exception of fever,nail changes,and arthralgia,which were mostly found in patients with psoriasis.Clinicohistopathological examination helps to establish the etiology of erythroderma and reminder doctors to focus on high-risk populations.
基金National Natural Science Foundation of China(No.81673042)。
文摘Introduction:Congenital ichthyosiform erythroderma(CIE)is characterized by fine,whitish scales on a background of erythematous skin over the whole body;it is reportedly caused by mutations inABCA12,ALOX12B,ALOXE3,CERS3,CYP4F22,NIPAL4,PNPLA1,andTGM1 genes.Case presentation:A 15-month-old girl presented with CIE associated with compound heterozygousABCA12 mutations,a known missense mutation c.4139A>G(p.Asn1380Ser)from her father,and a novel missense mutation c.4300A>G(p.Thr1434Ala)from her mother.Conclusion:This is the first report to indicate that compound heterozygous missense mutations in the first ATP-binding cassette ofABCA12 could contribute to the onset of CIE.
