Erythroderma

Question 1

What is Erythroderma?

Answer 1

• An intense and widespread reddening of the skin due to inflammatory skin disease
• It is often associated with exfoliation (skin peeling off in scales or layers)

Question 2

What are the causes of Erythroderma?

Answer 2

• Drug eruption (sulphonamides, gold, sulphonylureas, penicillin, allopurinol, captopril)
• Previous Skin disease: Dermatitis, Eczema, Psorasis
• Psoriasis - after the withdrawal of systemic steroids
• Blistering Diseases (bullous pemphigoid)
• HIV
• Haematological malignancies (lymphoma and leukaemia)

Question 3

What are the clinical features of Erythroderma?

Answer 3

• Skin appears inflamed, oedematous and scaly
• Skin feels warm to the touch
• Itch is usually troublesome and sometimes intolerable
• Lichenification seen
• Scaling of the skin - 2/6 days after erythroderma
• Systemically unwell with lymphadenopathy and malaise

Question 4

How is Erythroderma Diagnosed?

Answer 4

• Blood count: shows anaemia, WCC abnormalities and eosinophilia
• ## Skin Biopsy

Question 5

What is the treatment for Erythroderma?

Answer 5

• Treat the underlying cause - discontinue the medication
• Monitor fluid balance and body temperature
• Emollients and wet-wraps to maintain skin moisture
• Topical steroids to relieve inflammation
• Antibiotics
• Antihistamines

Question 6

What are the complications of Erythroderma?

Answer 6

• Secondary infections, Fluid loss, electrolyte inbalance, hypothermia