Author: Dr Amy Stanway, Dermatology Registrar, Waikato Hospital, Hamilton, New Zealand, 2004.
Erythroderma is a generalised redness of the skin. It is a very severe skin condition that can be fatal. It can be the result of many inflammatory skin conditions, drugs and malignancies but in a third of cases it is due to psoriasis.
Erythrodermic psoriasis may be precipitated by:
Erythrodermic psoriasis usually occurs in the setting of known worsening or unstable psoriasis but may uncommonly be the first presentation of psoriasis. Onset can occur acutely over a few days or weeks, or gradually evolve over several months from pre-existing psoriasis.
Features are those of any form of erythroderma (red dry skin all over the body).
Treatment of erythrodermic psoriasis can be difficult. Management includes:
Oral corticosteroids should be avoided if possible because withdrawal risks worsening of the erythrodermic state and may cause generalised pustular psoriasis. However, sometimes they are the only treatment that helps.
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