Erythroderma in the Post-Covid Era: Demographics, Histopathology, and Clinical Insights Publisher



Ehsani A ; Ghiasvand K ; Hamzelou S ; Nourmohammadpour P ; Mohmmadabadi MK ; Ehsani A ; Alivandi FK ; Rahimnia A
Source: Iranian Journal of Dermatology Published:2025

Abstract

Background: Erythroderma is a severe dermatologic emergency characterized by generalized erythema and scaling over more than 90% of the body surface area. It may result from various underlying conditions, including pre-existing dermatoses, infections, and adverse drug reactions. The COVID-19 pandemic has introduced new complexities to the pathogenesis of erythroderma, such as flare-ups triggered by viral infections or vaccines. Methods: This descriptive cross-sectional study analyzed 16 patients diagnosed with erythroderma at Razi Dermatology Hospital in 2023. Patient data, including demographic details, medical history, and histopathological findings, were collected retrospectively from hospital records. Only patients with complete medical records were included in the analysis. Descriptive statistics were used to analyze the data, and histopathological examinations were conducted to investigate the underlying causes. Results: Among the 13 patients analyzed, the majority were male (76.9%), with a mean age of 57.7 years. Most patients had no prior history of chronic skin conditions, while psoriasis was the most common final diagnosis (46.2%), followed by drug-induced erythroderma (30.8%) and mycosis fungoides (15.4%). Histological anal ysi s most f r equent l y demonst r at ed spongi osi s ( 76. 9%), lymphocytic exocytosis (84.6%), and epidermal hyperplasia (100%). Notably, drug-induced cases were associated with post-COVID status and vaccine-related reactions. Conclusion: Erythroderma remains a complex dermatologic condition with a multifactorial etiology. In this cohort, psoriasis and drug-induced reactions, including those triggered by COVID-19 vaccination, were predominant causes. Early diagnosis and histopathological evaluation are crucial for effective management, particularly given the evolving challenges posed by the COVID-19 pandemic. Further studies are needed to clarify the long-term implications of COVID-19 on erythroderma. © 2025 Elsevier B.V., All rights reserved.