Exfoliative Dermatitis, (Erythroderma) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
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About this ebook
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
Kenneth Kee
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 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders 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 autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” 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 1000 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 disorders.He has published 1000 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 disorders 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 Buona 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) startingwith the Apple computer and going to PC.The entire 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"
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Exfoliative Dermatitis, (Erythroderma) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Exfoliative Dermatitis,
(Erythroderma)
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2018 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes Exfoliative Dermatitis, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What The patient Need to Treat Exfoliative Dermatitis)
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Disorders
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 eBooks.
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 disorders.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Exfoliative dermatitis (Erythroderma)
What is exfoliative dermatitis?
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.
Exfoliative dermatitis is rare.
It can occur at any age and in people of all races.
It is about 3 times more frequent in males than in females.
Most have a pre-existing skin disease or a systemic disorder known to be linked with exfoliative dermatitis.
About 30% of cases of exfoliative dermatitis are idiopathic.
Erythrodermic