Erythrodermic psoriasis: Everything you Need to Know

March 17, 2021     

Psoriasis is a skin condition that causes red, itchy, scaly patches, most commonly on the knees, elbows, torso, and scalp.

Psoriasis is a common, long-term (chronic) disease without permanent cure. It tends to go through cycles, flaring for several weeks or months, then wear off temporarily or go into remission. Treatments are available to help you relieve your symptoms. And you can combine lifestyle habits and coping strategies to help you live better with psoriasis.

Here we are going to learn about Erythrodermic psoriasis. Erythrodermic psoriasis is an uncommon, aggressive form of inflammatory psoriasis. 

Erythrodermic psoriasis is one of the most persistent types of psoriasis. If complications arise, they can be life-threatening. This condition most often affects people who already have unstable plaque psoriasis.

It can also occur early in an episode of plaque psoriasis or conjunction with another rare type of psoriasis, Zumbusch’s pustular psoriasis.

Let us see this article to learn about Erythrodermic psoriasis provided by Cosmosure Clinic.

What is erythrodermic psoriasis?

Psoriasis is a chronic inflammatory skin disease that causes plaques or thick clusters of scaly skin cells. It affects about 2% of the population. Erythrodermic psoriasis is a rare and lethal type of psoriasis. It affects up to 3% of people with psoriasis.

Erythrodermic psoriasis causes a spreading, red, itchy rash that looks like burned skin. The rash affects most of the body and covers at least 75% of the skin’s surface. The skin can peel into large sheets and damage the skin’s protective function. Without intact skin protection, fever, hypothermia, and other symptoms can occur. It can also be linked to pustular psoriasis and cause pus-filled blisters.

Sudden bouts of psoriasis erythroderma can be the first sign of psoriasis. This gradual form of the disease is more stable and has a better prognosis. Although the exact cause is not known with certainty, there are several triggers. This includes stress, infections, severe sunburn, and certain medications. People who suffer from this disease are usually men aged around 50 years.

Erythrodermic psoriasis is an emergency medical treatment. Broken skin barriers can cause severe fluid, protein, and electrolyte imbalances and also, pneumonia, sepsis, heart failure and death may also occur. If you experience symptoms of erythrodermic psoriasis, see a doctor immediately. Treatment may require hospitalization to restore fluid balance. A patient may also require Antibiotics and biological therapy. In milder cases, treatment may include prescription medications, topical treatments, and bandages to protect other skin layers.

What are the symptoms of erythrodermic psoriasis?

Psoriasis symptoms can get worse and may not respond to treatment. Symptoms overlap with plaques that remain distinct. Other forms of erythrodermic psoriasis manifest themselves very quickly. It usually affects people with psoriatic arthritis and no skin plaque.

The main symptom of erythrodermic psoriasis is a red rash covering at least 75% of the skin surface. The rash makes the skin look like it’s burning. It can also be very itchy and painful. Other symptoms can include:

  • Rapid heartbeat and muscle weakness
  • Fever, chills, and malaise
  • Hair loss and nail changes
  • Joint pain, muscle pain, and swollen lymph nodes
  • Exfoliate or exfoliate a large area of ​​skin
  • swelling

Severe symptoms that could indicate a life-threatening condition

Erythrodermic psoriasis can be life-threatening. See a doctor immediately if you or anyone else with symptoms of erythrodermic psoriasis.

What causes erythrodermic psoriasis?

Doctors don’t fully understand what causes erythrodermic psoriasis. Studies suggest that this may be related to an imbalance in immune cells called helper T cells. These cells modulate the immune response by activating other parts of the immune system.

Most of the people who have this disease already suffer from psoriasis. And in more than half of cases, there are identifiable triggers for erythrodermic psoriasis. Well-known triggers are:

  • Alcoholism
  • Emotional stress
  • Infection
  • Medications, including antimalarials, lithium, and trimethoprim/sulfamethoxazole (Bactrim, Septra)
  • Rebound phenomenon after sudden stopping of systemic treatment for psoriasis, including steroids
  • Severe sunburn or skin injury or trauma, including an allergic rash (Koebner’s phenomenon

What are the risk factors for erythrodermic psoriasis?

Regarding the causes of erythrodermic psoriasis, not much is known about its risk factors. Small population health studies show that this is more common in men. Men appear to be three times more likely to develop this disease than women. It also occurred at a mean age of 53.7 years.

Reduces the risk of erythrodermic psoriasis

Since the exact cause is unknown, erythrodermic psoriasis may not be preventable. You can reduce your risk of developing it by avoiding specific triggers. If you have psoriasis or psoriatic arthritis, talk to your doctor about your risk of erythrodermic psoriasis. Ask about ways you can protect yourself and what to watch out for.


Your doctor will ask for your medical history first and perform a physical exam. You will ask whether:

  • You have a family history of psoriasis
  • You have been exposed to causes related to the disease, such as steroids, infections, or sudden withdrawal from psoriasis medication

You will then be checked for signs of psoriasis, such as:

  • Plaque
  • Joint pain
  • Psoriatic nail disease

You will likely have a skin biopsy. The doctor will remove a small portion of your skin and have the laboratory examine it for signs of psoriasis.

How is erythrodermic psoriasis treated?

Erythrodermic psoriasis treatment often requires hospitalization in severe cases. The first step is to restore fluid and electrolyte balance and stabilize the body and vital organs such as the heart. Doctors can then treat the disease on their own, usually with a combination of treatments.

Treatments can include:

  • Antibiotics to prevent infection
  • Biologics, including adalimumab (Humira), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), ixekizumab (Taltz), and ustekinumab (Stelara)
  • Systemic drugs, The most effective treatment for complete control of erythrodermic psoriasis are systemic drugs. These can be methotrexate or cyclosporine immunosuppressants or biologics that target a specific part of the immune system that causes disease.
  • Topical treatments, including wet wraps, oatmeal baths, moisturizers, and corticosteroid ointments
  • Light therapy

Other treatments. You may also need:

  • Pain reliever
  • Itching medicine
  • Anxiety medicine

People with erythrodermic psoriasis should see a doctor immediately. You may need to receive intravenous fluids to prevent dehydration and antibiotics from preventing severe and potentially life-threatening staph infections.

Combination therapy is usually the most effective. Your doctor may also prescribe pain relievers, anti-itch medications, and sleeping pills.


If you suspect you may have erythrodermic psoriasis, contact your doctor as soon as possible. Like other forms of the disease, rashes can become dangerous very quickly. For this purpose, drugs known to be effective in relieving symptoms are available only by prescription. To deal with this type of psoriasis, you need to see a dermatologist. Most people with erythrodermic psoriasis will have a response to treatment or a combination of medications.

Cosmosure Clinic specialists are specially trained to help you understand your condition. If you have symptoms, call us at 040 4953 0404 to make an appointment. We can help you develop a treatment that’s right for you.