Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.
J Eur Acad Dermatol Venereol. 2010 Jul;24(7):781-8. doi: 10.1111/j.1468-3083.2009.03526.x. Epub 2009 Dec 17.
Erythroderma is a severe syndrome and prognostic studies are rare in the literature.
Through a retrospective study of erythroderma in adults, we have analysed epidemiological and clinical data and precised the relevant aetiologies and survival in our patients.
This study was performed at the Department of Dermatology of Charles Nicolle Hospital of Tunis (1995-2007) including 82 cases of acquired erythroderma (>16 years). We have recorded epidemio-clinical, biological and histological data, treatment and outcome. Clinical-histological correlation was analysed [kappa coefficient (kappa)]. Follow-up time and disease-free survival time were calculated as were Kaplan-Meier estimates of overall survival and relapse-free survival for some aetiologies.
Erythroderma represented 0.44 per thousand of all dermatoses with an age of 55.13 +/- 18.16 and no sex predilection. Psoriasis was the predominant aetiology (32.9%) with a median duration of 6.75 years and previous one or more episodes of erythroderma. Psoriasis was significantly associated with pruritus (P = 0.0001), pachyonychia (P = 0.00001), palmoplantar keratoderma (P = 0.0001) and hypereosinophilia (P = 0.008). The latter is then not specific for drug induced erythroderma (P = 0.004). Carbamazepine (27.8%) and penicillin (22.2%) were the most implicated drugs. Positive Clinical-histological correlation was found in 77% of cases (kappa = 0.753). Relapse was seen in all aetiologies, but drug reactions and had occurred in the first 3 years in 90% of them. Mortality rate was 11.3 per 1000 patients-years.
Our study illustrates the severity of erythroderma. It alters heavily the quality of life of patients which is initially altered by the pre-existent dermatosis. It may be life threatening as mortality rate is high.
红皮病是一种严重的综合征，文献中很少有关于其预后的研究。
通过对成人红皮病的回顾性研究，我们分析了流行病学和临床数据，并明确了我们患者的相关病因和生存率。
本研究在突尼斯 Charles Nicolle 医院皮肤科进行（1995-2007 年），包括 82 例获得性红皮病（>16 岁）。我们记录了流行病学、临床、生物学和组织学数据、治疗和结果。分析了临床-组织学相关性（kappa 系数（kappa））。计算了随访时间和无病生存时间，并计算了某些病因的总生存率和无复发生存率的 Kaplan-Meier 估计值。
红皮病占所有皮肤病的 0.44%，发病年龄为 55.13±18.16 岁，无性别差异。银屑病是最主要的病因（32.9%），中位病程为 6.75 年，此前有 1 次或多次红皮病发作。银屑病与瘙痒（P=0.0001）、厚甲（P=0.00001）、掌跖角化过度（P=0.0001）和嗜酸性粒细胞增多（P=0.008）显著相关。嗜酸性粒细胞增多并不特异于药物引起的红皮病（P=0.004）。卡马西平（27.8%）和青霉素（22.2%）是最常见的致病药物。77%的病例存在阳性临床-组织学相关性（kappa=0.753）。所有病因均出现复发，但药物反应在 90%的病例中发生在 3 年内。死亡率为每 1000 患者年 11.3 例。
我们的研究说明了红皮病的严重性。它严重改变了患者的生活质量，最初是由先前存在的皮肤病引起的。它可能危及生命，因为死亡率很高。
