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Erythroderma (exfoliative dermatitis). Part 2: energy homeostasis and dietetic management strategies
Author(s) -
Tso S.,
Moiz H.,
Satchwell F.,
Hari T.,
Dhariwal S.,
Barlow R.,
Forbat E.,
Blee I. C.,
Tan Y. T.,
Thind C.,
Ilchyshyn A.,
Randeva H.,
Kwok M. M.,
Tso A. C. Y.,
Barber T. M.
Publication year - 2021
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.14667
Subject(s) - basal metabolic rate , erythroderma , medicine , homeostasis , energy homeostasis , physiology , thermogenesis , exfoliative dermatitis , intensive care medicine , gerontology , endocrinology , dermatology , obesity
Summary Erythroderma (exfoliative dermatitis) is associated with important metabolic changes that include an enhancement in energy expenditure. The key components to total energy expenditure (TEE) include basal metabolic rate (~68% of TEE), physical activity (~22% of TEE) and thermic effect of food (~10% of TEE). In the erythrodermic state, there are likely multiple contributors to the increase in basal metabolic rate, such as ‘caloric drain’ resulting from increased evaporation of water from enhanced transepidermal water loss, increased activity of the cardiovascular system (including high‐output cardiac failure), increased nonshivering thermogenesis and hormonal changes such as hypercortisolaemia. A change in the patient’s level of physical activity and appetite as a result of ill health status may further impact on their TEE and energy consumption. In Part 2 of this two‐part concise review, we explore the key constituents of energy homeostasis and the potential mechanisms influencing energy homeostasis in erythroderma, and suggest much‐needed dietetic management strategies for this important condition.