Treatment of erythrodermic psoriasis: From the medical board of the National Psoriasis Foundation

Rosenbach, Misha; Hsu, Sylvia; Korman, Neil J.; Lebwohl, Mark; Young, Melodie; Bebo, Bruce F.; Voorhees, Abby S. Van

doi:10.1016/j.jaad.2009.05.048

Cited by 147 publications

(212 citation statements)

References 37 publications

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“…In a study of 33 patients with erythrodermic psoriasis, the initial intervention was cyclosporin 4.2 mg/kg/day; after remission, the dosage was reduced by 0.5 mg/kg/day every 2 months. At 2-4 months, two-thirds of patients had attained complete remission, and marginally more than one-quarter had attained significant clinical improvement (Rosenbach et al, 2010).…”

Section: Rescue Therapymentioning

confidence: 94%

Systemic Cyclosporin in the Treatment of Psoriasis

Colombo¹,

Pietro²

2012

Psoriasis

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Section: Rescue Therapymentioning

confidence: 94%

Systemic Cyclosporin in the Treatment of Psoriasis

Colombo¹,

Pietro²

2012

Psoriasis

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“…Ocenia się, że erytrodermia dotyczy ok. 1-2% pacjentów z łuszczycą [2]. Ryzyko wystąpienia erytrodermii w przebiegu łuszczycy zwiększają okresowe stosowanie ogólnych glikokortykosteroidów, agresywna terapia miejscowa zmian łuszczycowych, nieodpowiednio prowadzona fototerapia lub gwał-towne odstawienie dotychczasowego leczenia ogól-nego łuszczycy.…”

Section: Wprowadzenieunclassified

“…Leczenie należy dostosować do stopnia nasilenia zmian skórnych i towarzyszących objawów ogólnych oraz ostrego lub przewlekłego charakteru erytrodermii. Ze względu na stosunkowo rzadkie występowanie erytrodermii łuszczycowej w piśmiennictwie nie ma dobrych jakościowo badań porównujących skuteczność poszczególnych metod terapeutycznych w tej postaci łuszczycy [2,3]. Z tego powodu ewentualne zalecenia terapeutyczne opierają się głównie na pojedynczych opisach przypadków skutecznego leczenia erytrodermii łuszczycowej oraz na doświadczeniu klinicznym intRODUCtiOn Erythroderma refers to generalized dermatitis which involves 90% or more of the patient's skin [1].…”

Section: Wprowadzenieunclassified

“…Erythroderma is estimated to affect about 1-2% of patients with psoriasis [2]. The risk of erythroderma secondary to psoriasis is increased by periodic treatments with systemic glucocorticosteroids, aggressive topical therapy of psoriatic lesions, inadequate phototherapy regimen or rapid discontinuation of prior systemic psoriasis treatment.…”

Section: Wprowadzeniementioning

confidence: 99%

“…Therapy should be adjusted to the severity of skin lesions and accompanying systemic symptoms, and to the acute or chronic nature of erythroderma. However, since psoriatic erythroderma occurs infrequently, the literature does not include high quality studies comparing the efficacy of different therapeutic modalities employed in the treatment of this variant of psoriasis [2,3]. As a result, recommended therapeutic options are largely based on isolated case reports describing effective treatment of psoriatic erythroderma and the clinical experience of researchers developing a particular set of therapeutic recommendations.…”

Section: Wprowadzeniementioning

confidence: 99%

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Severe exacerbation of psoriasis after cessation of methotrexate therapy successfully treated with cyclosporin A

Bartczyszyn-Kmiecik¹,

Żychowska²,

Reszke³

et al. 2017

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Introduction. It is estimated that erythroderma affects about 1-2% of patients with psoriasis.Objective. To present a case of psoriatic erythroderma, which was effectively treated with cyclosporin A. Case report. A 31-year-old man was admitted to the department to treat erythroderma. Approximately 3 weeks prior to hospital admission he discontinued methotrexate treatment which, in addition with upper respiratory tract infection resulted in rapid recurrence of psoriatic lesions and development of erythroderma. Methotrexate 20 mg weekly was re-introduced to treat skin lesions. Despite such treatment, no satisfactory improvement was achieved. On the 13 th day of hospitalization it was decided to start cyclosporin A (initially 200 mg/day, next increased to 300 mg/day). Cyclosporin A treatment was effective and well tolerated. Conclusions. Discontinuation of systemic treatment in patients with psoriasis may be associated with an exacerbation of the skin condition including erythroderma. Cyclosporin A is a valuable therapeutic option for patients with psoriatic erythroderma. The treatment is characterized by a rap id onset of action, good efficacy and generally favourable safety profile.

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Psoriasis and Related Disorders

Burden

Kirby

2016

Rook's Textbook of Dermatology, Ninth Edition

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Psoriasis encompasses a group of related immune‐mediated inflammatory skin diseases that affect up to 3% of the population. These diseases are heritable and over 40 genetic susceptibility loci have been identified, many of which are involved in antigen presentation, cytokine signalling or innate antimicrobial responses. The commonest presentation of psoriasis is plaque psoriasis but the disease is clinically hetereogeneous in its manifestations and natural history depending on the age of the patient, environmental triggers and the sites affected. Distinct but related phenotypes include psoriatic arthritis, palmoplantar pustulosis and generalized pustular psoriasis. Psoriasis is associated with co‐morbidities including obesity, diabetes, vascular disease, depression and inflammatory bowel disease, which contribute to the considerable morbidity and increased mortality. Treatments include topical agents for disease of limited extent, phototherapy (UVB, PUVA) and systemic therapy (methotrexate, ciclosporin, acitretin, fumarates) for more extensive disease, and biological treatment (tumour necrosis factor α inhibitors, ustekinumab) for severe resistant psoriasis.

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Treatment of erythrodermic psoriasis: From the medical board of the National Psoriasis Foundation

Cited by 147 publications

References 37 publications

Systemic Cyclosporin in the Treatment of Psoriasis

Systemic Cyclosporin in the Treatment of Psoriasis

Severe exacerbation of psoriasis after cessation of methotrexate therapy successfully treated with cyclosporin A

Psoriasis and Related Disorders

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