Erythrodermic psoriasis (erythroderma) can be life threatening and often requires emergency treatment and hospitalization. It may cause complications like heart failure that may affect someone’s overall health and outlook.
According to a 2023 study citing prior research, the mortality rate for erythrodermic psoriasis ranges from 9% to 64%, depending on many factors like age and underlying health conditions.
In their single-center study, the researchers found that 11% of people hospitalized for erythrodermic psoriasis received a diagnosis of heart failure. Older age and heart failure, especially along with other complications, were associated with a worse outlook.
The study also found that EP lasted 4 weeks on average.
Erythrodermic psoriasis causes widespread inflammation, which can damage multiple organs by affecting the body’s ability to regulate temperature and fluids.
It can be life threatening and requires emergency medical attention to prevent and manage complications, which may include:
- severe dehydration
- severe electrolyte imbalances
- fever
- hypothermia
- high-output heart failure
- pulmonary edema
- severe, life threatening infections like sepsis
It causes skin discoloration and inflammation on 75% or more of the body’s surface area. The skin may appear as if burned. It can also cause additional severe symptoms that may include:
- skin peeling that occurs in “sheets” rather than smaller scales
- increased heart rate
- severe pain and itching
- changes in body temperature
- fever
- swelling (edema)
Erythrodermic psoriasis is rare and affects about 2% of people with psoriasis. It can develop due to:
- an allergic reaction to a medication that begins as a rash
- certain medications, such as oral, infused, or injected steroids
- starting or stopping medications, including biologic medications
- an infection or illness, including COVID-19
- severe sunburn
- stress
- alcohol use
Erythrodermic psoriasis usually requires emergency care and hospitalization.
Treatment usually involves:
- regulating the body’s temperature
- balancing the body’s fluid levels, electrolytes, and proteins
- treating any complications, such as infections or organ damage
- medications to reduce the body’s immune response, such as monoclonal antibodies like infliximab (Zymfentra) and biologics like anti-IL-17 and anti-IL-23 biologics
Because erythrodermic psoriasis is rare, more research is still needed to evaluate the effectiveness of newer treatments like biologics.
After recovering from erythrodermic psoriasis, a doctor may recommend changes to the treatment plan to better manage the condition and prevent it from recurring.