Red, Scaly Babies: Neonatal Erythroderma

Erythroderma is defined as generalized skin erythema affecting at least 90% of the body. This skin reaction is not specific for one diagnosis. Neonatal erythroderma is potentially life-threatening and presents unique therapeutic and diagnostic challenges. The differential diagnosis is broad, and many of the potential diagnoses are exceedingly rare. Additional clinical or laboratory findings may point to the underlying primary disease, and understanding these clues can expedite establishing the diagnosis. Irrespective of the underlying cause, neonates who have erythroderma have a compromised skin barrier, which can lead to dehydration, electrolyte imbalances, temperature instability, protein losses, and increased risk for infection. This review focuses on an approach to managing erythroderma and reviews the features of several causes of erythroderma.