Exfoliative dermatitis

Introduction Exfoliative dermatitis is a chronic erythema scaly skin disease involving the whole body or almost the whole body skin. Exfoliative dermatitis is a rare skin side reaction in vaccination and is associated with contact dermatitis. If the amount of skin factor released after the allergic reaction is large and the lysosome is small, it is characterized by contact dermatitis; if both are large, it is exfoliative dermatitis. Exfoliative dermatitis is a rare and serious skin disease. Also known as erythroderma. It is characterized by diffuse erythema, swelling and scaling of the whole body or large areas of the skin.

Cause

Divided into three categories

1. The original skin diseases such as psoriasis, eczema, seborrheic dermatitis, red pityriasis, lichen planus, allergic contact dermatitis, etc. are caused by inappropriate treatment.

2, lymphoma and other malignant tumors such as mycosis fungoides, Hodgkin's disease, malignant lymphoma, leukemia, etc. may occur erythroderma.

3. Caused by drug allergy.

an examination

The diagnosis of the original skin disease should be based on the medical history, residual skin changes, previous skin biopsy results and response to treatment. Sometimes residual red pity or psoriasis lesions help to detect the original skin disease.

Differential diagnosis

Need to identify different types of drug eruptions:

(1) The most common type of fixed drug eruption is often caused by sulfa preparations, antipyretic analgesics or barbiturates. The rash is a round or oval edematous purple-red spot with a diameter of about 1 to 2 or 3 to 4 cm.

Often one, even a few boundaries are clear, and heavy ones have bullae on them. After about one week after stopping the drug, the erythema disappeared, and the gray-black pigmentation spots remained. If the drug is taken after a few minutes or hours, it will itch at the original drug rash, and then the same rash will appear and expand to the surrounding area, so that the central color is deep and blisters can also occur on the edge flushing. A new rash can also appear at the time of recurrence. The number of rashes can also increase as the number of relapses increases. Damage can occur in any part, but it is more common in the skin and mucous membrane junctions such as the lips, the glans, the anus, etc. The back of the hand and the trunk often occur, and can be counted in a single or phoenix. Occurred in the wrinkle mucosa easy to smash and produce pain. Generally, it can be regressed after 7 to 10 days. If it has ulcerated, it will be heavier and heavier.

(2) Urticaria-type drug eruption is more common with penicillin, serum products (such as tetanus or diphtheria antitoxin), furazolidone and salicylate. The symptoms are similar to acute urticaria, and may be accompanied by serum-like symptoms, such as Fever, joint pain, swollen lymph nodes, angioedema, and even proteinuria can be expressed as chronic measles.

(3) Measles-like or scarlet-like fever-like drug eruptions are more commonly caused by antipyretic and analgesic drugs, barbiturates, penicillin streptomycin and sulfonamides.

Sudden onset, often accompanied by systemic symptoms such as chills and fever. Measles-like drug eruption is scattered or dense, red cap needle to rice granules or maculopapular rash, symmetric distribution, can be generalized to the body to the trunk, similar to measles, severe cases may be accompanied by small bleeding point scarlet fever-like drug eruption, from the beginning It is a small piece of erythema, which develops from the face, neck upper limbs and trunk. It can spread throughout the body within 2 to 3 days. When the climax is reached, the whole body is covered with erythema and the limbs are swollen, resembling a scarlet hot rash, especially the wrinkles and the flexion of the limbs. The rash of this type of drug eruption is distinct, but the systemic symptoms are milder than measles and scarlet fever, no measles or Other symptoms of scarlet fever, white blood cell count can be elevated, and a small number of patients with liver function can have a transient abnormality. After 1 to 2 weeks after stopping the drug, the body temperature gradually decreased, and the color of the rash became lighter. The course of the sputum or large piece of desquamation was generally shorter, but if the cause was not found and the drug was stopped, the drug rash could be developed.

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