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Erythroderma: Not Your Everyday Sunburn

Erythroderma is defined as erythema and scaling of greater than 90% of the skin’s total body surface area. Take note: this isn’t like your run-of-the-mill, snotty-nosed kid with a bad viral rash. The erythema here is near confluent. Erythroderma is also known as exfoliative dermatitis because scaling and exfoliation are often involved. We’re talking cytokines—oh yeah, cytokines—causing inflammation and vasodilation of your skin

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 This Rash Puts You in the ICU

Erythroderma, or “red skin,” is a severe cutaneous condition that presents with diffuse erythema involving greater than 75% of the body’s surface and skin exfoliation.1 It classically spares the periorbital regions and nasolabial folds.

Articles of Interest

A case series of dermatological emergencies - Erythroderma

Erythroderma is a dermatological emergency defined as erythema and scaling occurring in a generalised distribution involving more than 90% of the total body surface area. Widespread alterations of the skin functions could result in a number of complications which are known collectively as acute skin failure.

Erythroderma: a dermatologic emergency

Erythroderma is a potentially fatal dermatologic emergency that is often mistaken for infection. Indeed, the fact that it is difficult to diagnosis is the main contributor to its significant mortality rate, as treatment is readily available.

Erythroderma: A Manifestation of Cutaneous and Systemic Diseases

Erythroderma, or generalised exfoliative dermatitis, is a rare inflammatory disorder characterised by generalised erythema, involving more than 90% body surface area accompanied by a variable degree of scaling.

When a Rash Is Deadly

Erythroderma is characterized by extensive cutaneous capillary dilation, resulting in widespread exfoliation of the epidermis. Inflammatory mediators result in a dramatic increase in the epidermal turnover rate and accelerated mitotic rate as well as an increased number of germinative skin cells. Causes include exfoliative toxin, eosinophils, basophils/histamine, and skin-homing T-cells.

Resources

Primary Care Dermatology Society

Erythroderma is a term used to describe erythema affecting more than 90% of the body surface. The term exfoliative dermatitis is also used, and describes the exfoliation (skin peeling) found in erythroderma. The extent of the skin changes can obscure the primary lesion making it difficult to diagnose the underlying cause.

Dermatology Advisor

In a majority of cases there has been preexisting dermatosis, and the diagnosis may be quite clear from the history. Patients with dermatologic disorders recalcitrant to therapy may develop erythroderma during a flare-up.

WikEM

Abrupt onset if related to drug, contact allergen, or malignancy; gradual onset if related to underlying cutaneous disorder. Generally starts on face and trunk with progression to other skin surfaces.