erythrodermic psoriasis; exfoliative psoriasis

Etiology

• may result from refractory or untreated psoriasis
• may be induced by severe sunburns
• medications
• glucocorticoid withdrawal
• cyclosporine withdrawal

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
• risk of electrolytes disorders due to fluid loss
• 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

More general terms

• psoriasis