exfoliative dermatitis

EXFOLIATIVE DERMATITISLopez, Camille Cecilia S.

a.k.a. dermatitis exfoliativa, pityriasis rubra (Hebra) & erythroderma (Wilson-Brocq)

- extensive erythema- dull scarlet body surface- small laminated scales- S/s: pruritus, diffuse erythema, epidermal sloughing

malaise, and chills

Andrew’s Diseases of the Skin 9th ed?Medscape

Etiology• Psoriasis• Atopic dermatitis• Chronic actinic

dermatitis• seborrheic dermatitis• Pityriasis• Rubra pilaris• Allergic Contact

dermatitis• Internal Malignancy• Erythrodermic

mycosis fungoides• Sezary synndrome• Medications

PATHOPHYSIOLOGY

Andrew’s Diseases of the Skin 9th ed?Medscape

Increased skin blood perfusion

Temperature dysregulation ( heat loss & hypothermia)

Basal metabolic rate rises

edema, hypoalbuminemia, loss of muscle mass

marked loss of exfoliated scales

In a study of 91 of 102 patients with exfoliative dermatitis by Sigurdsson et al,1 a mortality rate of 43% was observed.

No racial predilection is reported for exfoliative dermatitis.

Male-to-female ratio is 2-4:1 Usually occurs in persons older than 40

years,

TREATMENT mid- strength corticosteroid after soaking Acitretin, cyclosporin, methotrexate Immunosuppressive agents ( Azathioprine &

Methotrexate)

Andrew’s Diseases of the Skin 9th ed?Medscape