More than 90% of the body's surface area is affected by erythema (redness) and scaling as a result of erythroderma, also called exfoliative dermatitis. Various underlying factors can cause this condition and it requires prompt medical attention for proper management. In this article, we cover erythroderma's causes, symptoms, diagnosis, treatment, and prevention.
Causes
Erythroderma can be triggered by a wide range of underlying conditions, including:
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Psoriasis
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Atopic dermatitis (eczema)
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Reactions to drugs, such as antibiotics, anticonvulsants, and nonsteroidal anti-inflammatory drugs (NSAIDs)
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T-cell lymphoma of the skin
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Seborrheic dermatitis
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Contact dermatitis
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Autoimmune disorders, like lupus erythematosus
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Viruses, such as HIV, hepatitis, or fungi
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Malignancies underlying
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The exact cause of idiopathic diseases is unknown
Symptoms
The hallmark symptoms of erythroderma include:
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Skin redness (erythema) that is widespread
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Peeling or scaling of the skin, often in large sheets
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Pruritis (itching)
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Pain or discomfort
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Affected areas swell (edema)
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Sensitivity to touch or temperature changes
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Changes in the nails, such as thickening or pitting
Diagnosis
Erythroderma is diagnosed through a thorough evaluation of the patient's medical history, physical examination, and sometimes additional tests.
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Analyzing the patient's history of current illness, including recent medication use and exposure to possible triggers
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Assessing the extent and characteristics of erythema and scaling on the skin
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Examining affected tissue under a microscope and ruling out other skin conditions or malignancies
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Assessing inflammatory markers, screening for infectious or autoimmune diseases, and evaluating organ function with blood tests
Treatment
Depending on the underlying cause and severity of symptoms, treatment options for erythroderma may include:
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Medications or treatments suspected of being the culprit should be discontinued
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Inflammation and itching can be reduced with topical or systemic corticosteroids
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To prevent further moisture loss from the skin, moisturizers and emollients are used
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The use of antihistamines to relieve itching and promote sleep
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For severe or refractory cases, immunomodulatory agents such as methotrexate or cyclosporine may be used
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Wound care, pain management, and treatment of complications associated with wounds
Prevention
To prevent erythroderma, it is important to identify and avoid potential triggers, such as certain medications or environmental factors that exacerbate it. In addition to adhering to prescribed treatment regimens, patients with erythroderma should seek medical attention promptly if their symptoms worsen or become new.
In conclusion, erythroderma is a severe skin condition characterized by widespread erythema and scaling affecting the majority of the body's surface area. The best way to manage and improve patient outcomes is to understand its causes, symptoms, diagnosis, treatment, and prevention strategies.
