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Psoriatic erythroderma can be congenital or secondary to an environmental trigger. [12] [13] [14] Environmental triggers that have been documented include sunburn, skin trauma, psychological stress, systemic illness, alcoholism, drug exposure, chemical exposure (e.g., topical tar, computed tomography contrast material), and the sudden cessation of medication.
A history of psoriasis, the presence of typical psoriatic skin lesions at the time of diagnosis, and histological evidence in skin lesions of necrotic keratinocytes, neutrophil-rich infiltrates, eosinophil infiltrates, and/or lack of tortuous or dilated blood vessels favors a diagnosis of to AGEP. [20]
Erythroderma is generalized exfoliative dermatitis, which involves 90% or more of the patient's skin. [3] The most common cause of erythroderma is exacerbation of an underlying skin disease, such as Harlequin-type ichthyosis, psoriasis, contact dermatitis, seborrheic dermatitis, lichen planus, pityriasis rubra pilaris or a drug reaction, such as the use of topical steroids. [4]
Psoriatic erythroderma (erythrodermic psoriasis) involves widespread inflammation and exfoliation of the skin over most of the body surface, often involving greater than 90% of the body surface area. [18] It may be accompanied by severe dryness, itching, swelling, and pain. It can develop from any type of psoriasis. [18]
Withdrawal or administration of certain drugs in the patient's previous medication regimen may be required. Oral retinoids are the most effective treatment, and are considered first line. [2] Cyclosporine or infliximab may be required for particularly acute cases. [5] [6]
There is no standard treatment for pityriasis lichenoides chronica. Treatments may include ultraviolet phototherapy, sun exposure, oral antibiotics, and corticosteroid creams and ointments to treat rash and itching. [3] [5] One study identified the enzyme bromelain as an effective therapeutic option for pityriasis lichenoides chronica. [6]
Parapsoriasis refers to one of a group of skin disorders that are characterized primarily by their resemblance to psoriasis (red, scaly lesions), rather than by their underlying cause.
Psoriatic arthritis tends to appear about 10 years after the first signs of psoriasis. [3] For the majority of people, this is between the ages of 30 and 55, but the disease can also affect children. The onset of psoriatic arthritis symptoms before symptoms of skin psoriasis is more common in children than adults. [48]