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Exfoliative Dermatitis


Overview, Causes, & Risk Factors

Exfoliative dermatitis is the term for large areas of skin that are covered by a rash. It can be life-threatening in its most severe form.

What is going on in the body?

Exfoliative dermatitis is caused by an underlying condition. This underlying condition may be a skin disorder or it may be something totally unrelated to the skin.

What are the causes and risks of the condition?

The causes of exfoliative dermatitis include:

  • certain medications, such as penicillin, sulfonamides, isoniazid, phenytoin, and barbiturates
  • skin diseases, such as psoriasis
  • lymphomas, or cancers of the lymph nodes
  • In many cases, no cause can be found.


    Symptoms & Signs

    What are the signs and symptoms of the condition?

    Exfoliative dermatitis sometimes begins quite explosively and suddenly. Or sometimes it develops slowly, after a person has had a skin disease that gradually gets worse over time. The entire surface of the skin becomes red, scaly, thickened, and sometimes crusted. A person with exfoliative dermatitis may:

  • experience severe itching
  • develop swollen lymph nodes
  • have a fever
  • feel cold despite the fever, because so much heat is lost through the damaged skin
  • lose large amounts of fluid and protein through the damaged skin
  • shed hair and nails

  • Diagnosis & Tests

    How is the condition diagnosed?

    The diagnosis of exfoliative dermatitis is made when the healthcare provider examines the affected skin. It is important that this condition be diagnosed early, so that complications such as infection can be avoided. Early diagnosis can also keep the fluid and protein loss from becoming life-threatening.


    Prevention & Expectations

    What can be done to prevent the condition?

    A person who is taking a medication that could be causing the dermatitis may be advised by the healthcare provider to stop taking that medication.

    What are the long-term effects of the condition?

    If it is not treated, exfoliative dermatitis can cause dehydration if a lot of water and protein is lost through the skin. A person may become more and more sickly. He or she may even have congestive heart failure, due to the large amount of blood that is pumped through all the blood vessels in the skin.

    What are the risks to others?

    There are no risks to others, as exfoliative dermatitis is not contagious.


    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment for exfoliative dermatitis may include:

  • thorough and complete skin care, including cool compresses and creams, such as Vaseline or Eucerin, to help seal the skin and keep in water
  • antibiotics to treat infection
  • fluids given through an intravenous line to replace the lost fluid and electrolytes
  • corticosteroids given through an intravenous line, by mouth, or applied to the skin to decrease the swelling and redness
  • controlling body temperature, using heated blankets
  • What are the side effects of the treatments?

    Antibiotics may cause stomach upset, diarrhea, and an allergic reaction. Corticosteroids that are given through the veins or by mouth can lead to osteoporosis, high blood pressure, diabetes, and other serious problems.

    What happens after treatment for the condition?

    Treatment of exfoliative dermatitis is focused on clearing up the skin rash. The underlying cause of the skin disease also must be treated to prevent the rash from coming back.

    How is the condition monitored?

    Any new or worsening symptoms should be reported to the healthcare provider.


    Attribution

    Author:Lynn West, MD
    Date Written:
    Editor:Smith, Mary Ellen, BS
    Edit Date:08/22/00
    Reviewer:Adam Brochert, MD
    Date Reviewed:07/24/01

    Sources

    The Merck Manual of Medical Information, 1997

    Hill, Marcia J. Skin Disorders: Mosby's Clinical Nursing Series, 1994

    Harrison's Principles of Internal Medicine, 1998, Fauci et al.


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