Erythrodermic Psoriasis: An Exfoliative Dermatitis…

Erythroderma is a rare and aggressive inflammatory condition that results in generalized redness and exfoliation of the skin.  There are other conditions that can cause erythroderma, but psoriasis is one of the most frequent forms, causing a third of reported cases.  The eruption presents abruptly and generalizes quickly resulting in an itchy, burning condition that is often very intensely manifested.  This condition can be life threatening and requires aggressive medical management.

There are triggers for this condition, such as sudden discontinuation of psoriasis medications, use of certain psoriasis medications (drug eruption), overuse of systemic or topical corticosteroids, sunburn, infections, emotional stress, allergic reactions, excessive alcohol consumption, and certain medications such as lithium and antimalarials.

COMPLICATIONS:  Include dehydration, heart failure, hypothermia, sepsis, protein loss, malnutrition, edema and subsequent death.

TREATMENT:  These patient often require hospitalization for supportive care, fluid management and temperature regulation.  Bland emollients and wet dressings as well as bed rest should be administered.  Complications, such as infections (sepsis) should be monitored and treated with systemic antibiotics.  A variety of medications for psoriasis to include methotrexate, cyclosporine, acitretin, as well as a variety of biologics (TNF-inhibitors–infliximab, etanercept, adilibumab–and IL-23 inhibitor ustekinumab) have been utilized with success.  To read more about Erythrodermic Psoriasis click HERE and HERE.  To read more about psoriasis click HERE.