‘Erythrodermic psoriasis’ or ‘psoriatic erythroderma’ refers to psoriasis that affects all parts of the body such as the face, hands, nails, feet, trunk and extremities. It is the least common type of psoriasis and usually occurs at least once in the lifetime of a person who is susceptible to psoriasis. The condition presents itself as red, fiery lesions which are not clearly defined and is accompanied by severe itching and pain. Being life threatening, persons with severe erythrodermic psoriasis require hospitalization.
- Redness and itching over large parts of the body.
- Exfoliation is seen in the form of sheets rather than scales.
- Severe itching with pain.
- Skin has a burnt appearance.
- Increase in heart rate.
- Increase and decrease in body temperature on very hot or cold days.
This condition alters the body’s chemistry causing loss of proteins and fluids which in turn leads to malnutrition and dehydration. The inability of the body to control temperature causes shivering. Along with infection there is the possibility of developing edema or swelling due to fluid retention around the ankles. It could also cause pneumonia and congestive heart failure. The onset of this type of psoriasis can be abrupt or gradual and the exact cause is not known yet. However, there could be certain triggers which lead to the disease. These include:
- The abrupt withdrawal of systemic treatment.
- Use of systemic steroids or cortisones.
- Severe form of sunburn.
- Low levels of calcium.
- Strong coal tar preparations.
- Drug-induced rash caused due to lithium, anti-malarials and interlukin II. This allergic rash leads to the “Koebner” effect which causes psoriasis on the injured skin.
- Excess consumption of alcohol.
Treatment depends on the severity, efficacy and individual patient response.
The first form of treatment includes the use of moisturizers and topical steroids of medium strength. Antibiotics are also prescribed along with bed rest, oatmeal baths and wet dressings.
In severe cases, systemic medications like cyclosporine, methotrexate and acitretin are used to treat and control the symptoms. However, care should be taken to taper them off gradually as stopping them suddenly could cause flare-ups.
Patients are hospitalized to provide them with supportive care such as intravenous fluids and regulation of temperature.
Biologic agents like the TNF – alpha inhibitors adalimumab, infliximab and etanercept have also proved to be successful.
Diet plays an important role in treating erythrodermic psoriasis naturally. It is an inexpensive way of keeping the body fit and healthy without the need for spending huge amounts of money on treatment. Diet should consist of lots of green leafy vegetables, cabbage, broccoli and carrots which help in detoxifying the liver and kidneys. Consumption of spinach helps in cooling, clearing and detoxifying blood circulation, which in turn reduces swelling.
Apart from containing calcium, protein, carbohydrates, phosphorus and Vitamin C, eggplants are helpful in cooling the body and reducing swelling.
Rapeseed, when included in the diet, helps to detoxify the body and reduce swelling.
The removal of dead skin on a daily basis is very important in the prevention of excessive buildup. This can be achieved by rubbing the skin gently with a soft cloth after bathing. A moisturizer made of equal parts of olive oil and Vaseline may be used to lubricate the skin.
A bath with water and sea salt is said to cleanse the pores and detoxify the body.
Mental health should be taken care of by indulging in different activities. This is very important as persons suffering from the condition are prone to stress and depression.
And last but not the least, the importance of exercise is emphasized in improving strength and range of motion. The practice of Tai Chi and swimming in heated water are especially beneficial.