Clinical experience makes it indeed very likely that an extensive inflammation of the skin causes a repercussion on the entire organism. The cachectic and fatal end of a not unimportant number of our chronic erythroderma patients clearly points in this direction. Only rarely in these patients changes are found after death, related to the erythroderma, which by themselves may explain the fatal outcome. I would like to begin by stating that the thesis, defended by many authors, that internal disorders (metabolic diseases such as diabetes, or carcinoma, endocrine disturbances, senectitude) would be of great significance in a causative or predisposing sense in the development of erythroderma, is not acceptable in its general implications, but at most in incidental cases only. No one has ever succeeded even in making it seem plausible that an erythroderma would as a rule be the result of a primary internal disturbance. Endocrine