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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]
Large plaque parapsoriasis are skin lesions that may be included in the modern scheme of cutaneous conditions described as parapsoriasis. [2] These lesions, called plaques, may be irregularly round-shaped to oval and are 10 cm (4 in) or larger in diameter. [2]
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]
Psoriasis is a cellular autoimmune reaction caused by T-cells to what are thought to be skin-resident self-antigens. [3] The psoriasiform reaction is brought on by an increase in interferon-γ and interleukin-17, which interact with mast cells, neutrophils, macrophages, and dermal cells. [4]
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]
Due to the role streptococcal infection plays in the development of guttate psoriasis, systemic antibiotics have been considered as a potential treatment option. There is uncertain evidence whether systemic antibiotics or tonsillectomy are effective and safe in treating the disease. [13] The condition often clears up on its own within weeks to ...