How many skin conditions are you aware of? Besides the common acne, did you know there are several other skin conditions that are more severe?
One such condition is exfoliative dermatitis. It affects large parts of the body, can cause pain and may require hospitalization in some cases. Early diagnosis and timely treatments can help minimize its effects.
Read on to know more about this condition.
What Is Exfoliative Dermatitis?
The term “exfoliative” refers to the shedding or exfoliation of the skin and “dermatitis” is when your skin is inflamed or irritated. 
Exfoliative dermatitis is also known as erythroderma and it’s a condition where the skin becomes inflamed and peels off over large areas of the body. The affected areas become reddened, accompanied by pain and irritation. 
Symptoms And Signs
Exfoliative dermatitis may start slowly or at a rapid pace. One of the first signs in most people is when the surface of your skin turns red. Following this, your skin tends to turn thick, rough, scaly and at times, crusty.
Over large parts of the body, the epidermis, which is the first layer of the skin, falls or peels off. If severe, it affects your nails and hair too.
The dryness and peeling can cause itching. While the itching can be common, an occasional symptom for a few people is swollen lymph nodes.
- Extreme redness of the skin.
- Thickened skin.
- Itching. Typically, the itch is troublesome and sometimes intolerable.
- Scaling, as fine flakes or large sheets, is seen 2 to 6 days after the onset of erythema.
- Nails become dull, thick and may shed.
- Fever or flu-like symptoms. People have chills and feel cold as a lot of heat is lost through the damaged skin.
- Crusting lesions.
- Swollen lymph nodes.
- Loss of fluids, proteins and electrolytes may seep out of the damaged skin which can cause protein deficiency or dehydration.
- The damaged skin is a poor barrier, making the person easily prone to secondary infection, both bacterial and viral.
- Scaling of the scalp with varying degrees of hair loss and sometimes, even complete baldness.
These generalised signs and symptoms of exfoliative dermatitis may be similar to other skin conditions. It’s best to seek the advice of a professional for an accurate diagnosis; especially if the exfoliative dermatitis symptoms don’t get better, get worse or you see new symptoms.
What Causes Exfoliative Dermatitis?
A disorder of the skin cells is one of the root causes of exfoliative dermatitis. The cells die and shed rapidly, and this is known as ‘turning over’. The quick turnover of skin cells leads to significant scaling and peeling of the skin. This is known as ‘sloughing’.
According to the American Merck Manuals, up to 25 per cent exfoliative dermatitis causes are idiopathic. Idiopathic means when a condition or disease has no known cause.
Usually, the following conditions cause exfoliative dermatitis: 
1. Skin Disorders
One of the primary causes of exfoliative dermatitis is pre-existing skin disorders. This includes pityriasis rubra pilaris, lichen planus, psoriasis, seborrheic dermatitis, contact dermatitis and atopic dermatitis.
2. Reactions To Drugs
Adverse reactions to a variety of drugs may also be responsible for skin peeling. A few drugs causing exfoliative dermatitis are barbiturates, blood pressure medications, penicillin, isoniazid, phenytoin and other seizure medications, sulfa drugs and topical medications. Discuss with a professional before you consume any medication for a long-term.
3. Other Causes
Skin cell turnover rate can accelerate due to a few types of cancers like lymphoma or leukemia.
How Do You Treat Exfoliative Dermatitis?
To prevent the affected skin from developing an infection and to retain fluids and proteins, early diagnosis and supportive treatment of exfoliative dermatitis are vital. Typically, a dermatologist carries out the treatment for exfoliative dermatitis.
Often, those who have severe exfoliative dermatitis need to be hospitalized and they’re intravenously (through the veins) given fluids and salts and antibiotics for the infection. This corrects any dehydration, heat loss, nutritional or electrolyte deficiencies, low blood volume and to treat the issue.
One of the most important goals of treatment is to reduce the inflammation and make you more comfortable. Supportive care consists of oral antihistamines, rest, warm baths and heated blankets to control body temperature. Sometimes, a medicated cream can help moisten your dry, itchy skin.
Steroid medications are often the remedy for those who experience severe or chronic inflammation and flaking of the skin. A few cases find relief in phototherapy or light therapy, which is done using psoralen, a light-sensitive drug, and ultraviolet light.
Whether it’s exfoliative dermatitis on the face, hands or anywhere else on the body, here are a few treatments you can expect to undergo.
Because of the absence of the skin’s first layer, it’s common for fluids to easily escape from the body surface, leading to dehydration. If not taken seriously, dehydration can be life-threatening.
Therefore, rehydration is very important. You can rehydrate orally, or it’s given intravenously at a hospital.
2. Correcting Electrolyte Imbalance
Your body has a delicate balance of fluids and electrolytes. From contracting muscles to conducting nervous impulses, electrolytes help the body function the way it should.
Hence, correcting abnormalities is crucial. For severe cases, it can be done via IV fluids. Otherwise, supplements or electrolyte water work.
Typically, for most healthy individuals, you can get your daily dose of electrolytes from a balanced diet. Supplementing is usually unnecessary.
3. Replenish Nutrients
If patients don’t get sufficient micronutrients or macronutrients, they'll lack energy, the body will not be able to build and maintain its organs and various metabolic processes will suffer.
You need to restore all that’s lost due to erythroderma at regular intervals to ensure your body functions optimally.
4. Prevention Of Infections
A serious complication of this condition is an infection and an important part of preventing infections is dressings. A wound should receive proper attention and care. Infections are treated with antibiotics.
5. Soothe The Skin
Itching or scratching can aggravate your condition. If you scratch too much, you can even bleed and that's a setup for infection. Get fast relief by soothing your skin.
An effective way to smooth the skin is with emollients. During exfoliative dermatitis, your skin is dry, flaky and cracked because of the absence of water in the top layer of the skin.
This creates open spaces between your cells. Emollients fill up these spaces with lipids, a fatty substance helping your skin look smoother and softer.
Oatmeal is a proven skin soother and colloidal oatmeal baths have a soothing effect. No, we’re not talking about Quaker Oats, but colloidal oatmeal. Your dermatologist can recommend specific brands of oatmeal products to try.
Diagnosis Of Exfoliative Dermatitis
Diagnosis is based on clinical examination and detailed medical history. Just with observation, a trained dermatologist can diagnose the condition. Sometimes you will have to undergo a physical exam which involves having a look at your skin.
Since exfoliative dermatitis is not contagious, you or the medical practitioner have nothing to worry about.
Finding out the cause of the erythroderma is important. Your dermatologist will determine if other skin conditions, certain medicines or ailments are causing dermatitis.
How Long Does Exfoliative Dermatitis Last?
Typically, with proper treatment, within a period of 2-6 weeks you can expect the symptoms to reduce. 
The prognosis may be poor for those who are diagnosed with idiopathic exfoliative dermatitis. But with long-term treatment from a good dermatologist, you can expect positive results.
The outlook for exfoliative dermatitis varies from person to person. If it is exfoliative dermatitis that’s drug induced, it’s easy to treat. Overall, with appropriate treatment, within a few weeks, your skin clears up.
While it’s not in your hands, a few simple healthy lifestyle choices like protecting yourself from the sun, managing stress, eating a healthy diet and treating your skin well can help prevent various skin problems and delay natural ageing.
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