A sixty-three-year-old man came to us with his entire skin fiery red and tender. And, it had been that way for over a year. He had what is known as chronic erythroderma or exfoliative dermatitis, (French: l'homme rouge). He had lost most of his hair and fifty pounds of weight.

The mystery was the cause, not the diagnosis. Erythroderma has many causes. We could eliminate the two most common ones, longstanding eczema and psoriasis, because he had never had any skin disease before.

We ruled out a malignant lymphoma by skin biopsy, and also eliminated internal tumors by x-rays and CT scans. But the cause of his total body rash still eluded us, although we had clues it was due to an allergy. His complete blood count (CBC) showed an eosinophilia of 36%, which meant that a large number of his white cells were eosin staining, a certain sign of allergy (in contrast to the normal 0% to 5%). Furthermore, a second skin biopsy suggested that drug allergy might be the cause. However, he was taking no medications by mouth, and had only occasional cortisone injections to calm down his redness, itch and scaling.

Yet, there was one more item of medication to be considered, his eyedrops. They seemed so innocent and insignificant, used to control his glaucoma. We were, of course, reluctant to eliminate them, fearing progressive blindness. But until we finally stopped them, we could not control the eczema which covered every square inch of his body.