Generalized Exfoliative Dermatitis
What is generalized exfoliative dermatitis?
Generalized exfoliative dermatitis, or erythroderma, is a severe inflammation of the entire skin surface. This is due to a reaction to certain medicines, a pre-existing skin condition, and sometimes cancer. In approximately 25% of people, there is no identifiable cause. It is characterized by redness and scaling of the skin that begins in patches and spreads. The skin begins to slough off. This leads to problems with temperature regulation, protein and fluid loss, as well as an increased metabolic rate.
What are the symptoms of generalized exfoliative dermatitis?
The following are the most common signs and symptoms of generalized exfoliative dermatitis. However, each individual may experience symptoms differently:
Extreme redness of the skin
Swollen lymph nodes
Secondary infections (viral or bacterial)
Loss of fluids and proteins through the damaged skin. This can lead to dehydration and protein deficiencies
The symptoms of generalized exfoliative dermatitis may resemble other skin conditions. Always talk with your healthcare provider for a diagnosis.
How is the cause of generalized exfoliative dermatitis determined?
Diagnosis includes careful elimination of known causes, such as certain medicines (for example, penicillin and barbiturates). In addition, your healthcare provider may check for other skin conditions, such as atopic dermatitis, as well as for certain types of cancer, such as lymphoma, during a physical exam and medical history. Your healthcare provider may also perform a skin biopsy to have a sample of your skin analyzed in the lab.
Treatment for generalized exfoliative dermatitis
Specific treatment for generalized exfoliative dermatitis will be discussed with you by your healthcare provider based on:
Your age, overall health, and medical history
Extent of the reaction
Your tolerance for specific medicines, procedures, or therapies
Expectations for the course of the reaction
Your opinion or preference
Severe cases of generalized exfoliative dermatitis may need hospitalization while the person is treated with antibiotics, intravenous (IV) fluids, and nutritional supplements. Treatment will vary depending on the cause:
If certain medicines are causing the condition, eliminating them usually clears up generalized exfoliative dermatitis.
If another skin condition causes generalized exfoliative dermatitis, treating the other skin condition usually clears up the generalized exfoliative dermatitis.
If cancer is causing the condition, treating the cancer usually clears up the generalized exfoliative dermatitis.
Other treatments may include:
Heated blankets (to keep warm)
Petroleum jelly applied to skin, followed by gauze
Systemic corticosteroids (for severe cases)
Rehydration (putting fluids back into the body)
Comprehensive wound care to prevent infection
This condition can be life-threatening and many times needs hospitalization. The outlook (prognosis) depends on the cause. In the case of medicine reactions, the condition usually lasts 2 to 6 weeks after the medicine is stopped.
March 21, 2017
Goode, Paula, RN, BSN, MSN,Lehrer, Michael Stephen, MD