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Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Erythroderma

What is erythroderma?

Erythroderma is the term used to describe intense and usually widespread reddening of the skin due to inflammatory skin disease. It often precedes or is associated with exfoliation (skin peeling off in scales or layers) when it may also be known as exfoliative dermatitis (ED). It is sometimes called the ‘red man syndrome’ when no primary cause can be found (idiopathic erythroderma).

Erythroderma Erythroderma Erythroderma
Erythroderma

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What causes erythroderma?

Erythroderma can arise from a variety of causes, most often as an extension of a pre-existing skin disorder. Erythroderma may also be due to an adverse drug reaction. However, in as many as 30% of all cases of erythroderma, no underlying cause can be found. This is called idiopathic erythroderma.

The most common pre-existing dermatoses to result in erythroderma include:

Erythroderma may also be a symptom or sign of a systemic disease. These may include:

Click here to open a table with list of drugs that have been reported to cause erythroderma. If a drug is the cause, erythroderma is usually preceded by a morbilliform (measles-like) eruption.

What are the clinical features?

Erythroderma that is not due to eczema usually occurs in people older than 40 years. It is slightly more common in men than women. It can develop quite rapidly. Signs and symptoms of erythroderma include:

What is the management of erythroderma?

The underlying cause of erythroderma should be established if possible. Skin biopsies may or may not be helpful. Erythroderma is a serious disease and most patients require hospitalisation to restore fluid and electrolyte balance ,circulatory status and body temperature.

The following general measures apply:

If a cause can be identified then specific treatment should be started eg topical steroids for atopic dermatitis; acitretin or methotrexate for psoriasis.

What is the prognosis?

Prognosis of erythroderma depends on the underlying disease process. If the cause can be removed or corrected then prognosis is generally very good. If erythroderma is the result of a generalised spread of a primary skin disorder such as psoriasis or dermatitis, it usually clears with appropriate treatment of the skin disease but may recur at any time. The course of idiopathic erythroderma is unpredictable. It may persist for a long time with periods of acute exacerbation.

Related information

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Author: Vanessa Ngan, staff writer

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If you have any concerns with your skin or its treatment, see a dermatologist for advice.