Erythrodermic psoriasis is a particularly inflammatory form of the condition that often affects most of the body surface and is not limited to the elbows, knees, hands or feet. It is the least common form of the condition and is most common on people who have unstable plaque psoriasis where the lesions are not clearly defined.
Erythrodermic Psoriasis is characterized by periodic, widespread fiery red skin. The redness and shedding of the skin are often accompanied by severe itching and pain and swelling can also develop. Almost 80 percent of the skin\’s surface can be covered and this is considered one of the few true skin condition emergencies. Hospitalization is required for people who have erythrodermic psoriasis because it has the potential to be life-threatening, especially in the elderly population.
Complications that are associated with erythrodermic psoriasis include the loss of ability to regulate temperature because of the damage done to a vast majority of the skin. The skin is the largest organ in the body and the one responsible for temperature regulation. As a result of this damage done by the psoriasis, individual will lose heat, body fluids and protein requiring hospitalization for treatment.
If the individual develops a combination of erythrodermic and pustular psoriasis they can suffer from a serious condition called Zumbusch Psoriasis. Common symptoms include fever, chills, weight loss and muscle weakness and will be most serious in the elderly population and potentially life-threatening.
Individuals may find that they have specific triggers that increase their risk of a flareup of erythrodermic psoriasis. Some of the common triggers include lithium, anti-malarial drugs and interleukin-2. Other causes can include infections, calcium deficiencies, sudden withdrawal of oral corticosteroids and strong coal tar preparations.
In the hospital physicians will recommend supportive care which will include intravenous fluids and temperature regulation as well as cool wet dressings, bed rest and treatment of any complications which may have occurred including swelling and nutritional support.
Once the individual has been stabilized in the hospital physicians may recommend a variety of treatment protocols that can be used in combination or on a rotational basis. These include phototherapy in which the individual is exposed to ultraviolet light, Methotrexate, Acitretin a vitamin A derivative, systemic corticosteroids or cyclosporine A.
Although erythrodermic psoriasis is a relatively rare condition it can be serious and life-threatening and should be recognized immediately. On very rare occasions erythrodermic psoriasis is the first indication that an individual is suffering from psoriasis. More often however, psoriasis has already been diagnosed and erythrodermic psoriasis will show up if the control of the condition is unstable. Individuals should not overlook the severity of this condition and seek medical care immediately to prevent some of the serious side effects to the heart and lungs from the strain that this disease places on the body.
RESOURCES
National Psoriasis Foundation: Erythrodermic Psoriasis
http://www.psoriasis.org/document.doc?id=521
MayoClinic: Erythrodermic Psoriasis
http://www.mayoclinic.com/health/medical/IM04204