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Erythrodermia psoriaticaL40.8
Synonym(s)
erythroderma in psoriasis; erythrodermal psoriasis; erythrodermic; erythrodermic psoriasis; Psoriasis; psoriasis erythrodermica; psoriatic erythroderma
DefinitionThis section has been translated automatically.
Acute or chronic, severe form of psoriasis vulgaris with spread of the skin symptoms over the entire integument. S.a.u. Erythroderma. Erythrodermia psoriatica affects > 75% of the body surface.
Occurrence/EpidemiologyThis section has been translated automatically.
1.0%-2.25% of psoriatic patients are affected.
ManifestationThis section has been translated automatically.
S.u. Psoriasis vulgaris.
Clinical featuresThis section has been translated automatically.
Picture of erythroderma with generalized redness (from head to toe), edematous skin, exfoliative scaling, hair loss, nail dystrophies as well as accompanying general symptoms such as fever, chills, fatigue, cardiac arrhythmias, superinfections.
DiagnosisThis section has been translated automatically.
Main symptoms:
- universal redness from head to toe
- Psoriasis in the history
- Chronic course
- Scaling coarse lamellar (with naive non-pretreated form)
Secondary symptoms
- Itching and pain
- Feeling ill
- Histology: Dermatitis with psoriasiform pattern
- Histology: Munro microabscesses
- Inflammation parameters increased
TherapyThis section has been translated automatically.
- The therapy is carried out according to erythrodermia with special consideration of psoriatic diathesis.
- Ciclosporin A or Infliximab are recommended as first-line therapy for severe, unstable erythrodermia psoriatica in the absence of contraindications.
- Methotrexate is recommended as an alternative.
- The data on combination therapies is insufficient.
- In the initiation phase, high-dose glucorticoids (prednisolone 150 mg/day i.v.) in combination with a basic therapy for a period of 10-14 days are recommended.
- Further combinations are:
- Infliximab + Methotrexate
- Infliximab + Acitretin
- Ciclosporin A + Methotrexate
- Methotrexate + Acitretin.
Radiation therapyThis section has been translated automatically.
In addition to balneo-phototherapy, systemic treatment with antipsoriatric drugs has proven to be particularly effective, possibly as a combination therapy of several systemically effective antipsoriatric drugs.
LiteratureThis section has been translated automatically.
- Rosenbach M et al (2010) Treatment of erythrodermic psoriasis: From the medical board of the National Psoriasis Foundation. JAAD 62: 655-662