Erythrodermic psoriasis is an uncommon and severe type of psoriasis. Most of your body is covered with a red, peeling rash. It might be painful and/or itchy. You may feel a burning sensation. The condition is more common in people who already have another type of psoriasis.
Certain medications, like corticosteroids, can trigger it. So can an injury or severe sunburn. Sometimes, doctors aren’t sure what causes it. Erythrodermic psoriasis can lead to other health problems like dehydration, infections, or kidney failure if it’s not treated right away. Here’s what you need to know.
How Is Erythrodermic Psoriasis Treated?
If your erythrodermic psoriasis is especially severe, you may have to stay at the hospital for a while. That way, doctors can make sure you’re OK while you get treatment.
A doctor will start you on systemic therapy. These are oral drugs or shots that suppress, or curb, your immune system. This may ease inflammation and slow skin cell turnover.
The drugs can cause serious side effects, so you can use them for only a short time. The doctor may switch you to a different type of treatment while you’re taking a break. Systemic medications used to treat erythrodermic psoriasis include:
Cyclosporine. It’s taken for only short periods of time (usually 12 to 16 weeks) and is often the first treatment used for severe cases of erythrodermic psoriasis. It’s a pill you take daily.
Biologics. Most are given as a shot or through an IV. Your doctor might suggest them if another treatment hasn’t worked. Infliximab (Remicade) is the biologic most commonly used for erythrodermic psoriasis. Other biologics that may help include:
- Etanercept (Enbrel)
- Adalimumab (Humira)
- Ustekinumab (Stelara)
- Golimumab (Simponi)
- Apremilast (Otezla)
- Secukinumab (Cosentyx)
- Ixekizumab (Taltz)
Methotrexate (Rheumatrex). This is an oral medication often used to treat arthritis. Your doctor may suggest it if you have psoriatic arthritis and erythrodermic psoriasis. Methotrexate can cause side effects like an upset stomach. It tends to be milder than biologics. If you use it for long periods of time, it may raise your chances of serious complications like liver damage.
Acitretin (Soriatane). This is a retinoid you take in pill form. Retinoids are synthetic forms of vitamin A. Experts aren’t sure how acitretin helps control severe psoriasis, but they think it slows the speed at which your skin cells grow and shed. Acitretin can cause severe side effects, including birth defects. That’s why women who plan on getting pregnant within 3 years of taking it can’t use it.
Other medications. Your doctor may suggest another medication, such as thioguanine (Tabloid) or hydroxyurea, if you can’t take biologics or other drugs, or if they just don’t work for you.
Other Treatments
In addition to systemic therapy, your doctor may recommend:
Creams. These include topical steroids and vitamin D cream. They help ease skin inflammation.
Phototherapy. This uses low-dose ultraviolet light to calm inflammation. Your doctor is more likely to suggest phototherapy as a long-term treatment plan after you’ve already done systemic therapy or other treatments to get your psoriasis under control.
What You Can Do
Can Do
It’s important to follow the treatment plan your doctor gives you. Take all medications as prescribed. Tell them if side effects make you feel bad. Try to avoid triggers, like alcohol, smoking, and stress. If your doctor says it’s OK, here are things you can do at home to feel better:
Take baths at least once a day. Bathing for 10 minutes or so can help get rid of scales and extra skin. Bath oils, salts, or colloidal oatmeal may feel soothing. Don’t use harsh soaps and hot water. Gently pat -- don’t rub -- your skin dry with a towel.
Moisturize your skin every day.Dry skin can make psoriasis worse. Using a heavy moisturizing ointment or oil after taking a bath can help. Ask your doctor if you’re not sure which moisturizers are safe to use.
Use a humidifier. This helps keep the air moist in your home, particularly during dry winter months.
Soak up a little sun. Small amounts of sunlight can improve psoriasis. The amount of sun that’s safe depends on the season and climate you live in, as well as your health history. Talk to your doctor about how much sunlight is best for you. Put sunscreen on the parts of your skin that don’t have psoriasis plaques to lower your risk of skin cancer.
