Exfoliative erythroderma at Kenyatta National Hospital, Nairobi

East Afr Med J. 2007 Dec;84(12):566-70. doi: 10.4314/eamj.v84i12.9593.

Abstract

Background: Exfoliative erythroderma (EE), (Synonyms: Exfoliative dermatitis, Red man syndrome) is a clinical syndrome characterised by generalised erythema and scale. It is an important cause of functional skin failure and associated high morbidity and variable mortality rates.

Objectives: To study demographics, aetiology, complications and clinical outcomes of exfoliative erythroderma (EE) on patients attending Kenyatta National Hospital (KNH).

Design: Cross- sectional descriptive study.

Setting: Kenyatta National Hospital, Dermatology Unit.

Subjects: All available medical records on inpatients seen by qualified dermatologists at KNH with generalised erythema and scale from 1996 to 2006.

Main outcome measures: Discharge or death.

Results: Incidence exfoliative erythroderma was documented in 146 out of all 123 admissions (13%) into the dermatology unit from 1996-2006. Demographic mean age was 47 years, M: F ratio was 3:2, 67% had no income and 53% and 30% were residents of Nairobi and adjacent districts respectively. Sixty three percent were due to skin diseases, 23% due to systemic diseases of which 20% were due to HIV/AIDS and 14% due to adverse cutaneous drug reactions. Ninety percent of patients were treated and discharged and 10% died; 50% of whom had dermatoses and 29% due to HIV associated antituberculous drugs.

Conclusions: Exfoliative erythroderma is an important cause of morbidity, admission and mortality in patients attending KNH. Dermatoses and HIV / AIDS were the most frequent causes. The mortality rate was relatively low and attributable to controllable diseases.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cross-Sectional Studies
  • Dermatitis, Exfoliative / diagnosis
  • Dermatitis, Exfoliative / mortality
  • Dermatitis, Exfoliative / physiopathology*
  • Female
  • HIV Infections / complications
  • Humans
  • Incidence
  • Kenya
  • Male
  • Middle Aged
  • National Health Programs
  • Risk Factors
  • Skin Diseases / complications
  • Treatment Outcome*

Substances

  • Anti-Bacterial Agents