Mini Poster - Erythroderma e.c Drug Eruption

8/12/2019 Mini Poster - Erythroderma e.c Drug Eruption

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IZZAH MUNIRA HAMIDIN C11108791

MASYITA AHMAD OPIER C11108184RAISSA ALFAATHIR HERI C11108197


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Patients IdentityName : Kornelius Kadang

Gender : Male

Age : 52 years old

Marital Status : Married

Address : PERUM Stella Maris,

Tidung 10, Makassar

Admission Date : 29 January 2012


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History TakingChief complaint : red patches and

scaling almost the whole body

Happen 1 week ago, starts with itchy and thereare red spots at the face and it spreaded all ofthe body.

Post operation of prostate (1 month before)

Medication History : Cefadroxil, Mefenamicacid, Transamin, Ranitidin

Fever (+) before itch presented


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Physical ExaminationAnemic (-), icterus (-), cyanoses (-)

Diffuse erythema with overlying scale covering> 90% of the body surface area, pus and wound

on the left ear

Cor / Pulmonal : Normal

Abdomen : Normal, peristaltic (+)


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Current Status General status

Composmentis

Moderate Sickness

Adequate nutrition Moderate Hygiene

Vital sign (in normal limit)

Blood pressure : 120/80 mmHg

Pulse rate : 96 x/min

Respiration rate : 24 x/min

Temperature : 36,8 C


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Dermato-venerology Status

Location 1 : Regio Universalis

Effloresensi : Erythema Macule,

Squamatous, Erosion, Crust

Location 2 : Regio Facialis, auricularis

dextra et sinistra

Effloresensi : Erosion, Edema, Pustule,

Crust, Erythema


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Laboratory Result

Ureum : 20 mg/dl

Creatinin : 1,7 mg/dl

GDS : 87 mg/dl SGOT : 22 U/l

SGPT : 47 U/l

Natrium : 134 mmol/l

Kalium : 3,9 mmol/l

Chloride : 109 mmol/l


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Recommended examinationXray

Consult diet

Consult ENT


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ResumeA 57 years old man came to the hospital with complain

of having red patches and squamation on all over thebody since 1 week ago.

History of fever 1 week before red spot appeared

History of prostate operation

History of medication; cefadroxil, mefenamic acids,

ranitidin, transaminNo history of allergic


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DiagnosisErythroderma e.c Drug Eruption


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Treatment

1. IVFD RL 20 drops/min

2. Dexamethasone inj. 1 amp/ 6 h./ iv

3. Gentamicin 1 amp/12 h./ iv

4. Lanolin 10% + Vaseline add 100 gr

5. Fuson cr.

6. Compress NaCl


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PICTURES

(30-01-2012)


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(03-02-2012)


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ERYTHRODERMA

Universal redness and scaling of theskin affecting 90-100% of the body


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Idiopathic - 30%

Drug allergy - 28%

Seborrheic dermatitis - 2%

Contact dermatitis - 3%

Atopic dermatitis - 10%

Lymphoma and leukemia - 14%

Psoriasis - 8%


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Medications Implicated in

ErythrodermaThe most commonly implicated drugs include: Anti-epileptics Allopurinol

AntibioticsPenicillinSulfonamidesVancomycin

Calcium channel blockers

Cimetidine Dapsone Gold Lithium Quinidine


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Present with universal erythema. Scaling appears 2-6days after the onset of erythema usually starting fromflexural area.

Common symptoms : fevers, chills, malaise & pruritus Pruritus result in excoriation. When erythroderma

persist for weeks, hair may sheds, nails may becomeridge and thickened and also may shed.

A fine brawny scaling in drug-induced

A heavy scaling and silvery white scales in psoriasis


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Dilatation ofcapillary

Large amounts of

warm blood arepresent in the skin

heat dissipation

through insensiblefluid loss and byconvection

the loss of scales throughexfoliation (9 g/m2ofbody surface per day)

reduction in serumalbumin

the edema of the

lower extremities

fatigue, weakness, malaise,and shivering

Metabolic response to erythroderma:


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DiagnosisAnamnesis & history taking

Physical examination

Laboratory examinationo Low serum albumin and increase in gammaglobulins;

electrolyte imbalance; acute-phase proteins increased.

o

Leukocytosis


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Treatment

Remove any potential offending and unnecessary

medications

Address nutrition, fluid and electrolyte balance

Oral corticosteroid

Local skin care with compression to weeping orcrusted sites, bland emollients and mid-potencytopical corticosteroids

Oral antihistamines for relief of pruritus For secondary infection with systemic antibiotics


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Mini Poster - Erythroderma e.c Drug Eruption

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