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Background: Erythroderma may be secondary to several skin diseases, drug reactions, infections, and internal malignancies. Skin lesions usually have an unfavorable course until the underlying disease is treated, therefore a thorough search for the cause of erythroderma is mandatory. Case report: We present the case of a 51-year-old female patient who presented with an erythroderma of unknown etiology of 6 months duration. Extensive screening for the cause of erythroderma lead to the diagnosis of left ovarian papillary serous carcinoma invasive to the epiploon, parietal peritoneum and the wall of the urinary bladder, stage IIC FIGO, pT2c pN0 cM0. The patient underwent surgery, followed by multiple lines of chemotherapy. Whole body computed tomography scan, measurement of serum levels of tumoral markers and dermatologic reevaluation were performed every 3 months. Results: The course of skin lesions paralleled that of the subjacent malignancy and was most favorable under platinum plus gemcitabinum and platinum plus taxanes based chemotherapy that also best controlled the neoplastic process. Conclusion: The parallel evolution of the ovarian carcinoma and cutaneous lesions firmly supports the diagnosis of paraneoplastic erythroderma in our patient. Screening for internal neoplasia should be performed in all cases of erythroderma of unknown etiology. [ABSTRACT FROM AUTHOR]