eMedicine Specialties > Emergency Medicine > Dermatology

Dermatitis, Exfoliative: Follow-up

Author: Therese I McBride, DO, Assistant Professor, Department of Emergency Medicine, University of Arkansas for Medical Sciences
Coauthor(s): Barry E Brenner, MD, PhD, FACEP, Program Director, Department of Emergency Medicine, University Hospitals, Case Medical Center
Contributor Information and Disclosures

Updated: Jan 15, 2008

Follow-up

Complications

  • Bacterial or fungal superinfection
  • Hypothermia
  • Dehydration, electrolyte imbalance, or both
  • Heart failure

Prognosis

  • In general, long-term prognosis is good for patients with drug-induced disease after the offending agent is withdrawn and proper supportive measures are undertaken.
  • For patients with idiopathic exfoliative dermatitis, the prognosis is poor. Frequent recurrences or chronic symptoms require long-term steroid therapy and its attendant sequelae.
  • For patients with underlying disease or malignancy, prognosis rests on the outcome and course of the disease process.

Patient Education

  • Avoid known etiologic agents.
  • Educate patients with underlying disease about symptomatic treatment and advise that many cases spontaneously remit.
  • Advise patients on protection from hypothermia.
  • Advise patients to follow a high-protein diet as symptoms persist.
  • Encourage patients to be diligent in watching for signs of infection.

Miscellaneous

Special Concerns

  • In neonates, thoroughly investigate severe immunodeficiency as a possibility.
  • Elderly patients are at risk of cardiac complications. Fluid losses and shifts often are significant, and decreased compensatory mechanisms in members of the elderly population make them particularly vulnerable.
  • Use corticosteroids with caution. This syndrome has a clinically similar appearance to that of toxic epidermal necrolysis for which steroids have shown no benefit or increased morbidity or mortality.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Jonathan R Pilcher, MD, and Selwyn Waterton, MD, to the development and writing of this article.



More on Dermatitis, Exfoliative

Overview: Dermatitis, Exfoliative
Differential Diagnoses & Workup: Dermatitis, Exfoliative
Treatment & Medication: Dermatitis, Exfoliative
Follow-up: Dermatitis, Exfoliative
References
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References

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  11. Pruszkowski A, Bodemer C, Fraitag S, Teillac-Hamel D, Amoric JC, de Prost Y. Neonatal and infantile erythrodermas: a retrospective study of 51 patients. Arch Dermatol. Jul 2000;136(7):875-80. [Medline].

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Further Reading

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Keywords

exfoliative dermatitis, erythroderma, epidermis, epithelial layer, epithelial cells, scaling eruption, scaly dermatitis

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Contributor Information and Disclosures

Author

Therese I McBride, DO, Assistant Professor, Department of Emergency Medicine, University of Arkansas for Medical Sciences
Therese I McBride, DO is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Barry E Brenner, MD, PhD, FACEP, Program Director, Department of Emergency Medicine, University Hospitals, Case Medical Center
Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Mark Louden, MD, FACEP, Assistant Medical Director, Emergency Department, Duke Raleigh Hospital
Mark Louden, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Mark W Fourre, MD, Program Director, Department of Emergency Medicine, Maine Medical Center; Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP, Program Director, Department of Emergency Medicine, University Hospitals, Case Medical Center
Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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