Erythroderma is a severe systemic inflammatory skin disease. Clinically, it is characterized by diffuse erythema, infiltration, swelling, and desquamation affecting most (>2/3) or all of the skin. The main causative factors can be categorized into four types: (1) Drug allergies, such as common sulfonamides, penicillin, antimalarials, and biological products; (2) Secondary to other skin conditions, such as psoriasis, eczema, contact dermatitis, seborrheic dermatitis, and pityriasis rubra pilaris; (3) Secondary malignancies, primarily malignant tumors of the lymphatic system, such as mycosis fungoides; (4) Idiopathic causes, where the nature of the primary disease remains undetermined. This condition is more common in middle-aged men, and its prognosis depends on the causative factors, severity of the disease, and whether treatment is correct and timely. Severe cases may result in death due to serious complications or worsening of the primary disease.

bubble_chart Clinical Manifestations

1. Acute phase: Sudden onset, with extensive (over two-thirds of the body surface) erythema, swelling, and exudation of the skin, accompanied by large-scale desquamation and prominent systemic symptoms such as high fever and shivering. There may also be mucosal damage in the eyes, mouth, and genital areas, with subjective pain. 2. Chronic phase: The skin lesions appear dark red, dry, and markedly infiltrated, covered with bran-like scales. Hair and nail loss may occur, and large areas of desquamation resembling gloves or socks may appear on the palms and soles. Superficial lymphadenopathy is common, and hepatosplenomegaly may also be present. 3. Subjective symptoms: Cutaneous pruritus, a sensation of skin tightness, and chills. 4. Systemic complications: Due to extensive desquamation, protein loss, and constitutional decline, secondary conditions such as pneumonia, anemia, heart failure, and sepsis may occur.

bubble_chart Diagnosis

1. Multiple disease causes; 2. Generalized erythema and swelling with bran-like or large scales, and glove- or sock-like desquamation on the palms and soles; 3. Severe cases may present with hair and nail loss, as well as mucosal damage in areas such as the eyes; 4. Acute onset accompanied by systemic toxic symptoms and lymphadenopathy; 5. Symptoms include cutaneous pruritus, skin tightness, and chills.

Treatment Principles 1. Corticosteroid therapy; 2. Supportive therapy; 3. Immunosuppressant therapy; 4. Antihistamines for itching relief and sedation; 5. Topical medication; 6. Treatment of mucosal orifices; 7. Chinese medicine treatment: In the acute phase, focus on {|###|}clearing heat and removing toxin, cooling blood and resolving macula{|###|}; in the chronic phase, prioritize {|###|}enriching yin and clearing heat, tonifying qi and invigorating spleen{|###|}.

Medication Principles 1. For critically ill patients, emergency measures should be taken first, with reference to internal medicine treatment protocols; 2. If the {|###|}disease cause{|###|} is clear, it should be eliminated as early as possible, and the primary disease should be actively treated; 3. The dosage, administration, tapering, and discontinuation of corticosteroids should be determined based on the condition. During use, attention should be paid to potassium and calcium supplementation, antacids, and other measures to prevent adverse reactions.

bubble_chart Cure Criteria

1. Cure: Symptoms and signs disappear without recurrence; 2. Improvement: Symptoms and signs improve, skin lesions decrease; 3. No improvement: Symptoms and signs show no change.