Medical Care
Many patients with acute exfoliative dermatitis require hospitalization for correction of fluid losses and disturbed thermoregulation. [9] Interventions include the following:
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Discontinue any medications suspected as cause of drug-induced exfoliative dermatitis
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Application of bland emollients (eg, petrolatum) to reduce insensible fluid losses and enhance skin barrier function
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Weeping or crusted sites may be covered with nonadherent dressings and petrolatum to reduce damage to newly formed adjacent skin
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Correction of hyperthermia or hypothermia
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Antibiotic administration when underlying infection is suspected or identified as cause of exfoliative dermatitis or when a secondary skin and soft tissue infection is present
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Intravenous fluids to correct dehydration
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Sedating antihistamines for pruritus
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Systemic or topical corticosteroid therapy or immunosuppressants should be guided by a dermatologist as it may worsen some forms of exfoliative dermatitis; of note, increased absorption of topical medications when applied to damaged skin should be anticipated.
Consultations
Urgent consultation with a dermatologist is recommended.
Long-Term Monitoring
For patients who do not require hospitalization, outpatient follow up with a dermatologist should be arranged to avoid delays in care and further diagnostic testing.
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Exfoliative dermatitis diffuse skin involvement
Tables
| Underlying Disease | History | Examination |
|---|---|---|
Psoriasis (common)
|
|
|
| Atopic dermatitis (common) |
|
|
| Drug reactions (common) |
|
|
| Idiopathic (common) |
|
|
Cutaneous T-cell lymphoma (less common) |
|
|
Pityriasis rubra pilaris (less common) |
|
|
Contact and stasis dermatitis with autosensitization (less common) |
|
|
Paraneoplastic erythroderma (less common) |
|
|
| Common | Uncommon |
|---|---|
|
|
