Papuloerythroderma of Ofuji (PEO) is a rare form of erythroderma, most commonly seen in older men. It begins with pruritic, erythematous or brown, flat-topped papules that subsequently coalesce into plaques. The plaques eventually generalize into near-global erythroderma sparing the skin folds, a characteristic physical finding known as the deck-chair sign. Most patients present with associated pruritus and peripheral eosinophilia, while elevated immunoglobulin E (IgE) level and peripheral lymphopenia are less frequently observed. Reactive lymphadenopathy may be present.

PEO mostly affects men of Asian or Northern European descent, with onset at age 55 years or older. These patients are typically healthy, and PEO is usually idiopathic. However, etiological associations have been noted in a minority of cases, including an underlying atopic diathesis, hematologic malignancies, gastric and other solid organ malignancies, and, less frequently, drugs (such as aspirin and furosemide) and infections (such as hepatitis C virus [HCV] and human immunodeficiency virus [HIV]). Additionally, cases of cutaneous T-cell lymphoma (CTCL) with a PEO-like clinical appearance have been reported.

PEO is generally an indolent condition and requires long-term treatment. Those with secondary PEO may experience faster and complete resolution upon treatment of underlying conditions or cessation of offending drugs.