Atopic erythroderma Hill



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Abstract

Atopic erythroderma Hill is an uncommon and severe form of atopic dermatitis characterized by generalized skin involvement. It most frequently develops in children under the age of 3, accounting for 1.6%–8.7% of cases in this age group, although it may also occur in adolescents.

The widespread inflammatory process is accompanied by persistent, intense pruritus, symptoms of intoxication, impaired thermoregulation, cutaneous signs of autonomic dysfunction, lymphadenopathy, and frequent secondary infections. Exacerbation of concomitant allergic respiratory diseases is also common.

This article presents a case of erythroderma Hill in a 13-year-old child with a personal and family history of atopic diseases. The condition developed following a psychotraumatic event and was not immediately diagnosed. Positive clinical dynamics with gradual regression of skin symptoms were observed following systemic antibiotic therapy, desensitizing and antihistamine treatment, along with topical glucocorticoids and emollients.

Timely recognition of atopic dermatitis as the underlying cause of erythroderma, especially in late-onset presentations, is crucial for initiating appropriate anti-inflammatory therapy and preventing recurrences. Patient education on lifestyle modification and early intervention at the onset of exacerbations is essential.

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About the authors

Svetlana N. Shchava

Volgograd State Medical University

Email: snchava@rambler.ru
ORCID iD: 0000-0002-4946-6624
SPIN-code: 7449-7277

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Volgograd

Marina A. Shishkina

Volgograd State Medical University

Author for correspondence.
Email: marinashishkina_derm@mail.ru
ORCID iD: 0000-0001-5479-3075
SPIN-code: 5446-8406
Russian Federation, 1 Pavshikh Bortsov sq, Volgograd, 400131

References

  1. Sokolova TV, Safonova LA. The course and treatment of atopic erythroderma Hill (case study). Vestnik dermatologii i venerologii. 2016;(3):128–138. EDN: WGBBQN
  2. Tamrazova OB. Pathogenetic therapy of children suffering from severe forms of atopic dermatitis. (In Russ.) Russkii meditsinskii zhurnal. 2013;21(2):108–114. EDN: QZYYLT
  3. Luger TА, Loske KD, Elsner P, et al. [Topical skin therapy with glucocorticoids--therapeutic index]. (In German.) J Dtsch Dermatol Ges. 2004;2(7):629–634. doi: 10.1046/j.1439-0353.2004.03626.x
  4. Li J, Zheng HY. Erythroderma: A clinical and prognostic study. Dermatology. 2012;225(2):154–162. doi: 10.1159/000342365
  5. Paller AS, Silverberg JI, Cork MJ, et al. Efficacy and safety of dupilumab in patients with erythrodermic atopic dermatitis: A post hoc analysis of 6 randomized clinical trials. JAMA Dermatol. 2023;159(3):255–266. doi: 10.1001/jamadermatol.2022.6192

Supplementary files

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2. Fig. 1. Common erythematous-squamous rashes on the trunk.

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3. Fig. 2. Common erythematous-squamous rashes on the face and neck.

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4. Fig. 3. Hyperlinearity and dryness of the skin of the palms.

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5. Fig. 4. Pink papular elements on the chest.

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6. Fig. 5. Regression of rashes: on the skin of the trunk (a) and limbs (b).

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