Psoriasis – Erythrodermic Psoriasis

Erythrodermic Psoriasis is the rarest form of Psoriasis occuring in approximately 1% of all Psoriasis patients during their lifetime, thus I do not encounter this type very often in my The Woodlands dermatology and Conroe dermatology offices.  Erythrodermic Psoriasis occurs when the entire skin becomes red and scaly, essentially one very large Psoriasis plaque.  This condition is a life threatening emergency as the body’s homeostasis can become very dysregulated.  Patients with Erythrodermic Psoriasis can have fluctuations in core body temperature, electrolyte imbalances, and end organ failure such as congestive heart failure.  Some patients may develop skin infections and pneumonia.  Due to the large amount of body surface area affected, patients lose a significant amount of protein resulting in lower extremity edema.  Depending on the severity of the Erythrodermic Psoriasis, a patient may be hospitalized for supportive care and systemic treatment of the Psoriasis.  Cyclosporine is considered a “rescue drug” for severe cases of Psoriasis but Methotrexate may also be used along with topical steroids and occasionally NB UVB light therapy.  There are many triggers for Erythrodermic Psoriasis such as systemic steroid withdrawal, alcoholism, a drug rash, emotional stress, and infections.