Exfoliative dermatitis. A clinicopathologic study of 135 cases

Among 135 patients with exfoliative dermatitis, the most common causative factors were drugs and preexisting dermatoses. Instances of idiopathic exfoliative dermatitis probably represent examples in which the cause was overlooked. In about one fifth of the patients the exfoliative dermatitis was associated with mycosis fungoides and lymphomas. These patients did not develop specific clinical features indicating malignancy, but the lack of response to therapy should raise the question of an underlying malignant condition. Lymphadenopathy, usually generalized, often accompanied severe manifestations of exfoliative dermatitis. Microscopic examination was helpful in establishing the diagnosis of exfoliative dermatitis. The histologic picture of an underlying preexisting dermatosis such as psoriasis, or lichen planus may be occasionally but not always diagnosed. Skin from patients with drug allergy may show histologic features simulating those of mycosis fungoides.