What is erythroderma?As a rule, the complaints of erythroderma occur on the entire body of the affected person. It comes to the whole body to a reddening of the skin.
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Erythroderma is what doctors call it when the skin is reddened all over. This is a skin inflammation, which is associated with the dilation of the vessels. As a result, there is a loss of protein, salts and liquid. By subsequent infections in the worst case even mortal danger is possible. Erythroderma is not an independent disease. Rather, it is a symptom that is triggered by different diseases.
For example, erythroderma is a collective term for several dermatoses (skin diseases). Another typical feature of erythroderma is a scaling of the skin. The symptoms show only in certain parts of the body, is of a Suberythrodermie the speech, which is classified as a special form. In women, erythroderma is twice as common as male sex. The average age of onset is between 50 and 60 years.
Erythroderma is a manifestation of an accelerated epidermal cell turnover. The cause of this can not be determined so far. Erythroderma is usually associated with an underlying skin condition.
These may be seborrheic dermatitis, contact dermatitis, atopic eczema, pityriasis rubra pilaris or psoriasis.
But the use of certain medicines sometimes causes erythroderma. These drugs include sulfonamides, penicillin, barbiturates, phenytoin or isoniazid. Other triggers include malinomas such as leukemia (blood cancer), adenocarcinomas or mycosis fungoides. However, about 25 percent of all patients do not suffer from an underlying disease.
In medicine, erythroderma is divided into two forms: primary erythroderma and secondary erythroderma.
- The primary form shows up without a previous illness and gives an answer to an acute event. It occurs, inter alia, Sézary syndrome, mycosis fungoides, a drug eruption or Alterersythrodermie in men.
- Secondary erythroderma develops from a skin disease that is previously known. It is more common than the primary form and occurs in psoriasis or atopic dermatitis. Psoriasis accounts for about 25 percent of erythroderma.
Symptoms, complaints & signs
As a rule, the complaints of erythroderma occur on the entire body of the affected person. It comes to the whole body to a reddening of the skin. Furthermore, sufferers also suffer from chills and fever. In addition, those affected suffer from itching and a general sense of illness, so that the patient also look tired and beaten and thus not participate in everyday life. The erythema is initially diffuse and shows up in the form of spots. In the further course, the reddening of the skin extends to almost the entire body.
The redness also has a negative effect on the regulation of body temperature, so that those affected often sweat or freeze. Patients often need to dress warmly. Also, erythroderma can lead to deficiency symptoms or to various nutrient losses as the redness persists.
Because it also comes to an extensive peeling of the epidermis (epidermis), this has a negative effect on the regulation of body temperature. For this reason, the patients show increased sensitivity to cold due to heat loss from the dilation of the blood vessels. The affected people often dress warmly because they are cold.
Further problems are a lack of nutrients, which is caused by a marked protein loss, as well as the increase of the metabolism rate with a hyperkatabolen status. The transdermal loss of fluids also causes hypovolemia, which reduces the amount of blood within the bloodstream.
Due to an extensive peripheral blood vessel dilatation (vasodilatation) also threatens the occurrence of heart failure. In extreme cases, danger to life may exist. The symptoms of erythroderma can also have a negative effect on the mental state of the person affected, so that some patients also suffer from depression or other mental disorders.
To diagnose erythroderma, the attending physician first looks at the medical history of the patient. Then he makes a physical examination. If there is a recognizable skin disease in addition to the typical symptoms, a causal relationship can be established. If there is a suspicion of mycosis fungoides, tissue is removed (biopsy).
An examination of the blood often results in hypocalcaemia, iron deficiency or hypoproteinemia. In some cases, erythroderma is life-threatening. For this reason, the patient usually has to visit a hospital. So there is a risk of significant complications.
When should you go to the doctor?
Redness of the skin is considered unusual, no matter where it occurs on the body. A doctor should be consulted as soon as they appear spontaneously or spread further. If the skin changes occur repeatedly over several weeks or months, they should be presented to a doctor to clarify the cause. If there are more complaints, there is cause for concern. Open wounds can lead to the ingress of germs that trigger additional illnesses.
Itching, swelling or dry skin layers should be examined and medically treated. If the skin redness occurs after taking medication or the supply of certain foods, there may be an intolerance. A doctor should be consulted to obtain clarity about the cause through an allergy test. Scaling of the skin indicates dryness of the skin layers. Relief can be achieved with an appropriate remedy. If the skin changes cause psychological problems or changes in mood, the person should seek help.
Behavioral changes, a social withdrawal or feelings such as shame diminish the general well-being. If the sufferer notices signs of inflammation on the skin, he should consult a doctor. In the formation of pus, pain or increased body temperature, he needs medical treatment. Just as unusual and to be informed by a doctor are sensations of the skin.
Treatment & Therapy
The treatment of erythroderma depends on its extent and triggers. Since the accompanying symptoms often cause a life-threatening condition, in severe cases in principle a stationary therapy must be carried out. This is especially true for acute and severe erythroderma, because it is particularly pronounced in the risk of death. But even with a gradual form of the disease from a certain severity treatment must take place in the hospital. There the patient receives medicines such as cortisone and sufficient fluid.
It is particularly important in the context of the treatment of an imminent dehydration (dehydration) counteract due to the significant fluid loss. The same applies to the loss of protein and heat as well as the vasodilation of the peripheral blood vessels, which pollutes the heart and circulation.
Drug eruptions are not always ruled out in erythroderma. For this reason, all medicines are discontinued or changed during therapy. In addition, the sufferer may receive only those drugs that he absolutely needed. To care for the skin, the patient gets emollients. If a severe form of erythroderma is present, glucocorticoids such as prednisone are administered. The patient systemically takes 40 to 60 milligrams for ten days.
Outlook & Forecast
Erythroderma can be treated very well nowadays. If the condition is recognized at an early stage, usually a drug treatment is sufficient to relieve the symptoms and discomfort. Once decayed, erythroderma usually has no further symptoms. If the disease is recognized too late or not sufficiently treated, the redness can spread to other body regions.
Drug treatment can relieve symptoms, but scars and pigmentation may be left behind. Erythroderma basically has a good prognosis. Provided that the treatment is adequate, the pathological reddening of the skin stops within a few days to weeks. The dermatologist responsible can provide an accurate prognosis, taking into account the course of the disease and the patient's state of health.
To achieve a long-term improvement in the appearance of the skin, the underlying disease must be treated. Otherwise, erythroderma may occur again and again, causing the appearance of the skin to deteriorate progressively. Life expectancy is not reduced by erythroderma. Only when severe conditions such as ichthyosis are the cause, life expectancy may be reduced as the disease progresses progressively.
Preventive measures against erythroderma are unknown. If the condition is caused by certain medicines, it should be discontinued or replaced with other medicines.
The patient has very limited options for aftercare during erythroderma. The patient is primarily dependent on the medical treatment to permanently alleviate the symptoms and to avoid further complications. Since erythroderma can not be self-healing, early diagnosis and treatment of this disease is very important to limit the spread of the condition.
In most cases the complaints are treated with the help of medications or ointments and creams. The person concerned should pay attention to the regular use and application, whereby consultation with a doctor should be held. Since erythroderma can also lead to severe dehydration, it is recommended that you always drink enough water.
Only then can the symptoms be completely alleviated. The patient is also dependent on regular medical check-ups even after successful treatment of erythroderma. If the symptoms recur, further treatment is necessary. The life expectancy of the patient is not reduced by the disease. In some cases, the contact with other patients of the disease may be useful.