Erythroderma (3)

Question 1

What is it?

What are its risk factors?

What are it’s common causes?

Answer 1

➊ Intense, widespread reddining of the skin due to an inflammatory skin disease. It often precedes, or is associated with, skin peeling (then known as exfoliative dermatitis).

➋ * Male
* Pre-exisiting skin disease
* Systemic condition known to be associated with erythroderma

➌ * Drug eruption
* Dermatitis, especially atopic dermatitis
* Psoriasis, especially after the withdrawal of systemic steroids or other treatment (Erythrodermic psoriasis)
* Pityriasis rubra pilaris

Question 2

How does it present?

Answer 2

• Generalised erythema - can occur acutely or over wks to months in the chronic type
• Generalised oedema
• Often preceded by a measles-like (morbilliform) rash, dermatitis, or plaque psoraisis.
• Pruritis
• Scaling
• Lympadenopathy

Question 3

How is it diagnosed?

How is it managed?

What are its complications?

Answer 3

➊ * FBC, CRP, LFTs, IgE
* Skin biopsy

➋ * Stop all unneccessary medications
* Monitor fluid balance and body temp.
* Maintain skin moisture with emoillents and mild topical steroids
* Abx for infection
* Antihistamines for the pruritis

➌ The pt may have temperature dysregulation, therefore lose a lot of fluid through the skin, which can lead to:
* Hypothermia due to heat loss
* Electrolyte abnormalities and dehydration due to fluid loss
* Secondary skin infection e.g. cellulitis, impetigo
* Hypoalbuminaemia due to protein loss
* Pigmentory changes if chronic