Erythrodermic Psoriasis: A Case Report Highlighting Clinical Features and Management

Year : 2025 | Volume : 15 | Issue : 02 | Page : 01 05
    By

    Jeril,

  • Dipanwita Kamila,

  • Ruhana,

  • E. M .Neena Priyamalar,

  • Shobha Rani R H,

  1. Pharm D Intern, Department of Pharmacy Practice, Aditya Bangalore Institute of Pharmacy Education and Research, Yelahanka, Bangalore, India
  2. Pharm D Intern, Department of Pharmacy Practice, Aditya Bangalore Institute of Pharmacy Education and Research, Yelahanka, Bangalore, India
  3. Assistant Professor, Department of Pharmacy Practice, Aditya Bangalore Institute of Pharmacy Education and Research, Yelahanka, Bangalore, India
  4. Assistant Professor, Department of Pharmacy Practice, Aditya Bangalore Institute of Pharmacy Education and Research, Yelahanka, Bangalore, India
  5. Director, Aditya Bangalore Institute of Pharmacy Education and Research, Yelahanka, Bangalore, India

Abstract

Background: Erythrodermic psoriasis (EP) is a rare and severe variant of psoriasis that presents as widespread erythema, scaling, and systemic complications such as fever, dehydration, and electrolyte imbalances. It requires urgent medical attention due to the risk of life-threatening complications, including sepsis and multi-organ failure. The condition can arise de novo or as an exacerbation of pre-existing psoriasis, often triggered by medication withdrawal, infections, or systemic inflammation. Case Presentation: We report the case of a 31-year-old male who presented with generalized erythematous, scaly rashes affecting almost his entire body, accompanied by fever and signs of mild malnutrition. His history revealed multiple untreated episodes of similar symptoms over the past six years. Clinical examination confirmed severe erythrodermic psoriasis with acute-on-chronic plaque progression. Initial management with topical emollients failed to provide relief, necessitating a comprehensive treatment regimen consisting of cyclosporine, methotrexate, apremilast, and a macrolide antibiotic (roxithromycin). The patient showed significant improvement within six days, with reduced scaling, erythema, and no reported adverse effects. Discussion:Erythrodermic psoriasis poses a unique therapeutic challenge, as first-line treatments such as topical corticosteroids and moisturizers often provide inadequate relief. Systemic therapies, including immunosuppressants (methotrexate, cyclosporine) and newer targeted treatments like apremilast, play a crucial role in disease management. This case aligns with previous reports emphasizing the importance of early diagnosis, aggressive treatment, and a multidisciplinary approach to prevent life-threatening complications. Long-term disease control requires patient education, adherence to treatment, and lifestyle modifications to reduce the risk of recurrence. Conclusion: This case highlights the importance of early intervention, individualized treatment strategies, and continuous monitoring in managing erythrodermic psoriasis. While systemic therapies have shown effectiveness, there remains a need for further research into biologics and precision medicine to improve long-term outcomes. By integrating timely diagnosis, personalized treatment plans, and patient-centered care, clinicians can significantly enhance the quality of life for individuals affected by this debilitating condition.

Keywords: Erythrodermic psoriasis, Methotrexate, Cyclosporine, Apremilast, Immuno suppressants, Dermatology, Inflammatory skin disease.

[This article belongs to Research and Reviews: A Journal of Pharmacology ]

How to cite this article:
Jeril, Dipanwita Kamila, Ruhana, E. M .Neena Priyamalar, Shobha Rani R H. Erythrodermic Psoriasis: A Case Report Highlighting Clinical Features and Management. Research and Reviews: A Journal of Pharmacology. 2025; 15(02):01-05.
How to cite this URL:
Jeril, Dipanwita Kamila, Ruhana, E. M .Neena Priyamalar, Shobha Rani R H. Erythrodermic Psoriasis: A Case Report Highlighting Clinical Features and Management. Research and Reviews: A Journal of Pharmacology. 2025; 15(02):01-05. Available from: https://journals.stmjournals.com/rrjop/article=2025/view=208447


References

  1.  Armstrong AW, Read C. Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review. JAMA. 2020;323(19):1945–1960. doi:10.1001/jama.2020.4006
  2. Boehncke WH, Schön MP. Psoriasis. Lancet. 2015 Sep 5;386(9997):983-94
  3. Singh, R. K., Lee, K. M., Ucmak, D., Brodsky, M., Atanelov, Z., Farahnik, B., Liao, W. (2016). Erythrodermic psoriasis: pathophysiology and current treatment perspectives. Psoriasis: Targets and Therapy, 6, 93–104. https://doi.org/10.2147/PTT.S101232
  4. Rosenbach M, Hsu S, Korman NJ, Lebwohl MG, Young M, Bebo BF Jr, et al. Treatment of erythrodermic psoriasis: from the medical board of the National Psoriasis Foundation. J Am Acad Dermatol. 2010 Apr 1;62(4):655-62. https://doi.org/10.1016/j.jaad.2009.05.048
  5. Fujita H, Shemer A, Suárez-Fariñas M, Johnson-Huang LM, Tintle S, Cardinale I, Fuentes-Duculan J, Novitskaya I, Carucci JA, Krueger JG, Guttman-Yassky E. Lesional dendritic cells in patients with chronic atopic dermatitis and psoriasis exhibit parallel ability to activate T-cell subsets. J Allergy Clin Immunol. 2011 Sep;128(3):574-82.e1-12. doi: 10.1016/j.jaci.2011.05.016.
  6. Singh RK, Lee KM, Ucmak D, Brodsky M, Atanelov Z, Farahnik B, Abrouk M, Nakamura M, Zhu TH, Liao W. Erythrodermic psoriasis: pathophysiology and current treatment perspectives. Psoriasis (Auckl). 2016;6:93-104. doi: 10.2147/PTT.S101232.
  7. Boehncke WH. Etiology and pathogenesis of psoriasis. Rheumatic Disease Clinics. 2015 Nov 1;41(4):665-75.
  8. Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, Gelfand JM. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol. 2017 Mar;76(3):377-390. doi: 10.1016/j.jaad.2016.07.064
  9. Lowes MA. Suá rez-Fariñas M, Krueger JG. Immunology of Psoriasis. Annu. Rev. Immunol. 2014;32:227-55.
  10. Megna, M., Ruggiero, A., Salsano, A., Lauletta, G., Portarapillo, A., Torta, G., … Potestio, L. (2023). A Case of Erythrodermic Psoriasis Successfully Treated with Risankizumab. Clinical, Cosmetic and Investigational Dermatology16, 3503–3507. https://doi.org/10.2147/CCID.S447123
  11. Reynolds, K. A., Pithadia, D. J., Lee, E. B., Liao, W., & Wu, J. J. (2019). A systematic review of treatment strategies for erythrodermic psoriasis. Journal of Dermatological Treatment, 32(1), 49–55. https://doi.org/10.1080/09546634.2019.1689228
  12. CH K, Kumar S. Erythrodermic psoriasis: a case report. Manipal Journal of Pharmaceutical Sciences. 2019;5(2):11.
  13. Dessai R, Garg A. Erythrodermic Psoriasis – A Case Report. International Journal of Science and Research (IJSR). 2019 Mar 4;8(9):157–8.

Regular Issue Subscription Case Study
Volume 15
Issue 02
Received 02/02/2025
Accepted 21/02/2025
Published 21/04/2025
Publication Time 78 Days


Login


My IP

PlumX Metrics