Abstract
From a diagnostic and therapeutic perspective, erythroderma represents one of the most challenging entities within dermatology. This is due in part to the large number of disorders that can present as an erythroderma. Whilst in adults the commonest causes are inflammatory disorders such as atopic dermatitis and psoriasis, drug eruption should always be in the differential diagnosis. In children, a variety of rare genetic disorders also need to be considered. Careful clinicopathologic correlation is essential in order to identify specific underlying causes and extensive investigations are often required to exclude disorders such as cutaneous T cell lymphoma. Despite a thorough evaluation, a significant minority of patients (~25%) with erythroderma may have no identifiable etiology. While treatment should be directed at the underlying cause, weekly methotrexate can be an excellent empiric therapeutic option for patients with idiopathic erythroderma.
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