King L E, Dufresne R G, Lovett G L, Rosin M A
South Med J. 1986 Oct;79(10):1210-5. doi: 10.1097/00007611-198610000-00005.
We reviewed 82 cases of erythroderma, including clinical, laboratory, and biopsy material. The diseases most commonly associated with erythroderma were drug eruptions (34%), preexisting dermatoses (30%), and lymphoreticular neoplasms (20%), especially cutaneous T cell lymphomas (CTCL). The prognosis was related to the associated process; all deaths occurred in the drug or lymphoma groups. The clinical presentation of erythroderma was fairly uniform, with malaise (34%), pruritus (36%), and a subjective chilly sensation (34%) the most common symptoms. Keratoderma of the palms and soles (37%), mild generalized adenopathy (26%), and hepatomegaly (9%) were also common. Splenomegaly was rare (1%). Skin biopsy revealed the cause in 43% of the patients, but lymph node biopsy was not generally helpful in the initial evaluation. Although numerous laboratory values were abnormal, most findings were nondiagnostic and were related to the inflammatory process. A major exception was the Sezary cell preparation, which was selective for CTCL. A previously undiagnosed chronic erythroderma in a patient with no underlying skin disease may be the initial manifestation of CTCL. Thus, repeated evaluations and close follow-up are recommended.
我们回顾了82例红皮病病例，包括临床、实验室及活检资料。与红皮病最常相关的疾病为药疹（34%）、既往存在的皮肤病（30%）及淋巴网状肿瘤（20%），尤其是皮肤T细胞淋巴瘤（CTCL）。预后与相关病情有关；所有死亡均发生在药疹或淋巴瘤组。红皮病的临床表现相当一致，最常见的症状为不适（34%）、瘙痒（36%）及主观寒冷感（34%）。掌跖角化病（37%）、轻度全身性淋巴结病（26%）及肝肿大（9%）也很常见。脾肿大罕见（1%）。皮肤活检在43%的患者中明确了病因，但淋巴结活检在初始评估中一般无帮助。尽管众多实验室检查值异常，但大多数结果无诊断意义且与炎症过程有关。一个主要例外是 Sézary 细胞检查，其对CTCL具有特异性。无潜在皮肤病患者中先前未诊断出的慢性红皮病可能是CTCL的初始表现。因此，建议进行反复评估及密切随访。
