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What is Exfoliative Dermatitis?

By D. Jeffress
Updated May 17, 2024
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Exfoliative dermatitis is a skin disorder in which a large proportion of the body's surface area becomes red, scaly, and excessively dry. Many different underlying conditions can result in exfoliative dermatitis, including adverse drug reactions, skin allergies, and psoriasis. In many cases, however, doctors are unable to identify an exact cause. The condition can be debilitating, and often requires hospitalization so doctors can provide emergency medical care. Most patients who seek immediate treatment recover within a few weeks, though especially severe cases can result in life-threatening complications.

The outer layer of skin is comprised primarily of dead or dying cells. The body produces new skin cells quickly, and every cell is eventually replaced in a constant turnover cycle that spans about one month. In the case of exfoliative dermatitis, the cycle is sped up considerably. As new cells are produced, existing skin begins to flake and fall off. The newly exposed skin is raw, in a sense, and unable to provide sufficient protection or nutrient absorption.

In most cases, at least 90% of the skin appears red and scaly. The condition leaves a person extremely sensitive to heat, light, and clothing. It usually causes constant itching and burning sensations, and some people are unable to walk or move without extreme discomfort. Exfoliative dermatitis often comes on quickly in the case of allergic reaction, sometimes overtaking the body in a matter of hours. Instances that are not related to specific allergies or illnesses may develop gradually over the course of days or weeks.

Emergency room personnel can usually make a general diagnosis by examining the skin and evaluating symptoms. Doctors obtain medical histories and ask questions about when symptoms arose to try to identify an underlying cause. Blood and skin samples are collected and analyzed in a hospital laboratory to help confirm a diagnosis. While doctors wait for test results, they typically administer intravenous fluids and apply a soothing topical cream to ease symptoms.

Treatment for exfoliative dermatitis depends on the cause. A patient who experiences an allergic reaction to a drug, plant, or another irritating substance is typically able to recover quickly, once all of the toxins leave the body. Other conditions are treated accordingly with antibiotics, corticosteroids, and soothing topical solutions, usually bringing relief in one to four weeks. The prognosis is poorer when doctors do not know the underlying cause, and patients may need to remain in intensive care units for several weeks if their symptoms do not subside.

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