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erythrodermic psoriasis; exfoliative psoriasis
Etiology:
- may result from refractory or untreated psoriasis
- may be induced by severe sunburns
- medications
- glucocorticoid withdrawal
- cyclosporine withdrawal [2]
Epidemiology:
- rare (3% if psoriasis)
Pathology:
- shunting of blood to the skin
- increased skin metabolism & turnover
Clinical manifestations:
- widespread erythema & scaling of skin
- fever
- malaise
- hypothermia
- hypotension
Laboratory:
- complete blood count
- leukocytosis
Complications:
- potentially life-threatening
- high-output cardiac failure in the elderly
- high risk of infection [2]
- risk of electrolytes disorders due to fluid loss [2]
- nutritional deficiencies with chronic erythrodermic psoriasis
Differential diagnosis:
- severe drug eruption
- cutaneous T-cell lymphoma
- severe seborrheic dermatitis associated with HIV1
Management:
- consider hospitalization, especially in elderly or with comorbidities
- treatment is supportive
General
psoriasis
References
- Meffert J (image)
Psoriasis: Manifestations, Management Options, and Mimics.
Medscape. Dec 17,, 2015
http://reference.medscape.com/features/slideshow/psoriasis-subtypes
- Medical Knowledge Self Assessment Program (MKSAP) 19
Board Basics. An Enhancement to MKSAP19.
American College of Physicians, Philadelphia 2022