One of the few skin-condition emergencies, erythrodermic psoriasis is a rare but very serious complication of psoriases. It is characterized by most (over 80%) of the skin surface becoming covered with redness, inflammation and psoriases. Hospitalization is required for people with erythrodermic psoriasis, as it has the potential to be life threatening- especially in older people.
We will look at the signs and symptoms, complications, and causes of erythrodermic psoriasis.
Signs and Symptoms of Erythrodermic Psoriasis
Erythrodermic psoriasis is an extremely inflammatory type of psoriasis. Most of the skin surface will be continuously scaling - becoming red and hot (erythema) and then shedding. This scaling will usually be accompanied by severe pain, itching, and possibly swelling.
Complications of Erythrodermic Psoriasis
The complications of erythrodermic psoriasis are similar to those associated with pustular psoriasis. Both types of psoriases have very critical complications, which include the body losing its ability to regulate temperature. This impaired temperature regulation is due to the large area of skin affected by psoriasis. As a result, the patient loses heat, body fluids and protein, and hospitalization is necessary for treatment.
If a patient has a combination of erythrodermic and pustular psoriasis, they may develop excessive fluid build-up, protein loss, and electrolyte imbalances - a serious condition called Zumbusch psoriasis. This condition will be accompanied by fever, chills, weight loss, and muscle weakness. Hospitalization is required for these patients, as fluid and chemical balances need to be restored and temperature stabilized as soon as possible.
Zumbusch psoriasis affects the elderly more seriously than the young, and has the potential to be life-threatening for older people. Although occurring less frequently in children, it will improve more rapidly in them and might be treated without medication.
Causes of Erythrodermic Psoriasis
Erythrodermic psoriasis is related to unstable plaque psoriasis, a type characterized by lesions which are not clearly defined. In most cases, it will occur in people with unstable plaque psoriasis. In rare cases, erythrodermic psoriasis can be the first instance of psoriasis for a patient.
Specific medications including lithium, antimalarials and interleukin II are shown to be triggers of Erythrodermic psoriasis. More causes include infections, calcium deficiency, sudden withdrawal of oral corticosteroids (prednisone), withdrawal of excessive use of strong topical corticosteroids, and strong coal tar preparations.
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