Merck Manual

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Erythroderma

(Exfoliative Dermatitis)

By

Thomas M. Ruenger

, MD, PhD, Georg-August University of Göttingen, Germany

Full review/revision Jan 2023
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Topic Resources

Erythroderma is severe inflammation that causes most of the skin surface to become red.

Several skin disorders can result in erythroderma:

Erythroderma can develop in people who have skin disorders, such as those listed above, but it can also develop spontaneously in people who have no history of a skin disorder.

An older term for erythroderma is exfoliative dermatitis. This term is rarely used now.

Symptoms of Erythroderma

Erythroderma may start rapidly or slowly. At first the entire skin surface becomes red and shiny. It may then become scaly, thickened, and sometimes crusted and eventually peels. The skin is often itchy and may be painful.

Although many people have a fever, they may feel cold and have chills because so much heat is lost through the inflamed skin.

Diagnosis of Erythroderma

  • A doctor's evaluation

  • Possibly a skin biopsy

Doctors base the diagnosis of erythroderma on the person's history and the results of a physical examination.

Determining the cause of erythroderma may require many tests, directed at what the cause is suspected to be.

Treatment of Erythroderma

  • Treatment of underlying cause

  • Possibly stopping or changing any medication that may be the cause

  • Often hospitalization for supportive care

  • Skin care

  • Sometimes corticosteroids

Ultimately, the treatment of erythroderma depends on the specific cause. For example, if the erythroderma is caused by a medication reaction, people should stop taking that medication. If erythroderma is a manifestation of a skin lymphoma, people should undergo treatment for the lymphoma.

Early diagnosis and supportive treatment of erythroderma are important in preventing infection from developing in the affected skin and in keeping fluid and protein loss from becoming life threatening.

People with erythroderma often need to be hospitalized and given antibiotics (for infection), fluids and salts (to replace those lost through the skin) by vein (intravenously), and nutritional supplements as needed. Care may include the use of medications and heated blankets to control body temperature. Moisturizing agents (emollients) may help soothe the skin.

Corticosteroids applied to the skin (such as hydrocortisone ointment) are often given. Corticosteroids given by mouth (such as prednisone) are often given to people who have severe erythroderma.

Prognosis for Erythroderma

The prognosis depends on the cause.

Erythroderma may be life threatening.

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