A 65-year-old man presents with generalised erythema involving 90% BSA, scaling, fever, and lymphadenopathy. His skin biopsy shows spongiosis with exocytosis. The MOST common underlying cause of erythroderma in adults is:
- A Drug reactions
- B Cutaneous T-cell lymphoma (Sézary syndrome)
- C Pre-existing dermatosis (most often psoriasis or eczema) ✓
- D Internal malignancy
Correct answer: C. Pre-existing dermatosis (most often psoriasis or eczema)
Explanation
Exfoliative dermatitis (erythroderma) in adults is most commonly caused by a pre-existing dermatosis — particularly psoriasis and eczema — accounting for approximately 50% of all cases collectively. Drug reactions are the second most common cause (~20–30%), while cutaneous T-cell lymphoma (Sézary syndrome) and internal malignancy together account for a smaller proportion. The 'idiopathic' category accounts for 15–20%. Identifying the underlying cause determines prognosis and treatment.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.