Exfoliative dermatitis causes redness and peeling of your skin over large areas of your body. The word “exfoliative” refers to the exfoliation which means shedding of the skin. Dermatitis term means irritation of the skin. The skin peeling often occurs with pre-existing medical conditions or medications in some people. The exact cause is unknown in others.
Exfoliative dermatitis, or erythroderma, is serious but uncommon. Complications include infection, loss of nutrients, dehydration, and heart failure, rarely leading to death.
What is Causing Exfoliative Dermatitis?
The root cause of exfoliative dermatitis is a disorder of your skin cells. The cells die and shed quickly in a process that called turning over. The rapid turnover of skin cells causes peeling and scaling of the skin. The peeling and scaling will also be known as sloughing.
It can be underlying conditions
People who already suffer from chronic skin conditions including autoimmune diseases, psoriasis, seborrheic dermatitis, and eczema, also develop exfoliative dermatitis.
It can be Drug Reactions
Reactions to a variety of drugs can contribute to massive skin peeling. Drugs which produce this condition may include:
- sulfa drugs
- calcium channel blockers
- blood pressure medications
- topical medications
Generally, almost any drug can cause exfoliative dermatitis.
Certain types of cancer, which include leukemia and lymphoma, can also accelerate the skin cell turnover rate. As Merck Manuals has reported, up to 25% of cases of exfoliative dermatitis are idiopathic. Idiopathic is when a disease has no known cause.
What Are the Symptoms of Exfoliative Dermatitis?
- Flu-Like Signs
Those who have exfoliative dermatitis may have flu-like symptoms, such as fever and chills. It is because widespread skin peeling will affect your internal thermometer and cause heat loss from your damaged skin. So, your body can’t control its temperature well. Most people with exfoliative dermatitis feel generally ill.
- Skin and Nail Changes
Exfoliative dermatitis commonly starts with extreme reddening spreading over large portions of the body. This change in skin color is known as erythroderma. Erythroderma and exfoliative dermatitis are names for this condition. Massive peeling of your skin follows the reddening and inflammation. Your skin will be rough and scaly. The dryness and peeling of your skin may cause itching and pain. Your nails can also become thicker and more ridged.
What are the Complications from Skin Shedding?
Those with this condition may also have a low blood volume. This is due to loss of fluid through the shed skin. Skin shedding starts in small patches; however, over time, it spreads to most of the body. Skin is made of protein. The constant shedding of your skin can prevent your body from absorbing essential nutrients which help to maintain a healthy epidermis. You may lose protein and fluids from the sloughing. Dehydration and protein deficiencies are common complications. Fluid and electrolyte levels need to be monitored by you and your doctor.
There are two important functions of your skin that are providing a barrier to infections and protecting your inner organs. When your skin sheds, it loses some of these abilities. This makes you at risk for serious infections and damage to underlying muscles and bones.
When to Worry?
Severe symptoms of exfoliative dermatitis can be serious and life-threatening. People who develop complications of infection, fluid and electrolyte abnormalities, and cardiac failure are most at risk of death. The most common causes of death in patients with exfoliative dermatitis are pneumonia, septicemia, and heart failure.
How to Treat Exfoliative Dermatitis?
You may receive treatment for exfoliative dermatitis in the hospital. Your doctor works to correct any dehydration, low blood volume, heat loss, and electrolyte or nutritional deficiencies. Your doctor can give you IV fluids and nutrients to treat these complications.
The most important goals of treatment is reducing inflammation and making you more comfortable. The Supportive care includes warm baths, rest, and oral antihistamines. Your doctor will also prescribe medicated creams to moisten your dry and itchy skin.
Moreover, steroid medications can treat severe inflammation and flaking of the skin. Some patients can benefit from phototherapy, treatments with psoralen, a photosensitizing agent, and ultraviolet A. Drugs which suppress the immune system will slow the rate of skin shedding for people with chronic symptoms.
However, infection can be a serious complication of this condition. Antibiotics will treat and prevent dangerous skin infections. In addition, proper attention to wound care and dressings are important to prevent infections.
Your doctors will manage any underlying conditions. You probably need to stop taking medications that cause allergic skin reactions.