Exfoliative erythroderma at Kenyatta National Hospital, Nairobi.

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.