Detailed information on generalized exfoliative dermatitis, including symptoms, causes, and treatment.
The Medical Dermatology Program at Massachusetts General Hospital is a full-service dermatology practice that provides care for all skin, hair and nail conditions.
What is erythroderma?
Erythroderma is a severe and potentially life-threatening inflammation of most of the body’s skin surface. It's also called generalized exfoliative dermatitis. It may be caused by a reaction to a medicine. Or it may be caused by another skin condition or cancer.
It causes redness and scaling of the skin. This starts in patches and spreads over the body. The skin begins to peel (slough) off. This leads to problems with your ability to manage body temperature. It can also cause protein and fluid loss. And it can cause an increased metabolic rate. Erythroderma can be life-threatening. You may need to spend time in the hospital or burn center for treatment.
What causes erythroderma?
It can be caused by:
A complication of atopic dermatitis, psoriasis, pityriasis rubra pilaris, or another skin condition
A reaction to medicines, such as penicillin, barbiturates, or sulfonamide
Certain types of cancer, such as lymphoma
In about 1 in 4 people, the cause is not known.
Who is at risk for erythroderma?
You are more at risk if you:
Already have a skin condition
Are taking penicillin, barbiturates, or sulfonamide
What are the symptoms of erythroderma?
Erythroderma causes very red skin all over the body. Other symptoms may include:
Scaly skin patches
Crusty sores (lesions)
The red, peeling skin patches may appear and spread over hours, days, or weeks.
Other symptoms can include:
Swollen lymph nodes
Feeling generally ill (malaise)
The symptoms of erythroderma can seem like other health conditions. Make sure to see your healthcare provider for a diagnosis.
How is erythroderma diagnosed?
Your healthcare provider will ask about your symptoms and health history. They will give you a physical exam. The physical exam will include checking your skin. This is because the diagnosis is based on how your skin looks. But it’s also important to find the cause of the erythroderma. Your provider will see if that might be certain medicines, other skin conditions, or certain types of cancer.
You may also have a skin biopsy. Small pieces of skin are taken from your body and sent to a lab. A pathologist looks at them with a microscope.
How is erythroderma treated?
Treatment will depend on the cause, your symptoms, your age, and your general health. It will also depend on how severe the condition is.
If your symptoms are severe, you may need to spend time in the hospital. You may be treated with:
IV (intravenous) fluids to balance the electrolytes
You may need to:
Stop any medicines that may be causing the condition
Treat another skin condition that may be causing it
Treat cancer that may be causing it
Other treatments may include:
Heated blankets to keep you warm
Petroleum jelly applied to skin, then covered by gauze
Systemic corticosteroids, in severe cases
Adding fluids back into the body (rehydration)
Extensive wound care, to prevent infection
If your symptoms are caused by a medicine reaction, they should go away 2 to 6 weeks after the medicine is stopped.
Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.
What are possible complications of erythroderma?
Possible complications include:
Secondary infection from a virus or bacteria
Loss of fluids and proteins through the damaged skin that can lead to dehydration and nutrition problems
Can erythroderma be prevented?
Researchers don’t know how to prevent erythroderma.
When should I call my healthcare provider?
Erythroderma is a very severe and life-threatening condition. You should call your healthcare provider if you think you have it.
If you have been diagnosed with erythroderma and sent home with treatment, call your provider if you have:
Symptoms that don’t get better, or get worse
Key points about erythroderma
Erythroderma is a severe inflammation of most of the body’s skin surface.
It causes redness and scaling of the skin. This starts in patches and spreads over the body.
Erythroderma can be life-threatening.
It may be caused by a reaction to a medicine. Or it may be caused by another skin condition or cancer.
You may have a skin biopsy. Small pieces of skin are taken from your body and sent to a lab.
If your symptoms are severe, you may need to spend time in the hospital. You may be treated with antibiotics, IV fluids, nutritional supplements, and ointments for your skin.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your healthcare provider if you have questions.
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