An estimated 7.5 million Americans have psoriasis, according to the National Psoriasis Foundation. Psoriasis affects the body’s immune system, causing it to produce an excessive amount of skin cells. These extra cells build up on the skin creating a flaky rash.
Erythrodermic psoriasis is a very rare type of psoriasis. It only affects about 3 percent of people with psoriasis, but it can be very serious. It typically occurs in people with unstable plaque psoriasis.
Erythrodermic psoriasis can cause your skin to lose its ability to control your body temperature and protect against infections. Losing the ability to perform these vital functions can be life-threatening.
The main symptom of erythrodermic psoriasis is a deep red rash that forms all over the body. Other symptoms include:
- shedding of the skin in sheets instead of smaller scales
- burned looking skin
- increased heart rate
- severe pain and itching
- fluctuating body temperature, especially on hot and cold days
Erythrodermic psoriasis not only affects the skin, it can disrupt your overall body chemistry. It can lead to wild temperature swings in your body. This may cause fluid retention that leads to swelling — especially in the ankles. In severe cases, people can get pneumonia or have heart failure, requiring hospitalization.
You can rub a steroid ointment on your skin to bring down redness and swelling. Moisturizers and wet dressings can protect your skin and prevent it from peeling.
If the rash is itchy and painful, an oatmeal bath can feel soothing on your skin. And make sure to also drink plenty of liquids to keep well hydrated.
There are also medications that can help combat symptoms.
There are a few oral medications that can help treat erythrodermic psoriasis, including:
- etanercept (Enbrel)
- adalimumab (Humira)
- golimumab (Simponi)
- ixekizumab (Taltz)
- cyclosporine, an anti-rejection drug that dampens the immune response that causes psoriasis
- infliximab, a drug used to treat autoimmune diseases
- acitretin (Soriatane)
- methotrexate, a cancer treatment that can help treat erythrodermic psoriasis
All of these medicines can have potentially dangerous side effects. It’s important to keep in close touch with your doctor while taking them.
It’s best to see a dermatologist for psoriasis treatment. Your doctor may give you a combination of oral and topical medication. Combining a few different medications may work better than taking a single drug alone.
You may also need pain relievers to control your discomfort, as well as medications to help you sleep. Some people also take medications for controlling the itch and antibiotics for clearing up a skin infection.
Although very rare, certain changes in your body can trigger erythrodermic psoriasis in people who already have psoriasis. These triggers can include:
- severe sunburn
- emotional stress
- use of systemic steroids
- abrupt withdrawal of systemic medications
Treating erythrodermic psoriasis isn’t always easy. It can involve a lot of trial and error. You may have to try a few different drugs, or a combination of medications and lifestyle remedies, to find the course of treatment that works best for you.
You will most likely need to keep taking these drugs for years to keep your symptoms under control. Your doctor can help you find an effective treatment plan.
Also, one of the best ways to deal with erythrodermic psoriasis is to try to prevent flare-ups. It may be helpful to avoid potential triggers, which can include:
- abrupt withdrawal of systemic treatments
- emotional stress
- allergic, drug-induced rash that brings on Koebner phenomenon