Emergency Dermatology: ERYTHRODERMA/EXFOLIATIVE DERMATITIS

AN EXTREME STATE of skin irritation resulting in extensive erythema and/or scaling of the body in several skin disorders may ultimately culminate in erythroderma/exfoliative dermatitis. Largely, it is a secondary process; therefore, determining its cause is needed to facilitate precise management. Its clinical pattern is fascinating and has been the subject of detailed studies: Its changing scenario in various age groups, its presentation postoperatively, and its occurrence in human immunodeficiency virus (HIV)-positive individuals are vivid indicators. Several factors may be responsible for the causation of this extensive skin disorder. A detailed outline of a patient's history to elicit possible triggering events, namely, infection, drug ingestion, topical application of medicaments, and sun/ultraviolet light exposure, among other factors. It is also challenging to manage the condition, because the intricate process puts an extensive strain on an already compromised body system. In addition, the original dermatosis may be masked by extensive erythema/scaling, thus making it difficult to obtain a clear-cut diagnosis. Its intriguing clinical expression in neonates/infants and children poses a serious emergent challenge for its life-threatening overture. DEFINITION Erythroderma and exfoliative dermatitis are largely synonymous; however, erythroderma is the preferred term and is currently in vogue. The former is characterized by extensive and pronounced erythema, coupled with perceptible scaling, whereas the latter is conspicuous by the presence of widespread erythema and marked scaling. Accordingly, 90% or more skin-surface involvement is considered as a salient prerequisite to make a clinical diagnosis of exfoliative dermatitis.