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What Is Exfoliative Dermatitis?

Exfoliative dermatitis is a severe skin condition that causes extreme shedding of the top layers of your skin. It may cover most of your body and lead to so much skin damage that your body can't keep warm. Dehydration is also a risk due to your skin losing its ability to hold onto moisture.

You need medical care for exfoliative dermatitis ASAP. Without it, you could have complications like dehydration, infection, or shock. It can be deadly.‌

What Is Exfoliative Dermatitis?

You might hear your doctor call it “erythroderma.” It’s a skin condition that causes red and peeling skin. The peeling may affect 90% or more of your body. It begins in patches then spreads all over your body. 

You may notice pain or itching. Your skin may flake off and cause significant loss of surface skin. This is called sloughing. It’s a serious health problem.

Other symptoms of exfoliative dermatitis are:

  • Lesions that crust over
  • Areas of thickened skin
  • Swollen lymph nodes
  • Fever
  • Malaise
  • Viral or bacterial infections due to weakened skin
  • Trouble with body temperature due to skin loss

You may also have swelling in your arms and legs. Some people notice a fast heart rate as well. Your skin may have an unpleasant odor.

Losing layers of your skin may also cause hydration and nutrition issues. You can become seriously dehydrated without enough skin to keep moisture in your body. You may also have a nutritional imbalance as you lose proteins in your skin.

Treatment for exfoliative dermatitis sometimes involves IV fluids and nutritional support to prevent complications from dehydration and malnutrition.

What Causes Exfoliative Dermatitis?

Several things can cause it, like:

Medication reaction. Certain antibiotics or barbiturates can trigger an allergic reaction in some people. Some anti-seizure medicines have also been known to cause exfoliative dermatitis.

Skin conditions. Exfoliative dermatitis may happen as a complication of other skin issues. It might be related to atopic dermatitis, psoriasis, pityriasis rubra pilaris, or another skin condition.

Cancer. Certain cancers like lymphoma can lead to exfoliative dermatitis.

Unknown origin. There is no apparent cause in almost a quarter of cases of exfoliative dermatitis.

Your doctor will do an exam and discuss your medical history to figure out the reason for your exfoliative dermatitis. They’ll ask you about any medications you’ve taken recently to see if that's the cause. 

They may also order blood tests for a more complete picture of your health. They might biopsy some of the affected skin and send it to a lab for analysis.

How to Treat Exfoliative Dermatitis

The treatment depends on the cause. If you’re having an allergic reaction, your doctor will likely tell you to stop taking the medication that caused it. 

You may need to keep working with your medical team to find a replacement medication. Exfoliative dermatitis caused by an allergic reaction usually starts to clear up within weeks of stopping the medication.

You’ll need to see a specialist if you have an underlying issue such as cancer or a condition like psoriasis. They’ll come up with a treatment plan for you. Treating the underlying issue can help relieve your symptoms. 

Managing the symptoms of exfoliative dermatitis is another important step. This condition can be life-threatening without treatment. Your loss of skin can result in dehydration, body temperature issues, and loss of proteins. 

People who have this condition sometimes need to be hospitalized until the symptoms improve.‌ Treatment to manage symptoms might include:

  • Heated blankets
  • Cool baths
  • Petroleum jelly and gauze dressing to protect the skin
  • IV fluids

Wound care is a critical factor in exfoliative dermatitis. Open sores due to loss of skin can get infected. Keeping your skin clean and bandaged correctly will help lower your chances of getting an infection. Your doctor will give you instructions for wound care that you should follow. 

Call your doctor immediately if you notice any new or worsening redness, pain, swelling, or unusual discharge from a wound. You may need antibiotics to treat the infection.

Some people with exfoliative dermatitis need to be hospitalized in a unit specializing in burns. Burn unit staff have lots of experience caring for people with skin loss. It may take weeks for your symptoms to get better.

Exfoliative dermatitis can be life-threatening. Call your doctor right away if you have the symptoms of the condition.

WebMD Medical Reference

Sources

SOURCES:

Cedars Sinai: "Erythroderma."

Clinical and Experimental Dermatology: “Erythroderma (exfoliative dermatitis). Part 1: underlying causes, clinical presentation and pathogenesis.”

JOHNS HOPKINS: "Generalized Exfoliative Dermatitis."

Mount Sinai: "Exfoliative dermatitis."

PCDS: “Erythroderma (syn. exfoliative dermatitis).”

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