Erythroderma & Loss of Skin Function Flashcards
What is erythroderma?
“Red skin”
Widespread inflammation affecting 90% or more of the body surface.
What is the most common cause?
Many causes!
Underlying skin disease and drug hypersensitivity are most common
Common causes of erythroderma?
Atopic eczema Psoriasis Drugs Seborrhoeic eczema Idiopathic
What drugs can precipitate erythroderma?
Sulphonamides Gold Sulphonylureas Penicillin Allopurinol Captopril
Rare causes of erythroderma
Chronic actinic dermatitis
Cutaneous T cell lymphoma (Sezary’s syndrome)
Malignancy (especially leukaemia)
Pemphigus foliaceus
Pityriasis rubra pilares (a hereditary disorder of keratinisation)
HIV infection
Toxic shock syndrome
What are the complications of erythroderma?
High output cardiac failure Hypothermia Pre-renal AKI from fluid depletion Hypoalbuminaemia Catabolism and increased BMR Secondary bacterial infection Capillary leak syndrome
What is capillary leak syndrome?
Most severe complication and potentially fatal!
Release of inflammatory mediators from the skin causes extensive vascular leakage with oedema, hypovolaemic shock and ARDS
Management
Maintain body temperature (e.g. warming blankets)
Close monitoring of vital signs and electrolytes
Skin swabs if secondary bacterial infection suspected
Stop all non essential medication
Topical therapy with bland emollient or mild topical steroid (while underlying cause is identified after which systemic therapy for specific cause, e.g. ciclosporin for psoriasis)
