Erythroderma Complications — RACP Adult Medicine MCQ

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ModerateDermatologyErythroderma ComplicationsRACP Adult Medicine

A 50-year-old man with psoriasis develops erythroderma (>90% BSA involvement). He has generalised exfoliation, shivering, and tachycardia. His albumin is 22 g/L. What is the most dangerous acute complication of erythroderma?

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Correct answer: C — Hepatic failure

Erythroderma is a dermatological emergency. The most dangerous acute complications are: (1) high-output cardiac failure (massive cutaneous vasodilation increases cardiac output 2–3×, which decompensated hearts cannot sustain); (2) hypothermia (loss of thermoregulation from massive cutaneous blood flow and evaporative heat loss); (3) hypoalbuminaemia/protein loss (from skin exfoliation); and (4) secondary infection/sepsis. Management requires admission, temperature monitoring, IV fluid resuscitation, electrolyte correction, emollients, and treatment of the underlying cause. Biologic therapy may be needed for psoriatic erythroderma.

Reference: eTG – 2025 – Dermatology