Erythroderma (Exfolliative Dermatitis, Red Man Syndrome)

Last updated 20.09.12

 

Definition

-  Excessive perfusion of skin causing erythema (>90% involvement)

 

Features

-  Dermatological emergency: esp elderly patients

-  Pruritus

-  May be ass w scale (2-6 days post erythema), erosions or pustules

-  Shedding of hair or nails if prolonged (weeks)

-  Male 2-4:1 female

 

 

Causes

-  Dermatological condition

-  Eczema 10%

-  Psoriasis 8%

-  Seborrhoeic dermatitis

-  Cutaneous T-cell lymphoma

-  Drugs 28%

-  Penicillins, Sulfonamides, Vancomycin

-  Carbamazapine, Phenytoin, Allopurinol, Captopril..

-  30% Idiopathic (Red Man Syndrome)

 

Associated S/S

-  Fever, chills, hypothermia: increased skin perfusion

-  Reactive lymphadenopathy

-  Hypoalbuminaemia (skin loss as protein): peripheral oedema

-  High output cardiac failure

 

Ix

-  ESR

-  FBE + Blood film: anaemia, leukaemia, lymphoma

-  Biopsy: psoriasis, eczema, T-cell lymphoma

 

Mx

- Treat underlying cause

- Wet dressings

- Topical steroids

- Monitor & manage cardiac failure & peripheral oedema

 

 

References