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Erythroderma in children: a clinico-etiological study
R Sarkar1, R C Sharma, R V Koranne
1Department of Dermatology and Sexually Transmitted Diseases, Lady Hardinge Medical College, New Delhi, India.
Insights
Erythroderma in children is uncommon, with drugs being the most frequent cause. This study highlights the clinical and etiological factors in pediatric erythroderma patients, emphasizing drug-induced cases.
Area of Science:
- Pediatric Dermatology
- Clinical Research
- Dermatology
Background:
- Erythroderma studies predominantly focus on adults, leaving a gap in understanding pediatric cases.
- A dedicated pediatric dermatology unit provides a unique opportunity to investigate childhood erythroderma.
Purpose of the Study:
- To analyze the clinical, etiological, and laboratory parameters of erythroderma in a pediatric cohort.
- To identify common causes and features of erythroderma in children.
Main Methods:
- Retrospective study of 17 pediatric erythroderma patients (1993-1998).
- Data collection included clinical presentation, onset, symptoms, cutaneous and systemic features, and etiology.
- Laboratory findings were also assessed for diagnostic contribution.
Main Results:
- The mean age of onset was 3.3 years; 47% were infants.
- Itching and burning were primary complaints; scalp involvement and alopecia were common cutaneous features.
- Drugs (29%) were the leading cause, followed by genodermatoses, psoriasis, and staphylococcal scalded skin syndrome (SSSS).
Conclusions:
- Erythroderma is rare in children, but drug-induced cases are significant.
- Clinicians should consider medications as potential triggers for erythroderma in pediatric patients.
Abstract:
Although there are various published studies on erythroderma from western and Asian countries, most of them have only included patients in the adult age groups. As we have an exclusively pediatric dermatology unit, we thought it would be intriguing to study the clinical, etiological and laboratory parameters of erythroderma in children. Seventeen erythroderma patients of both sexes were inducted into the study between 1993 to 1998. The mean age of onset was 3.3 years and the male:female ratio was 0.89:1. Eight (47%) of the patients were infants; 9 (53%) others belonged to the preschool and school going age group (age range between 1 to 12 years). An acute onset of the disease was seen in 47% of the patients while 53% of the patients had a chronic onset. The main presenting complaints were itching in 41% and burning in 18% of patients. Scalp involvement (71%), nail involvement (18%), and alopecia (6%) were the main cutaneous features observed while fever (53%), tachycardia (53%), pedal edema (12%), lymphadenopathy (18%), and hepatomegaly (12%) were the main systemic features observed in this study. Etiologically, drugs (29%), showed the highest incidence, followed equally (18%) by genodermatoses, psoriasis, and staphylococcal scalded skin syndrome (SSSS). Two (12%) patients had erythroderma due to atopic dermatitis, while one was (5%) due to infantile seborrheic dermatitis coexisting with dermatophytosis. Laboratory parameters contributed little towards diagnosis of the underlying dermatological condition. Thus, though erythroderma is a striking entity, it is yet uncommon in the pediatric age group. Because the drug induced group was the largest in this study, we recommend that drugs should be suspected as important causative factors of erythroderma in children.