OLDER ADULT WITH ERYTHRODERMA, A MEDICAL EMERGENCY. CASE REPORT

Introduction: Erythroderma is a severe inflammatory skin syndrome that affects more than 90% of the body’s surface area. The most common causes include psoriasis, a history of dermatological disease, and the use of certain medications. Due to the extent of skin involvement, it is considered a medical emergency because of the high risk of skin barrier dysfunction. This risk is exceptionally high in older adults, in whom the onset of erythroderma can exacerbate functional decline, lead to nutritional impairment, and cause mood disturbances. These complications are associated with an increased likelihood of developing systemic infections, dehydration, and electrolyte imbalances, which are acute and potentially life-threatening conditions.
Case presentation: A 76-year-old male patient was admitted to the emergency
department of the Hospital Universitario San Ignacio de Bogotá (Colombia) due to a one-and-a-half-year history of pruritic, erythematous, painful, and scaly skin lesions on the lower limbs, which later spread throughout the body, causing systemic involvement. The patient was admitted to the hospital with a diagnosis of erythroderma secondary to psoriasis. A skin biopsy showed nonspecific chronic dermatitis. A comprehensive geriatric assessment led to the establishment of a treatment focused on controlling disease progression and minimizing the risk of associated systemic complications, which resulted in the satisfactory recovery of the patient.
Conclusions: Dermatologic diseases in older adults are often underestimated due to the skin changes associated with aging. However, conditions such as erythroderma should be suspected considering the high risk of acute skin failure and associated complications. In these patients it is critical to implement optimal strategies based on functional status, with an emphasis on nutritional, mental, and social management.
Comprehensive geriatric assessment is essential to determine treatment goals,
ensure proper adherence to treatment, and improve the patients’ quality of life.