Senile erythroderma with hyper IgE: an independent and novel disease form

Abstract

Erythroderma is a rare exfoliative dermatitis with various causes [1, 2]. The exact pathophysiology of this disease has not received much attention. Moreover, while it has been reviewed many times [1, 2], there is little mention of senile erythroderma. The accumulated findings [1, 2] reveal 3 factors involved in its etiology: drugs such as carbamazepine, preexisting skin diseases such as psoriasis [1], and stages of malignancies such as cutaneous T-cell lymphomas. Li and Zheng [2] reported the most prevalent causative factors—preexisting dermatoses (70.77%), followed by idiopathic causes (14.23%), drug-induced reactions (12.69%), and malignancies (2.31%). Among the pre-existing dermatoses, psoriasis was the most common etiology (55%). Several case analyses show that males are 4 times more likely to be affected by erythroderma than females [1, 2]. The average age is 52 to 57 years, including those in 80s [1, 2]. One study reported a unique case of erythroderma caused by propolis [3]—a food product produced by honeybees. Steroid withdrawal erythroderma [4] has been reported; as it is caused by medical care, it is called iatrogenic. Patients with systemic eczema have received steroids for external use at various medical institutions for many years due to the intractability of their conditions. In cases of steroid withdrawal, erythroderma occasionally occurs. As the cases caused by an underlying disease are diverse, dermatologists and clinicians should first determine the possible cause in patients with erythroderma.