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.
Exfoliative dermatitis is caused by any of several underlying conditions. This underlying condition may be a skin disorder or it may be something totally unrelated to the skin.
Exfoliative dermatitis sometimes begins quite explosively and suddenly. Sometimes, however, it develops slowly, after a person has had a skin disease that has gradually worsened over time. The entire surface of the skin becomes red, scaly, thickened, and sometimes crusted.
A person with exfoliative dermatitis may: experience severe itchingdevelop swollen lymph nodeshave a feverfeel cold despite the fever, because so much heat is lost through the damaged skinlose large amounts of fluid and protein through the damaged skinshed hair and nails
The causes of exfoliative dermatitis include: certain medications, such as penicillin, sulfonamides, isoniazid, phenytoin, and barbituratesskin diseases, such as psoriasislymphomas, or cancers of the lymph nodes
In many cases, no cause can be found.
A person who is taking a medication that could be causing the dermatitis may be advised by the healthcare professional to stop taking that medication.
The diagnosis of exfoliative dermatitis is made when the healthcare professional 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.
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 increasingly ill and may even experience congestive heart failure.
There are no risks to others, as exfoliative dermatitis is not contagious.
Treatment for exfoliative dermatitis may include: thorough and complete skin care, including cool compresses and creams, such as Vaseline or Eucerin, to help hydrate and seal the skin and keep in waterantibiotics to treat infectionfluids given through an intravenous line to replace the lost fluid and electrolytescorticosteroids given through an intravenous line, by mouth, or applied to the skin to decrease the swelling and rednesscontrolling body temperature, using heated blankets
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.
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 returning.
Any new or worsening symptoms should be reported to the healthcare professional.
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.
