Exfoliative dermatitis may occur in response to drug therapy, systemic disease, or an idiopathic entity. The remaining cases are idiopathic. Histopathologic patterns seen for drug-induced and idiopathic causes of exfoliative dermatitis are nonspecific. Biopsy in individuals with preexisting cutaneous disease during an exfoliative stage may reveal, inconsistently, the underlying skin lesion. No cause other than exfoliation was found for the remaining 17 cases.
Exfoliative dermatitis occurs in all races.
More commonly, patients complain of skin erythema, tightness, and scaling. Firm, rubbery lymphadenopathy, referred to as dermatopathic lymphadenitis, is a common finding. Steatorrhea also may develop and tends to resolve when exfoliative dermatitis clears. Patients with exfoliative dermatitis also have increased cutaneous blood flow, transcutaneous fluid losses, and radiation and convective heat losses. A number of cases of hypothermia have been reported.