Author: Dr Anne-Marie Aubin, Resident Medical Officer, John Hunter Hospital, NSW, Australia
Reviewing dermatologist: Dr Ian Coulson (2023). Edited by the DermNet content department.
A 58-year-old male presents with a six month history of erythroderma, non-responsive to topical and oral steroids. He is otherwise well and has no mucosal lesions or ocular involvement.
This rash shows the classical ‘deck chair sign’, a clinical pattern characterised by selective sparing of skin folds and flexures in an erythematous eruption. Often widespread papules coalesce to form plaques, the papular component can be seen in the images.
Deck chair sign is characteristic of papuloerythroderma of Ofuji (PEO). It has also been observed in:
A high index of suspicion is needed to rule out associated malignancy. Comprehensive investigations including skin biopsy, tumour markers, and imaging are recommended.
