Exfoliative Dermatitis

Exfoliative Dermatitis is not a common skin disorder. However, it can cause some serious side-effects and complications, so an accurate clinical diagnosis is important to get. The underlying disease process creates widespread inflammation and eventual scaling of the skin. The disease affects both men and women, but is more common in men. Average onset of the disease is around 55 years of age, although it can occur at any age.

Symptoms

Symptoms can include pruritus (i.e. itching), malaise (i.e. general feeling of being unwell) and hyper/hypothermia. This disease usually starts out as “patches” (head, trunk and genital region) – but gradually spreads in the following days and weeks to cover most of the body. The loss of significant portions of outer skin layers (depending upon intensity and duration) can lead to abnormal thermoregulation (due to heat loss), nutritional deficiencies, increased metabolic rate (progressing to a catabolic state) and hypovolemia (decrease in the amount of circulating blood).

Causes

The cause of Exfoliative Dermatitis remains unknown. However, incidence of this disease is associated with preexisting skin conditions (e.g. atopic dermatitis, contact dermatitis, seborrheic dermatitis, psoriasis, etc.), drug reactions (penicillin, sulfonamides, isoniazid, phenytoin, barbiturates), and malignancies (e.g. mycosis fungoides, leukemia, and specific carcinomas). In about 25% of the cases, a specific diagnosis or underlying condition is not identified. A significant number of these progress to cutaneous T-cell lymphoma.

Treatment

Hospitalization is often necessary. Normally, all medications are stopped (if possible) to rule this factor out as the underlying cause. Emollients, soaks/baths, and oral antihistamines can help to sooth the inflamed, itchy skin. In more severe cases, corticosteroids and topical steroids can be used. Other treatments, including PUVA (psoralen plus ultraviolet A light) phototherapy, immunosuppressive agents, and retinoids have been used in chronic cases.

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