Which clinical history findings are characteristic of exfoliative dermatitis?

Updated: Aug 15, 2019
  • Author: David Vearrier, MD, MPH; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

A thorough history may elucidate the underlying etiology for the exfoliative dermatitis. The most common cause of exfoliative dermatitis is generalization of a preexisting dermatitis. Therefore, patients should be queried about a history of psoriasis or atopic, contact, seborrheic, or chronic actinic dermatitis. Drug eruption is a common cause of exfoliative dermatitis, so a thorough medication history is essential. Drug-induced exfoliative dermatitis may occur with oral or topical medications. A history of a localized exanthem followed by generalization is more common with topical medications, while a history of a morbilliform or scarlatiniform eruption is common with oral medications.

The most common complaint in patients with exfoliative dermatitis aside from rash is pruritus, which occurs in approximately 90% of patients. [1] The severity of the pruritus varies by underlying condition, being most severe in atopic dermatitis and cutaneous T-cell lymphoma. Complaints of hair loss and nail changes are common. Sun exposure may worsen the rash, particularly in pityriasis rubra pilaris.


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