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Erythroderma — RACP Adult Medicine MCQ

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ModerateDermatologyErythrodermaRACP Adult Medicine

A 55-year-old man with psoriasis develops acute onset erythroderma (>90% BSA) with systemic symptoms including fever, tachycardia, and peripheral oedema. What is the most important initial concern?

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Correct answer: D — High-output cardiac failure and hypothermia

Erythroderma (generalised exfoliative dermatitis affecting >90% BSA) is a dermatological emergency. The extensive skin inflammation causes massive insensible fluid loss, thermoregulatory failure (hypothermia or hyperthermia), high-output cardiac failure (due to cutaneous vasodilation), and protein loss. Management requires admission for fluid resuscitation, temperature monitoring, electrolyte correction, and treatment of the underlying cause. Topical emollients and, when stable, cautious immunosuppression.

Reference: eTG – 2025 – Dermatology