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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.
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. [17] It may be accompanied by severe dryness, itching, swelling, and pain. It can develop from any type of psoriasis. [17]
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]
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