The most severe form of psoriasis is erythrodermic psoriasis. It is a rare but life-threatening condition that resembles a large-scale rash. Erythrodermic psoriasis usually affects most of the body. It requires urgent medical attention.
Overview of Erythrodermic Psoriasis
This type affects around two percent of people with psoriasis, usually those with uncontrolled plaque psoriasis.
The outburst of erythrodermic psoriasis will cause the skin to become fiery red, itchy, and painful. You may also notice blisters filled with pus and large lesions covered in scales that peel off easily.
The main problem with erythrodermic psoriasis is that it does not only affect the skin. It also harms some skin functions. These include regulation of body temperature, retention of moisture, and the ability to fight off infections.
That can lead to symptoms such as those listed below, and may include pain and swelling, an increased heart rate, pneumonia, and eventually, heart failure.
Erythrodermic psoriasis can cause complications rapidly. If you have any of the symptoms, see your doctor immediately.
Symptoms of Erythrodermic Psoriasis
A tell-tale sign of erythrodermic psoriasis is a red rash that covers most of the body. Large sections of the skin display scales and pus-filled blisters. Other symptoms may include:
- Intense itch
- Shedding large patches of skin
- Frequent changes in body temperature
- Joint pain
- Edema (swelling of the joints due to water retention)
- Increased heart rate (tachycardia)
Causes and Triggers of Erythrodermic Psoriasis
People who experience erythrodermic psoriasis flare-ups usually already suffer from another psoriasis type. In most cases, that is unstable plaque psoriasis. The main characteristic of unstable plaque psoriasis is the lack of clearly defined edges of the scaly skin patches.
However, a sudden outburst of erythrodermic psoriasis can happen to healthy individuals as well.
In both situations, erythrodermic psoriasis flare-ups need a trigger. These are the most common ones:
- Severe sunburn
- Overuse of steroid medications
- Sudden termination of psoriasis therapy
- Alcohol (and other substances) abuse
Risk Factors for Erythrodermic Psoriasis
The skin plays a big part in your health. It serves as a protective barrier that shields the body from harmful environmental effects. The skin also helps to regulate body temperature and keeps the fluid balance in check.
Erythrodermic psoriasis inhibits all these functions. Without treatment, it can lead to hypothermia, dehydration, kidney failure, heart failure, and infections such as sepsis and pneumonia.
Erythrodermic Psoriasis Diagnosis
Severe symptoms usually make erythrodermic psoriasis obvious. Still, a medical specialist will want to do a physical check-up. That can reveal other signs of psoriasis, such as joint pain and “nail psoriasis.”
They will also enquire about any exposure to known triggers, such as sudden stop of psoriasis medications or sunburn.
A small sample of the skin (biopsy) is often necessary for lab testing.
Erythrodermic Psoriasis: The Final Word
Erythrodermic psoriasis sufferers should seek medical help as soon as possible due to associated complications. Once the erythrodermic psoriasis is under control, a holistic management approach to the underlying (usually) plaque psoriasis can be applied.