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. 2016:6:93-104.
doi: 10.2147/PTT.S101232. Epub 2016 Jul 20.

Erythrodermic psoriasis: pathophysiology and current treatment perspectives

Rasnik K Singh  1 , Kristina M Lee  2 , Derya Ucmak  2 , Merrick Brodsky  3 , Zaza Atanelov  4 , Benjamin Farahnik  5 , Michael Abrouk  3 , Mio Nakamura  2 , Tian Hao Zhu  6 , Wilson Liao  2
Affiliations

Erythrodermic psoriasis: pathophysiology and current treatment perspectives

Rasnik K Singh et al. Psoriasis (Auckl). 2016.

Abstract

Erythrodermic psoriasis (EP) is a rare and severe variant of psoriasis vulgaris, with an estimated prevalence of 1%-2.25% among psoriatic patients. The condition presents with distinct histopathologic and clinical findings, which include a generalized inflammatory erythema involving at least 75% of the body surface area. The pathogenesis of EP is not well understood; however, several studies suggest that the disease is associated with a predominantly T helper 2 (Th2) phenotype. Given the morbidity and potential mortality associated with the condition, there is a need for a better understanding of its pathophysiology. The management of EP begins with a comprehensive assessment of the patient's presentation and often requires multidisciplinary supportive measures. In 2010, the medical board of the US National Psoriasis Foundation published consensus guidelines advocating the use of cyclosporine or infliximab as first-line therapy in unstable cases, with acitretin and methotrexate reserved for more stable cases. Since the time of that publication, additional information regarding the efficacy of newer agents has emerged. We review the latest data with regard to the treatment of EP, which includes biologic therapies such as ustekinumab and ixekizumab.

Keywords: EP; biologics; erythrodermic psoriasis; pathogenesis; pathophysiology; treatment.

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Conflict of interest statement

Disclosure: Doctor Wilson Liao serves as a research investigator for Abbvie, Janssen, Pfizer, and Novartis. Doctor Liao has no stocks, employment, or board memberships with any pharmaceutical company. The other authors report no conflicts of interest in this work.

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