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Exfoliative Dermatitis

Exfoliative Dermatitis, also known as erythroderma, is a rare skin disease in which the whole skin can be affected by severe inflammation that results in substantial scaling, redness, and swelling. The causes for this disease are not always known, although scientists believe that it may be the result of a reaction to certain drugs such as penicillin, sulfonamide, and barbiturate, or underlying malignant cells. Complications in underlying skin disorders such as atopic dermatitis and contact dermatitis may trigger the disease. The underlying cause is normally treated and all causative factors removed. The disease accounts for less than 2 percent of dermatological patients admitted to hospital. It affects people over 55 years and mainly men, though women may also suffer from the disease.

Drastic increase of the epidermal turnover rate causes the symptoms. The cells don’t get enough time to mature and to move through the epidermis. It leads to a larger loss of epidermal material, resulting in large scale flaking of the skin. Normal epidermis undergo exfoliation every day, but very little essential protein and amino acids are lost. Exfoliative Dermatitis leads to greater protein and folic acid losses.

Symptoms Exfoliative Dermatitis

Exfoliative Dermatitis can start slow or appear suddenly. The whole skin surface starts to show signs of redness and may also shine. It then thickens, scales and forms crusts. Hair and nail loss may occur together with itching and swollen lymph nodes. Heat loss is experienced, which results in a cold feeling although the patient experiences fever. The skin loses protein and fluid and becomes vulnerable to secondary infections. It first appears on the neck, skull and genitals and spreads until the total skin area is affected with multiple pruritic eruptions. The soles of the feet, palms and hands are usually not affected. A quarter of patients develop alopecia of the skull. Patients are also at risk of contracting methicillin-resistant Staphylococcus aureus. The inability of the body to control heat may result in hypothermia, which can be life threatening as it leads to a decrease in the heart rate and subsequent hypertension. The risk of cardiac failure is increased through blood flow that causes high-blood pressure. Patients may lose weight rapidly.

Diagnosis for Exfoliative Dermatitis

The doctor does a physical examination and takes blood samples to rule out other skin infections. Laboratory results are often inconclusive. Biopsies may not indicate Exfoliative Dermatitis even when the patient has a history of dermatitis. Blood counts may show underlying leukemia. The disease is also associated with hepatitis and immune deficiency syndrome.

Types of Dermatitis associated with Exfoliative Dermatitis

Here are some of the underlying conditions associated with the disorder:

  1. Lichen planus
  2. Pemphigus
  3. Prurigo
  4. Atopic Dermatitis
  5. Psoriasis
  6. Seborrheic Dermatitis
  7. Mastocytosis
  8. Contact Dermatitis
  9. Reiter’s Syndrome
  10. Ichthyosis

Treatment for Exfoliative Dermatitis

Early treatment is important to keep the loss of fluid and protein to a minimum and to prevent severe infections. People are usually hospitalized and receive intravenous fluids. They also receive antibiotics to help fight the infection, as well as cool baths. The doctor normally applies petroleum jelly to the affected areas and covers the wounds with gauze. Corticosteroids are administered when other measures fail to reduce symptoms and infections. It helps to treat an underlying disease such as lymphoma. The patient’s fluid and electrolyte levels are closely monitored to prevent dehydration. Treatment may also include phototherapy and the administering of immunosuppressants. The patient should try not to scratch as it increases infection.

Withdrawal of drugs that cause Exfoliative Dermatitis leads to full recovery within a short period. When patients are treated for underlying skin disorders, recovery also sets in, but may take longer. The mortality rate is high when patients develop complications. Most of these patients die of heart attacks or pneumonia.

Supplements for the treatment of the disorder

The following supplements are also administered to help the body fight the disease:
Vitamin C: acts as an antioxidant and helps with collagen formation.
Biotin: is a water-soluble vitamin that helps to sustain intermediary metabolism and stimulates the differentiation of the epidermal cells.
Folic acid: is essential for the production of deoxyribonucleic acid in the body’s tissue cells.

Exfoliative Dermatitis is a serious skin disorder and anyone who experiences the symptoms should seek medical advice since early diagnosis and treatment help to prevent life threatening complications.

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