16 Apr 2012

Red Man Syndrome and l'homme rouge

Red Man Syndrome

Red Man Syndrome proper is now used to describe an erythroderma that remains idiopathic. The word 'idiopathic' is a wonderful medical term that means 'of unknown cause', or 'we haven't a clue'. You may find it of interest to read my Diary of a Red Man blog entry on idiopathy so that it is clear what we mean by the question, “What is the cause of your erythroderma?”

One problem with defining Red Man Syndrome in terms of a lack of known causes is that, if one day your dermatologist actually finds the root cause of your condition, then the name of your condition will change too; all without any apparent change in symptoms. However, the most important thing is that with the new name comes a new treatment. It is worth remembering that all names are just labels and that it is more important to know what each label means rather than being attached to a mere name.

However, Red Man Syndrome also has a number of characteristic symptoms: palmoplantar keratoderma (a hardening of the skin on the palms of the hands and soles of the feet); dermatopathic lymphadenopathy (a problem with the lymphatic system requiring a lymph node biopsy for verification); and a raised level of serum immunoglobulin E (IgE), which requires a blood test to verify.

L’homme rouge

L’homme rouge is, of course, merely the French for ‘red man’, but now (perhaps confusingly) refers to an erythroderma that is secondary to cutaneous T-cell lymphoma (CTCL). Other types of exfoliative dermatitis that have been brought into the secondary CTCL camp are mycosis fungoides, Wilson-Brocq, Hebra and Savill types. You may still find these names on the internet but their reclassification is a significant step forward in the often obscure etiology of this skin condition.

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