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34-Year-Old with Widespread Redness and Scaly Skin

  • Michael P. Lee
  • Kevin K. Wu
  • Jashin J. Wu
Chapter
Part of the Clinical Cases in Dermatology book series (CLIDADE)

Abstract

Erythrodermic psoriasis is a rare, life-threatening variant of psoriasis characterized by widespread redness, itching, pain, and scaly skin. Initial management focuses on correcting any fluid or electrolyte abnormalities, treatment of infections, and hypothermia prophylaxis. This is a 34-year-old patient with a long history of psoriasis that presented with generalized erythema on adalimumab. He was started on cyclosporine for treatment of his erythrodermic psoriasis.

Keywords

Erythrodermic psoriasis Psoriatic arthritis Cyclosporine 

References

  1. 1.
    Boyd AS, Menter A. Erythrodermic psoriasis. Precipitating factors, course, and prognosis in 50 patients. J Am Acad Dermatol. 1989;21(5 Pt 1):985–91.CrossRefGoogle Scholar
  2. 2.
    Lebwohl M. Psoriasis. Lancet. 2003;361(9364):1197–204.  https://doi.org/10.1016/S0140-6736(03)12954-6.CrossRefPubMedGoogle Scholar
  3. 3.
    Green MS, Prystowsky JH, Cohen SR, Cohen JI, Lebwohl MG. Infectious complications of erythrodermic psoriasis. J Am Acad Dermatol. 1996;34(5. Pt 2):911–4.CrossRefGoogle Scholar
  4. 4.
    Zhang P, Chen HX, Duan YQ, Wang WZ, Zhang TZ, Li JW, Tu YT. Analysis of Th1/Th2 response pattern for erythrodermic psoriasis. J Huazhong Univ Sci Technolog Med Sci. 2014;34(4):596–601.  https://doi.org/10.1007/s11596-014-1322-0.CrossRefPubMedGoogle Scholar
  5. 5.
    Rosenbach M, Hsu S, Korman NJ, Lebwohl MG, Young M, Bebo BF Jr, Van Voorhees AS, National Psoriasis Foundation Medical Board. Treatment of erythrodermic psoriasis: from the medical board of the National Psoriasis Foundation. J Am Acad Dermatol. 2010;62(4):655–62.  https://doi.org/10.1016/j.jaad.2009.05.048.CrossRefPubMedGoogle Scholar
  6. 6.
    Management of erythrodermic psoriasis with low-dose cyclosporin. Studio Italiano Multicentrico nella Psoriasi (SIMPSO). Dermatology. 1993;187(Suppl 1):30–7.  https://doi.org/10.1159/000247289.CrossRefGoogle Scholar
  7. 7.
    Poulalhon N, Begon E, Lebbe C, Liote F, Lahfa M, Bengoufa D, Morel P, Dubertret L, Bachelez H. A follow-up study in 28 patients treated with infliximab for severe recalcitrant psoriasis: evidence for efficacy and high incidence of biological autoimmunity. Br J Dermatol. 2007;156(2):329–36.  https://doi.org/10.1111/j.1365-2133.2006.07639.x.CrossRefPubMedGoogle Scholar
  8. 8.
    Haustein UF, Rytter M. Methotrexate in psoriasis: 26 years’ experience with low-dose long-term treatment. J Eur Acad Dermatol Venereol. 2000;14(5):382–8.CrossRefGoogle Scholar
  9. 9.
    Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, Gottlieb AB, Koo JY, Lebwohl M, Lim HW, Van Voorhees AS, Beutner KR, Bhushan R. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61(3):451–85.  https://doi.org/10.1016/j.jaad.2009.03.027.CrossRefPubMedGoogle Scholar
  10. 10.
    Pescitelli L, Dini V, Gisondi P, Loconsole F, Piaserico S, Piccirillo A, Stinco G, Errichetti E, Talamonti M, Tripo L, Volpi W, Prignano F. Erythrodermic psoriasis treated with ustekinumab: an Italian multicenter retrospective analysis. J Dermatol Sci. 2015;78(2):149–51.  https://doi.org/10.1016/j.jdermsci.2015.01.005.CrossRefPubMedGoogle Scholar
  11. 11.
    Saeki H, Nakagawa H, Ishii T, Morisaki Y, Aoki T, Berclaz PY, Heffernan M. Efficacy and safety of open-label ixekizumab treatment in Japanese patients with moderate-to-severe plaque psoriasis, erythrodermic psoriasis and generalized pustular psoriasis. J Eur Acad Dermatol Venereol. 2015;29(6):1148–55.  https://doi.org/10.1111/jdv.12773.CrossRefPubMedGoogle Scholar
  12. 12.
    Weng HJ, Wang TS, Tsai TF. Clinical experience of secukinumab in the treatment of erythrodermic psoriasis: a case series. Br J Dermatol. 2018;178(6):1439–40.  https://doi.org/10.1111/bjd.16252.CrossRefPubMedGoogle Scholar
  13. 13.
    Saraceno R, Talamonti M, Galluzzo M, Chiricozzi A, Costanzo A, Chimenti S. Ustekinumab treatment of erythrodermic psoriasis occurring after physical stress: a report of two cases. Case Rep Dermatol. 2013;5(3):254–9.  https://doi.org/10.1159/000348645.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Michael P. Lee
    • 1
  • Kevin K. Wu
    • 2
  • Jashin J. Wu
    • 3
  1. 1.Eastern Virginia Medical SchoolNorfolkUSA
  2. 2.Frank H. Netter MD School of Medicine at Quinnipiac UniversityNorth HavenUSA
  3. 3.Founder and CEODermatology Research and Education FoundationIrvineUSA

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