What causes skin burning and peeling, also known as erythema and desquamation?

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Last updated: April 22, 2025View editorial policy

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Differential Diagnosis for Skin Burning and Peeling

  • Single most likely diagnosis:
    • Sunburn: This is the most common cause of skin burning and peeling, especially after prolonged exposure to the sun without adequate protection. The symptoms typically appear a few hours after sun exposure and can range from mild to severe.
  • Other Likely diagnoses:
    • Chemical burns: Exposure to harsh chemicals can cause skin irritation, burning, and peeling. This could be due to accidental exposure or improper use of chemical products.
    • Allergic contact dermatitis: An allergic reaction to substances like poison ivy, oak, or sumac, or to certain metals or chemicals in personal care products, can lead to skin burning and peeling.
    • Insect bites or stings: Certain insect bites or stings can cause an allergic reaction, leading to skin burning, redness, and peeling.
    • Eczema (atopic dermatitis): A chronic condition characterized by dry, itchy skin that can sometimes burn and peel, especially if scratched excessively.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Stevens-Johnson syndrome: A rare but life-threatening condition usually caused by an adverse reaction to medication or infection, characterized by widespread skin burning, peeling, and blistering.
    • Toxic epidermal necrolysis (TEN): Similar to Stevens-Johnson syndrome but more severe, with widespread skin necrosis and detachment, often requiring immediate medical attention.
    • Sepsis: In severe cases of skin burns or infections, if left untreated, can lead to sepsis, a potentially fatal condition.
  • Rare diagnoses:
    • Pemphigus: A group of rare skin disorders that cause blistering of the skin and mucous membranes, which can lead to burning and peeling.
    • Staphylococcal scalded skin syndrome (SSSS): A rare condition caused by staphylococcal toxins that typically affects infants and young children, leading to widespread skin peeling.
    • Autoimmune disorders: Certain autoimmune conditions, such as lupus or rheumatoid arthritis, can sometimes manifest with skin symptoms including burning and peeling, though this is less common.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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