The Basics of Erythrodermic Psoriasis

erythrodermic psoriasis

Suffering from a rare and/or painful skin condition can wreak havoc on the quality of your life. However, according to recent studies, there are at least a few hundred cases of erythrodermic psoriasis reported in the United States every year. And since this particular form of psoriasis can be life-threatening, it’s important to know all you can about it before you or someone you love has to deal with it.

What Is Erythrodermic Psoriasis?

Erythrodermic psoriasis is a relatively rare form of inflammatory psoriasis that can present on nearly any part of the body. Often occurring in conjunction with Zumbasch pustular psoriasis, erythrodermic psoriasis can develop on its own depending on several individual factors. However, in about three percent of the people who have psoriasis, erythrodermic breakouts occur once or repeatedly throughout a lifetime.

Considered extremely dangerous, erythrodermic psoriasis often requires immediate medical attention. The symptoms are easy to recognize and several treatment options are available. Ignored erythrodermic outbreaks should never be ignored, and everyone should know that symptoms tend to come on suddenly.

Causes and Diagnosis

Commonly appearing on people who are already dealing with a form of unstable plaque psoriasis, erythrodermic psoriasis actually has many causes. Psoriasis itself is an autoimmune disease, meaning it’s indicative of your body attacking its own healthy tissues. Because of that, some cases of erythrodermic psoriasis can be triggered by certain lifestyle choices.

In addition, EP outbreaks may also appear suddenly if you stop taking your medications for psoriasis. Other possible causes typically include:

  • Alcohol consumption
  • Medication side effects
  • HIV
  • Infections
  • Steroids
  • Sunburns
  • Stress
  • Anxiety

To properly diagnose and treat erythrodermic psoriasis, a doctor must perform a thorough physical examination and may also use lab testing and imaging. Usually, you’ll be asked a series of questions which might include topics such as:

  • Your personal medical history, including a list of all medications you’re currently taking
  • Your family medical history
  • Your exposure to certain triggers like steroids, infection, or stress

Most people are well aware when they’re experiencing a psoriasis outbreak, although those suffering from erythrodermic psoriasis may not grasp the severity without first knowing the symptoms. 

The Most Common Symptoms of Erythrodermic Psoriasis

The painful and off-putting symptoms of erythrodermic psoriasis can slowly develop over time or appear almost suddenly. Typically, this form of psoriasis is categorized by the presence of lesions (puss-filled or not) as well as widespread redness all over the skin. Exfoliation is also characteristic, as are severe itching and extreme pain as a result.

You might also experience the following symptoms in association with an erythrodermic psoriasis outbreak:

  • Fever
  • Chills
  • Swelling
  • Joint stiffness
  • Increased heartrate

If those symptoms are experienced in tandem with visible lesions, seek medical attention right away.

Treatment and Symptom Management Options

Before finding out about the safest and most effective treatment options currently available for erythrodermic psoriasis, it’s important to understand why it’s such a dangerous skin condition. First of all, your skin is vital to your overall wellbeing. Not only does it keep germs and toxins at bay but it also regulates your body temperature and keeps crucial moisture where it belongs. Severe upsets like erythrodermic psoriasis can throw your body into a form of shock that might threaten your life.

Widespread skin conditions like EP can cause serious health problems if left untreated. People often suffer from one or more of the following as a result:

  • Hypothermia
  • Protein depletion
  • Dehydration
  • Sepsis
  • Pneumonia
  • Heart failure
  • Shock
  • Kidney failure

Self-care and at-home management of symptoms are usually not recommended, as erythrodermic psoriasis can become deadly in a hurry. Fortunately, doctors tend to act quickly once a diagnosis is made. The initial treatment typically involves the combined use of medium-strength topical steroids and medicated and/or fortified moisturizers. Wet dressings, oatmeal baths and bed rest are almost always suggested as well.

In severe cases, erythrodermic psoriasis is treated using antibiotics. However, treatment options may also include one or more of the following three:

  • Systemic Medications

Effective and generally used only on the most severe cases, systemic medications such as methotrexate, acitretin and cyclosporine are considered safe in lieu of the otherwise controversial systemic steroid treatments used previously. 

  • TNF-Alpha Blocking Biologics

Medicines like etanercept, adalimumab, infliximab, and golimumab are often used to target a specific type of immune cell that causes erythrodermic psoriasis outbreaks. The T-cell, which causes the telltale inflammation associated with plaque psoriasis and psoriatic arthritis, blocked and therefore slows or stops producing symptoms.

  • Combination Approaches

Combination treatments are often necessary when one or more of the previously mentioned treatment options don’t work independently as needed. Healthcare providers typically use a blend of topical products and 1 or 2 systemic medications to provide relief. However, UVB and PUVA light exposure is generally not used until skin redness and/or exfoliation have decreased significantly.

Important Things to Note about Erythrodermic Psoriasis

Erythrodermic psoriasis, or EP, can cause skin discoloration and scarring if it’s not managed properly. However, once the flare passes, psoriatic outbreaks tend to revert back to their original appearance without leaving a trace. And since EP can be extremely painful in severe cases, many doctors are willing to prescribe strong pain killers, sleep aids and/or anti-anxiety medications alongside many of the other treatment options mentioned above. 

If you enjoyed reading this article on erythrodermic psoriasis, you may also be interested in reading Natural Treatments & Home Remedies for Psoriasis.