Erythroderma is an inflammatory skin disease with erythema

Erythema

Erythema is redness of the skin, caused by hyperemia of the capillaries in the lower layers of the skin. It occurs with any skin injury, infection, or inflammation...

 and scaling that affects nearly the entire cutaneous surface.

In ICD-10

ICD-10

The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...

, a distinction is made between "exfoliative dermatitis" at L26, and "erythroderma" at L53.9.

Historical aspects

The classification of exfoliative dermatitis into Wilson-Brocq (chronic relapsing), Hebra or pityriasis rubra (progressive), and Savill (self-limited) types may have had historical value, but it currently lacks pathophysiologic or clinical utility.

Causes

Erythroderma is generalized exfoliative dermatitis, which involves 90% or more of the patient's skin. The most common cause of erythroderma is exacerbation of an underlying skin disease, such as psoriasis

Psoriasis

Psoriasis is an autoimmune disease that appears on the skin. It occurs when the immune system mistakes the skin cells as a pathogen, and sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. However, psoriasis has been linked to an increased risk of...

, contact dermatitis

Contact dermatitis

Contact dermatitis is a term for a skin reaction resulting from exposure to allergens or irritants . Phototoxic dermatitis occurs when the allergen or irritant is activated by sunlight....

, seborrheic dermatitis, lichen planus

Lichen planus

Lichen planus is a chronic mucocutaneous disease that affects the skin, tongue, and oral mucosa. The disease presents itself in the form of papules, lesions, or rashes. Lichen planus does not involve lichens, the fungus/algae symbionts that often grow on tree trunks; the name refers to the dry and...

, pityriasis rubra pilaris

Pityriasis rubra pilaris

Pityriasis rubra pilaris refers to a group of chronic disorders characterized by reddish orange, scaling plaques and keratotic follicular papules...

 or a drug reaction. Primary erythroderma is less frequent and is usually seen in cases of cutaneous T-cell lymphoma, in particular in Sézary's disease

Sézary's disease

Sézary's disease is a type of cutaneous lymphoma that was first described by Albert Sézary. The affected cells are T-cells that have pathological quantities of mucopolysaccharides. Sézary's disease is sometimes considered a late stage of mycosis fungoides with lymphadenopathy...

.

The most common causes of exfoliative dermatitis are best remembered by the mnemonic device ID-SCALP.
. The causes and their frequencies are as follows:

• Idiopathic - 30%

• Drug allergy - 28%

• Seborrheic dermatitis - 2%

• Contact dermatitis - 3%

• Atopic dermatitis - 10%

• Lymphoma and leukemia - 14%

• Psoriasis - 8%

Differential diagnosis

Differential diagnosis

A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...

in patients with erythroderma may be difficult.