Erythrodermic psoriasis: symptoms, causes, drugs, etc. • hello healthy

Definition

What is erythrodermic (erythrodermic) psoriasis?

Erythrodermic (erythrodermic) psoriasis is a type of psoriasis that causes lesions (abnormal skin tissue) similar to burns on the skin, where red skin peels and feels very painful.

Inflammation of the skin that occurs due to erythroderma can damage 75% of the skin area of ​​the body at the same time.

The causes of skin inflammation due to erythrodermic psoriasis are still not fully explained. However, it is suspected that there is a link between the work of the immune system and the appearance of symptoms of this disease. Several risk factors also play a role in triggering skin inflammation.

Erythrodermic psoriasis is the most severe type and can be life threatening. Need emergency medical help as a form of appropriate treatment.

How common is this disease?

In WHO statistics, 2-3% of the 125 million people in the world are psoriasis sufferers.

Based on the period onset or when psoriasis symptoms appear, most of the presence of this disease is detected at the age of 15-25 years, but it does not rule out psoriasis can be experienced at any age.

Erythrodermic psoriasis is among the rarest. In a study entitled Erythrodermic Psoriasis: Pathophysiology and Current Treatment Perspectives, it is estimated that there are only 1-2.25% of erythrodermic sufferers among all psoriasis cases.

In comparison, another study published by the Tunisian Society for Medical Sciences reported that the mean symptom onset period occurred in people aged 53 years with the majority of sufferers (3: 1) being male.

Signs and symptoms

What are the signs and symptoms of erythrodermic psoriasis?

Although rare, erythrodermic psoriasis can be very dangerous. Therefore, it is very important for you to recognize every symptom.

Reddened skin lesions such as burning, crusting, and covered by peeling skin surfaces are the main features of erythroderma. This condition can cause an unbearable itching feeling as well as painful.

In some cases of erythroderma, pustules or pus-filled skin rashes, such as the symptoms of psoriasis, pustulosa can appear on the inflamed area of ​​the skin.

Symptoms can get worse slowly, inflammation can also occur in almost all parts of the skin (75-90%) at the same time.

In addition to experiencing the signs as above, you can also feel other clinical problems such as:

• rapid rise and fall in body temperature,
• fever,
• joint pain (psoriasis arthritis),
• increased heart rate, and
• swelling of the legs.

Complications

Skin lesions or damage caused by erythrodermic psoriasis have a serious impact on your health, and can even be life-threatening.

This is because the skin which plays a role in protecting the body from germs, exposure to toxic substances, and keeping the body's moisture is damaged in a short time. People with erythrodermic psoriasis can develop fever, impaired body temperature regulation, and loss of fluids as a result of the transpiration process from the skin.

As a result, the body temperature can immediately drop rapidly which triggers hypothermia. When the body loses a lot of fluids, these complications can lead to dehydration and electrolyte disturbances. This disorder in turn can lead to serious complications for the body.

When should I see a doctor?

You need to immediately see medical personnel, especially a dermatologist to perform an examination, when you experience skin inflammation that shows symptoms like the above.

Do not delay because the treatment needed for this disease is medical treatment as soon as possible.

The doctor will try to stop the skin inflammation as quickly as possible so that it doesn't cause further damage to the skin while preventing complications.

Cause

What causes erythrodermic psoriasis?

Psoriasis is not a skin disease that can be passed from person to person. This disease is also not caused by the use of cosmetics or products that contain dangerous chemicals.

The cause of psoriasis as a whole is skin inflammation related to autoimmune conditions, which is when the immune system, which is responsible for fighting germs, attacks healthy skin cells.

The mechanism that causes skin inflammation in erythroderma is not yet known with certainty.

Autoimmune conditions that are thought to be involved are caused by interactions between blood cells, namely T lymphocytes, dendritic cells, keratinocytes, neutrophils, and proinflammatory cytokines. These three cells make the immune system promote the growth of new skin cells that are too fast.

Risk factors

What increases my risk for erythrodermic psoriasis?

Although the cause is not clearly known, several things and conditions can trigger factors that cause a person to experience erythrodermic psoriasis.

The trigger factors for each person can be different and even change from time to time. The triggers for erythrodermic psoriasis include the following.

• Stopping psoriasis treatment suddenly.
• Have certain psoriasis medications, such as the oral steroid drug cortisone.
• Using drugs with excess coricosteroid content.
• Have an infection.
• Experiencing stress.
• Excessive alcohol consumption.
• Experiencing an allergic reaction that results in a skin rash.
• Soak in the sun too long.

According to the National Psoriasis Foundation, psoriasis vulgaris disease has a higher chance of developing erythrodermic psoriasis.

Diagnosis

How do doctors diagnose this disease?

To diagnose this disease, the doctor will perform a physical examination to identify symptoms. These include symptoms such as joint pain and nail damage from psoriasis (also known as nail psoriasis). The doctor will then investigate whether you have a condition that is a risk factor.

Because erythroderma is common in people with a history of psoriasis vulgaris, the doctor will also ask you about a history of skin diseases that you have experienced.

To confirm a diagnosis of the disease, the doctor may also perform a follow-up examination with several procedures including:

Skin biopsy: the doctor will take a sample of the affected skin to be analyzed for signs of psoriasis.

Laboratory test: there is no lab test that can confirm this disease, but allergy and contact dermatitis tests can be done to determine the type of trigger factors that play a role in causing inflammation.

Treatment

What are my treatment options for erythrodermic psoriasis?

Treatment of psoriasis must be done quickly in order to restore normal body temperature and levels of electrolytes and body proteins that are lost.

Medical treatment also aims to stop inflammation so that it can relieve symptoms such as stinging and itching. To restore skin health through treatment still takes a long time.

The following are medical steps taken by doctors in dealing with erythrodermic psoriasis.

• Emergency treatment with electrolytes to prevent dehydration.
• Hospitalization with intravenous fluid injection and body temperature regulation.
• Systemic drugs which include oral or injection drugs such as ciclosporin, acitretin, methotrexate to suppress severe inflammation.
• Immune system control drugs (alpha inhibitors) such as adalimumab, infliximab, ixekizumab, and ustekinumab.
• Topical medicine (topical) containing vitamin D analogues to restore the skin's regeneration process back to normal.
• Topic medications in the form of corticosteroid creams or ointments that stop inflammation, reduce itching, and keep the skin moisturised.
• Antibiotic drugs to stop a bacterial yeast infection, if an infection does occur.
• Light therapy or phototherapy for further healing processes.

Although in some cases treatment has succeeded in stopping inflammation and the patient can return to health, the possibility of the patient not being saved is also high. In addition, patients who experience this disease also have a greater risk of infection, pneumonia, and heart failure.

Home remedies

What are some lifestyle changes or home remedies for erythrodermic psoriasis?

Erythrodermic psoriasis can be prevented, especially for people who experience symptoms of psoriasis vulgaris by avoiding some of the risk factors for this disease or doing regular skin care for psoriasis.

The trick is as follows.

• Do not stop taking the psoriasis medication prescribed by your doctor suddenly.
• Protects the skin affected by psoriasis to prevent infection.
• Manage stress well.
• Reducing alcohol consumption.
• Avoiding the skin being exposed to the sun directly for too long.
• Avoid things that can cause skin irritation, such as not wearing rough clothes.

If you still have various questions about symptom prevention measures, you can discuss this with your doctor.