Update and clinical pearls in the diagnostic and therapeutic approach on erythroderma in adults

Abstract

Erythroderma consists in erythema and generalized exfoliation that involves 90% or more of the cutaneous surface. This is a rare condition, its global and national incidence are currently unknown, but predominates in men of 42-61 years old. Its pathophysiology involves a complex interaction of cytokines that generates a massive recruitment of inflammatory cells to the skin, increase of the mitotic activity and an elevated epidermic turnover with the subsequent exfoliation of the superficial strata. The etiology is wide, but in the great part there is a generalization of a preexistent dermatosis, mainly atopic dermatitis, and psoriasis; also, could be seen like a drug`s hyper sensibility reaction, in cutaneous T lymphoma or other malignancies or could be idiopathic. The diagnosis of this etiology requires a detailed history, complete physical exam, lab exams and other tests depending on the cause suspected. The management of erythroderma must be directed toward the control of the cutaneous disease, the subjacent disease and to the systemic complications.