This protocol addresses erythroderma arising as a complication of atopic dermatitis — a severe, diffuse inflammatory skin presentation — in patients where initial systemic therapy has not produced an adequate response. Exfoliative dermatitis attributable to atopic dermatitis has been reported to account for a meaningful proportion of erythroderma cases across clinical series.
This protocol applies when first-line systemic treatment — specifically narrow-band UVB phototherapy or oral cyclosporin — has failed to achieve the therapeutic goal of clinical remission of erythroderma. The failure to meet this target is the indication for escalation to the next treatment line described here.
Once phototherapy or cyclosporin has not led to remission, the protocol turns to other systemic immunosuppressant options. Several agents within this class are considered, each with its own place in the structured decision pathway. The complete regimen — including agent selection, sequencing, and follow-up — is available via the full protocol.
DOI: 10.1016/j.adengl.2018.05.033
It has been reported that exfoliative dermatitis related to atopic dermatitis varies from 4.76 to 23.9%.
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