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Erythroderma

Exfoliative dermatitis; Dermatitis exfoliativa; Pruritus - exfoliative dermatitis

Erythroderma is widespread scaling, peeling, and flaking of the skin. It is often accompanied by, itching, skin redness, and hair loss.

Causes

This condition may occur in severe cases of many common skin conditions, such as eczema and psoriasis. It is sometimes caused by an allergy to medicines, chemicals that come in contact with the skin, or by body-wide disease.

Sometimes the cause is unknown.

Symptoms

Symptoms may include any of the following:

  • Redness and scaling with weeping or crusting that cover over 80% to 90% of the body
  • Skin is itchy or painful and often has an odor
  • Swelling of the arms or legs
  • Fast heart beat
  • Loss of fluids leading to dehydration
  • Loss of temperature regulation by the body

There may be secondary infections of the skin.

Exams and Tests

The health care provider will perform an examination and ask about the symptoms. The skin will be carefully checked, often with an instrument called a dermascope. Most of the time, the cause can be identified after the exam.

If needed, the following tests may be ordered:

  • Biopsy of the skin
  • Allergy testing
  • Other tests to find the cause of erythroderma

Treatment

Since erythroderma can quickly lead to serious complications, the provider will start treatment right away. This usually involves strong doses of cortisone medicines to reduce inflammation.

Other treatments may include:

  • Medicines to treat the underlying cause of erythroderma, such as psoriasis
  • Antibiotics for any infection
  • Dressings applied to the skin
  • Ultraviolet light

Outlook (Prognosis)

In serious cases, the person needs to be treated in the hospital.

Possible Complications

Complications may include:

  • Secondary infections that can lead to sepsis (bodywide inflammatory response)
  • Fluid loss that can result in dehydration and an imbalance of minerals (electrolytes) in the body
  • Heart failure

Prevention

Risk for erythroderma may be reduced by following the provider's instructions on skin care for psoriasis or other skin conditions.

References

Habif TP. Exanthems and drug eruptions. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 14.

Whittaker S. Erythroderma. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 10.

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  • Eczema, atopic - close-up - illustration

    This view shows the red, scaly patches called plaques that are characteristic of atopic dermatitis.

    Eczema, atopic - close-up

    illustration

  • Psoriasis - magnified x4 - illustration

    This picture shows a 400% magnification of psoriasis. The whitish scales give the silvery appearance to the typical psoriasis lesion.

    Psoriasis - magnified x4

    illustration

  • Atopic dermatitis - illustration

    The term dermatitis describes an inflammatory response of the skin, caused by contact with allergens or irritants, exposure to sunlight, or by poor circulation, even stress. An example of atopic dermatitis is eczema, an itchy rash that produces redness, blisters and scaling. AVOID SCRATCHING. Scratching the rash may spread the inflammation, lead to infection and even leave scars.

    Atopic dermatitis

    illustration

  • Eczema, atopic - close-up - illustration

    This view shows the red, scaly patches called plaques that are characteristic of atopic dermatitis.

    Eczema, atopic - close-up

    illustration

  • Psoriasis - magnified x4 - illustration

    This picture shows a 400% magnification of psoriasis. The whitish scales give the silvery appearance to the typical psoriasis lesion.

    Psoriasis - magnified x4

    illustration

  • Atopic dermatitis - illustration

    The term dermatitis describes an inflammatory response of the skin, caused by contact with allergens or irritants, exposure to sunlight, or by poor circulation, even stress. An example of atopic dermatitis is eczema, an itchy rash that produces redness, blisters and scaling. AVOID SCRATCHING. Scratching the rash may spread the inflammation, lead to infection and even leave scars.

    Atopic dermatitis

    illustration

 

Review Date: 2/27/2018

Reviewed By: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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