persistent erythema, accompanied by profuse and repeated exfoliation. This includes nails and hair. There are also enlarged lymph nodes and the patient complains of a constant cold. This is EXFOLIATIVE DERMATITIS. 

The entire skin is erythematous, oedematous and scaly. Mostly it is idiopathic without a preceding skin condition or it may follow dermatitis, it can also be a reaction to several drugs like, sulphonamides, sulphonylureas, gold, etc. it can occasionally be a feature of other systemic disorders like lymphoma.

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The root cause of exfoliative dermatitis is a disorder of the skin cells. The cells die and shed too quickly in a process called turning over. The rapid turnover of skin cells causes significant peeling and scaling of the skin. The peeling and scaling may also be known as sloughing.

Underlying conditions

Many people who already live with chronic skin conditions, including autoimmune diseases, psoriasis, seborrheic dermatitis, and eczema, can also develop exfoliative dermatitis.

Drug reactions

Adverse reactions to a variety of drugs can also contribute to massive skin peeling. Drugs that may produce this condition include:

  • sulfa drugs
  • penicillin
  • barbiturates
  • phenytoin (Dilantin) and other seizure medications
  • isoniazid
  • blood pressure medications
  • calcium channel blockers
  • topical medications (medications put on the skin)

However, almost any drug can cause exfoliative dermatitis.

Other causes

Certain types of cancer, including leukemia and lymphoma, may also accelerate the skin cell turnover rate. According to Merck Manuals, up to 25 percent of cases of exfoliative dermatitis are idiopathic. Idiopathic is when a disease or condition has no known cause.

Skin and nail changes : Exfoliative dermatitis begins in most people with extreme reddening, which spreads over large portions of the body. This change in skin color is known as erythroderma. Erythroderma and exfoliative dermatitis are both names for this condition. Massive peeling of the skin follows the reddening and inflammation. The skin may be rough and scaly. The dryness and peeling of your skin can cause itching and pain. Your nails may also become thicker and more ridged.

Flu-like symptoms : People who have exfoliative dermatitis may also have flu-like symptoms, such as fever and chills. This is because widespread skin peeling can affect your internal thermometer and cause heat loss from your damaged skin. Your body isn’t able to control its temperature well. Most people with exfoliative dermatitis also feel generally ill.

Complications from skin shedding : Those with this condition may also have a low blood volume. This is due to loss of fluid through the shed skin.

Skin shedding may start in small patches, but over time, it spreads to most of the body. Skin is made of mainly protein. The constant shedding of the skin can prevent your body from absorbing essential nutrients that help to maintain a healthy epidermis (such as vitamins A and D). You also lose protein and fluids from the sloughing. Dehydration and protein deficiencies are common complications. 

Severe symptoms : Severe symptoms of exfoliative dermatitis can be life-threatening. Those who develop complications of infection, fluid and electrolyte abnormalities, and cardiac failure are most at risk of death. The most common causes of death in patients with exfoliative dermatitis are pneumonia, septicemia, and heart failure.


Exfoliative dermatitis is characterized by persistent, almost universal exfoliation; hair and nails may also be shed. More than pruritus there is a sensation of tightness and discomfort. If it is not treated it may persist for months and years. Good nourishing is essential.

Kalium arsenicosum patient has a tendency for anxiety and skin diseases. Restless, nervous and anaemia patient. Skin is dry, scaly and wilted. Chronic eczema with intolerable itching. Suffering is worse at night, from underrssing, warmth and walking. Fissures on the bends of arms and knees. Skin has a tendency to cancer and it sets in without any signs and symptoms.

Berberis aquifolium has eruptions on the scalp, extending to the face and neck. At times the skin is dry, rough, scaly and pimply. Puruitus is located in localized spots initially and then spreads over the entire skin. Dry eczema, better by washing in cold water.

Petroleum is for eczema with deep with deep cracks in the folds, nipples and finger tips; worse during winters; itching is worse at night. Itching of orifices with burning. Smallest injury suppurates . thick greenish crusts, with burning itching, redness and bleeding. Skin is extremely sensitive to the touch of clothes.

Graphites has eczema with dry, rough skin that breaks easily oozes an exudates, gluey moisture. It is worse in the folds and healing is slow. Eczema behind the ears; with cracks and fissures. Eyelids red, swollen; eczema of lids; fissured. Moist, crusty eruptions, worse from heat