Generalized Exfoliative Dermatitis

What is generalized exfoliative dermatitis?

Generalized exfoliative dermatitis is a severe inflammation of the entire skin surface due to a reaction to certain drugs, a pre-existing skin condition and sometimes cancer. In approximately 25 percent of people, there is no identifiable cause. It is characterized by redness and scaling of the skin that begins in patches and spreads. The skin begins to slough off leading to problems with temperature regulation, protein and fluid loss, as well as an increased metabolic rate.

What are the symptoms of generalized exfoliative dermatitis?

The following are the most common signs and symptoms of generalized exfoliative dermatitis. However, each individual may experience symptoms differently:

  • Extreme redness of the skin

  • Scaling

  • Crusting lesions

  • Thickened skin

  • Itching

  • Swollen lymph nodes

  • Fever

  • Malaise

  • Secondary infections (viral or bacterial) 

  • Loss of fluids and proteins through the damaged skin that can lead to dehydration and protein deficiencies 

The symptoms of generalized exfoliative dermatitis may resemble other skin conditions. Always consult your doctor for a diagnosis.

How is the cause of generalized exfoliative dermatitis determined?

Diagnosis includes careful elimination of known causes, such as certain drugs (for example, penicillin and barbiturates). In addition, your doctor may check for other skin conditions such as atopic dermatitis, as well as for certain types of cancer, such as lymphoma, during a physical examination and medical history.

Treatment for generalized exfoliative dermatitis

Specific treatment for generalized exfoliative dermatitis will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the reaction

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the reaction

  • Your opinion or preference

Severe cases of generalized exfoliative dermatitis may require hospitalization while the person is treated with antibiotics, intravenous (IV) fluids, and nutritional supplements. Treatment will vary depending on the cause:

  • If certain drugs are causing the condition, eliminating them usually clears up generalized exfoliative dermatitis.

  • If another skin condition causes generalized exfoliative dermatitis, treating the other skin condition usually clears up the generalized exfoliative dermatitis.

  • If cancer is causing the condition, treating the cancer usually clears up the generalized exfoliative dermatitis.

Other treatments may include:

  • Heated blankets (to keep warm)

  • Cool baths

  • Petroleum jelly applied to skin, followed by gauze

  • Systemic corticosteroids (for severe cases)

  • Rehydration (putting fluids back into the body) 

  • Comprehensive wound care to prevent infection     

This condition can be life-threatening and many times requires hospitalization. The outlook (prognosis) depends on the cause. In the case of drug reactions, the condition usually lasts two to six weeks after the drug is stopped.