Erythroderma and exfoliative dermatitis

Abstract

Erythroderma is conventionally defined as inflammation of at least 90% of the skin surface, characterized by erythema and variable scaling. When the scaling is prominent it is often called exfoliative dermatitis. Erythroderma is a potentially life-threatening state of 'skin failure' in which patients are at risk from complications including hypothermia, fluid, and electrolyte imbalance, hypo-albuminaemia, cardiac failure and infection including septicaemia. There are a multitude of possible causes which encompass virtually all inflammatory skin diseases; a proportion develop without any apparent trigger and remain 'idiopathic'. The commonest causes of acute erythroderma are psoriasis, atopic and other varieties of eczema, cutaneous T-cell lymphoma and drug reactions. Management of erythroderma requires a combination of general supportive measures and treatment directed at the underlying cause. Acute cases need hospital management with intensive monitoring and support. The prognosis depends substantially on the aetiology and is best for drug-induced erythroderma, which often resolves promptly when the offending drug is withdrawn. © Springer Berlin Heidelberg 2009.