9th June 2025

Erythroderma

Erythroderma is a dermatological emergency. It describes erythema and scaling of approximately 90% of the body total surface area. 

Aetiology 

Erythroderma can be categorised into congenital, infective, inflammatory, neoplastic, iatrogenic, and idiopathic causes. It is commonly present in pre-existing dermatological conditions such as psoriasis and eczema, with erythroderma occurring following sudden treatment cessation or the commencement of corticosteroids. 

Causes

• Pre-existing psoriasis or eczema
• Spongiotic dermatitis 
• Corticosteroid commencement 
• Medication reactions
• T cell lymphoma

Complications

The onset of erythroderma puts the body into a catabolic state, leading to inflammation and increased heat loss. These processes can lead to the following complications:

• Cardiac failure – Due to increased cardiac output 
• Dehydration, Hypotension & Shock – Due to increased trans-epidermal water loss 
• Hypoalbuminemia – Due to desquamation in erythroderma 
• Skin infection

Management

The management of erythroderma is based on establishing the underlying cause and reversing/delaying that process e.g., stopping causative medication. 

Following this, the management is supportive e.g., restoring fluid balance +/- normal body temperature.

Dry sites can be managed with emollients and/or topical corticosteroids.