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Case Reports
. 2016 Sep 19;8(1):6599.
doi: 10.4081/dr.2016.6599. eCollection 2016 Jun 15.

Erythrodermic Psoriasis Treated with Apremilast

John Arcilla  1 , Daniel Joe  1 , Johnathan Kim  1 , Yohanan Kim  1 , VuAnh N Truong  1 , Navin Jaipaul  2
Affiliations
Case Reports

Erythrodermic Psoriasis Treated with Apremilast

John Arcilla et al. Dermatol Reports. .

Abstract

Erythroderma is a rare potentially deadly exfoliative dermatitis characterized by diffuse cutaneous erythema which may be associated with multi-organ dysfunction. Therefore, it is imperative to recognize and treat it promptly. Erythrodermic psoriasis is the most common form of erythroderma. Management of this condition is largely based on aggressive supportive care and the use of anti-inflammatory immunosuppressive and biologic agents. We describe a case of psoriatic erythroderma which was triggered by withdrawal from systemic steroids and successfully treated with apremilast and cyclosporine. Apremilast induced atrial fibrillation limited its continued use after the initial response period.

Keywords: Apremilast; Erythroderma; Erythrodermic psoriasis; Psoriasis.

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Conflict of interest statement

the authors declare no potential conflict of interest.

Figures

Figure 1.
Figure 1.
Skin findings on day one of hospitalization demonstrating (A) well defined generalized erythema and scaling most prominently involving the head, neck, chest, back, upper arms, abdomen, buttocks, groin, and proximal thighs and (B) magnified view of the erythema and scaling.
Figure 2.
Figure 2.
Skin biopsy demonstrating mild psoriasiform hyperplasia and rare intracorneal pustules with mild superficial perivascular mixed inflammation consistent with evolving pustular psoriasis.
Figure 3.
Figure 3.
Skin findings on day ten of hospitalization demonstrating reduced intensity of erythema and scaling in response to apremilast treatment.
See this image and copyright information in PMC

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