CLINICAL ASPECTS AND ALGORITHMS DIAGNOSTICS OF DIFFERENT TYPES OF ERYTHRODERMA

Erythroderma - the term used for the description intensive and usually widespread reddening of the skin which has arisen owing to activation of the previous inflammatory dermatosis. The aim is to study and compare clinical manifestations of various forms of an erythroderma and also to develop an algorithm of their diagnostics and therapy. We observed 133 patients with an erythroderma undergoing investigation and treatment on bases of dermatologic depatments: V.A. Rakhmanov Clinic of skin and veneral diseases I.M. Sechenov First Moscow State Medical University, Leningrad Regional centre of specialized types of a medical care, Skin-Venerologic Clinic of St. Petersburg and university clinic Bonn the period from 2001 to 2018. A prospective study was conducted at 51 patients, is retrospective - at 82 patients. From them were men - 83 persons and women - 50 people, whose average age was 49 years (in the range 26-85 years). The collecting of the anamnesis is carried out; clinical data are studied and for verification of the diagnosis are compared with results of a histological research. Clinical manifestations of all surveyed groups were similar. The most frequent symptoms were generalized reddening and a peeling of the skin, an itch of skin, different degree of expressiveness and a form of changes of nail plates, changes of palms and soles. Diagnosis on the basis of only clinical examination gave the chance to make the correct diagnosis in 77(58%), in comparison with the final diagnosis 112(84,1%) from 133 made on the basis of set of clinical, histological data and reaction to therapy. In particular, the diagnosis of a psoriatic erythroderma was made in 26(34,58%) from 133, an atopic eythroderma - 20(26,6%), the eythroderma caused by reception of drugs - 24(31,92%), an erythrodermic form of mycosis fungoides/Cezary syndrome - 7(9,31%) from 133 patients. The clinical diagnosis didn’t correspond to the final diagnosis in other 56(42%) from 133 patients. Thus, at diagnosis and definition of forms of an erythroderma important aspect is clinical examination and clinicopathologic correlation.