Exfoliative dermatitis, also known as erythroderma, is an uncommon but serious skin disorder defined as erythema and scale covering over 90% of the body surface area (Fig. 33-34). The four most common causes of erythroderma are psoriasis, AD, cutaneous T-cell lymphoma (CTCL), and drug reactions. More than 60 drugs have been implicated in cases of exfoliative dermatitis; more often allopurinol, beta-lactam antibiotics, antiseizure medications, and sulfa drugs. More than half of patients will have a known underlying skin disease, but in up to 25% an etiology may never be determined and is termed idiopathic erythroderma. The majority of patients are adults over age 40.
The long-term prognosis is good in patients with drug-induced exfoliative dermatitis. The course tends to be remitting and relapsing in idiopathic cases. The prognosis of patients with associated malignancy usually depends on the
resolution occurs within 4 to 6 weeks in most patients, but residual leg pain and ankle edema can persist for weeks.
Figure 33-34 Erythroderma secondary to pustular psoriasis. © Richard P. Usatine.)
outcome of the malignancy. A skin biopsy can help establish the diagnosis when the underlying skin disease is not known. The approach to treatment should include discontinuation of potentially causative medications and a search for any underlying malignancy. Initial evaluation and treatment usually require hospitalization for fluid and electrolyte replacement, temperature modulation, and prevention and treatment of secondary infection.
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Do You Suffer From the Itching and Scaling of Psoriasis? Or the Chronic Agony of Psoriatic Arthritis? If so you are not ALONE! A whopping three percent of the world’s populations suffer from either condition! An incredible 56 million working hours are lost every year by psoriasis sufferers according to the National Psoriasis Foundation.