Erythroderma is severe inflammation that causes most of the skin surface to become red.
(See also Overview of Dermatitis.)
Several skin disorders can result in erythroderma:
- Different types of dermatitis (for example, atopic dermatitis, allergic contact dermatitis, seborrheic dermatitis)
- Pityriasis rubra pilaris
- Drug reactions
- Lichen planus
- Cutaneous T-cell lymphoma (particularly Sézary syndrome)
Erythroderma can develop in people who have skin disorders, such as those listed above, but it can also develop spontaneously in people who have no history of a skin disorder.
An older term for erythroderma is exfoliative dermatitis. This term is rarely used now.
Symptoms of Erythroderma
Erythroderma may start rapidly or slowly. At first the entire skin surface becomes red and shiny. It may then become scaly, thickened, and sometimes crusted. The skin is often itchy and may be painful.
Although many people have a fever, they may feel cold and have chills because so much heat is lost through the inflamed skin.
Diagnosis of Erythroderma
- A doctor's evaluation
- Possibly a skin biopsy
Doctors base the diagnosis of erythroderma on the person's history and the results of a physical examination.
A skin biopsy is sometimes done, but even that may not confirm the diagnosis. Determining the cause of erythroderma may require many tests, directed at what the cause is suspected to be.
Prognosis for Erythroderma
Erythroderma may be life threatening, but the prognosis depends on the cause.
Treatment of Erythroderma
- Often hospitalization for supportive care
- Skin care
- Treatment of underlying cause
- Sometimes corticosteroids
- Possibly stopping or changing any drug that may be the cause
Early diagnosis and supportive treatment of erythroderma are important in preventing infection from developing in the affected skin and in keeping fluid and protein loss from becoming life threatening.
People with erythroderma often need to be hospitalized and given antibiotics (for infection), fluids and salts (to replace those lost through the skin) by vein (intravenously), and nutritional supplements. Care may include the use of drugs and heated blankets to control body temperature. Moisturizing agents (emollients) may help soothe the skin.
Corticosteroids applied to the skin (such as hydrocortisone ointment) are often given. Corticosteroids given by mouth (such as prednisone) are often given to people who have severe erythroderma.
Ultimately, the treatment of erythroderma depends on the specific cause. For example, if the erythroderma is caused by a drug reaction, people should stop taking that drug. If erythroderma is a manifestation of a skin lymphoma, people should undergo treatment for the lymphoma.
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