Internal Medicine

P1: OXT/OZN/JDO P2: PSB

0521779407-E-01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:10

562 Exfoliative Dermatitis Eyelid Lesions

■Physical – usually dermatitis is diffuse with involvement over many

areas, up to 100% body surface area

■Generalized erythroderma with desquamation

May be related to recent medication, viral exanthema, or other

infection

tests

■Skin biopsy to assess cause

differential diagnosis

■Dermatitis

■Psoriasis

■Cutaneous lymphoma

■Internal malignancy

■Lichen planus or other papulosquamous disease

Pityriasis rubra pilaris

management

■Assess cause and remove.

■Assess possible high–output cardiac failure.

specific therapy

Based on cause, but management of skin usually requires aggressive

topical therapy as well as systemic therapy

follow-up

Based on cause. It is important that biopsies are occasionally repeated

to rule out cutaneous lymphoma, even if they are initially inconclusive.

complications and prognosis

Based on cause. If related to medication, withdrawal and therapy with

appropriate measures usually leads to resolution. If T-cell lymphoma,

condition may be lifelong.

Eyelid Lesions.......................................

DEVRON H. CHAR, MD

history & physical

■Prior basal cell carcinoma (BCC) at any site, mandates a biopsy of

new lid lesions.

■Lash loss, a pearly, cavitated border, or a unilateral chronic ulceration

requires biopsy.