Clinical Patterns and Clinicopathologic Correlation of 100 Patients with Erythroderma in a Tertiary Care Institute in India.

Erythroderma is a severe dermatologic manifestation of a variety of diseases. We analyzed the clinical parameters and the clinicopathologic correlation in patients with erythroderma. Consecutive patients diagnosed with erythroderma at a tertiary care institute were evaluated for 5 years. Detailed history and clinical examination were noted along with extensive hematologic and biochemical investigations, radiologic studies, and skin biopsy for histopathologic examination, and if required, for immunoflourescence and immunohistochemistry; 83 men and 17 women were included in the study. Based on microscopic findings, 34 patients were given a diagnosis of psoriasis, 28 of spongiotic dermatitis with predominant eosinophilic infiltrate, five of chronic actinic dermatitis, 18 of drug-induced erythroderma, three of pemphigus foliaceous, and two each of pityriasis rubra pilaris and erythrodermic mycosis fungoides. Histology was inconclusive in five cases, one each of psoriasis, dermatitis, pityriasis rubra pilaris, bullous pemphigoid, and drug eruption. Clinical-pathologic correlation occurred in 78.3% cases. The most common etiologies found in our study were psoriasis, airborne contact dermatitis, and drugs.

Dermatofibroma: Atypical Presentations.

Dermatofibroma is a common benign fibrohistiocytic tumor and its diagnosis is easy when it presents classical clinicopathological features. However, a dermatofibroma may show a wide variety of clinicopathological variants and, therefore, the diagnosis may be difficult. The typical dermatofibroma generally occurs as a single or multiple firm reddish-brown nodules. We report here two atypical presentations of dermatofibroma - Atrophic dermatofibroma and keloidal presentation of dermatofibroma. Clinical dermal atrophy is a common phenomenon in dermatofibromas as demonstrated by the dimpling on lateral pressure. However, this feature is exaggerated in the atrophic variant of dermatofibroma. Atrophic dermatofibroma is defined by dermal atrophy of more than 50% of the lesion apart from the usual features of common dermatofibroma. The keloidal variant of dermatofibroma should not be overlooked as a simple keloid. The findings of keloidal change in dermatofibromas may support that trauma is a possible cause of dermatofibroma.