Clinico-Pathologic Study of Exfoliative Dermatitis in Patients Visiting a Tertiary Care Centre in South India

Introduction: Exfoliative dermatitis is an extreme state of skin irritation resulting in extensive erythema and or scaling of the body. More than 90% of skin surface involvement is considered as a salient pre-requisite to make a clinical diagnosis of exfoliative dermatitis. Histopathology aids in the diagnosis of many cases of exfoliative dermatitis. Purpose: Exfoliative dermatitis can be caused by a wide range of pre-existing dermatosis or can develop de novo. Our study aimed at studying the clinical and pathological correlation in exfoliative dermatitis. Materials and Methods: 50 patients with clinical diagnosis of exfoliative dermatitis who presented to our skin department were taken up, evaluated with lab tests and skin biopsies. Skin biopsies were classified as conclusive, compatible, and undefined according to the biopsy reporting. Results: Psoriasis was the most common cause of exfoliative dermatitis, followed by atopic in the pre-existing dermatosis group leading to exfoliative dermatitis. Drug-induced erythroderma was seen in 24%. 26% of exfoliative cases were idiopathic. A skin biopsy was able to yield a diagnosis in 60% (36% biopsy were conclusive, 24% were compatible with a diagnosis). The rest 40% biopsy reports were undefined or non-specific findings. Conclusion: Thus, in our series of patients presenting with exfoliative dermatitis, the etiologic diagnosis was defined in 60.0% of patients with the skin biopsy. The biopsy could not establish a definitive diagnosis in the remaining 40.0% patients. We would like to emphasize the importance of biopsy in a case of exfoliative dermatitis. Furthermore, in the population with undefined biopsy report, we would suggest follow-up biopsies 3 months later or so.