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Emergency: requires immediate attention
Erythrodermic psoriasis in Adult
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Erythrodermic psoriasis in Adult

Contributors: Craig N. Burkhart MD, Dean Morrell MD, Susan Burgin MD
Other Resources UpToDate PubMed


Erythrodermic psoriasis (EP) is an acute life-threatening complication of psoriasis. It is the least common form of psoriasis, but it occurs in all ages, from infancy through adulthood. It can occur suddenly, as the first sign of psoriasis, but more commonly develops as a complication of sun exposure, steroid withdrawal, drugs, or an illness in those with known plaque (common) psoriasis or in those with difficult-to-control psoriasis. Additionally, erythroderma may occur from generalized pustular psoriasis. Dehydration and temperature control problems are significant morbidities necessitating hospitalization for fluid management as well as treatment of disease.

Immunocompromised Patient Considerations:
HIV-associated psoriasis is often severe and refractory to treatment. This is interesting, because HIV is a disease of T-lymphocyte depletion and psoriasis is a disease of cytokine-mediated T-lymphocyte proliferation. Psoriasis is nonetheless exacerbated by HIV.


L40.8 – Other psoriasis

200977004 – Erythrodermic psoriasis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Erythrodermic drug eruption
  • Chronic, poorly responsive Atopic dermatitis with or without secondary infection
  • Seborrheic dermatitis
  • Stevens-Johnson syndrome / Toxic epidermal necrolysis
  • Cutaneous T-cell lymphoma (Sezary syndrome)
  • Pityriasis rubra pilaris
  • Staphylococcal scalded skin syndrome
  • Toxic shock syndrome
  • Erythroderma
  • Scarlet fever
  • Drug-induced hypersensitivity syndrome (DIHS)
  • Erythrodermic Dermatomyositis
Erythrodermic pustular psoriasis:
  • Acute generalized exanthematous pustulosis (AGEP) – Clinically indistinguishable from pustular psoriasis. Time of onset and a drug history may help differentiate AGEP from pustular psoriasis. Antibiotics are the likely causative agents in AGEP. Histology can also help differentiate between the two. Also look for high fever, edema of the face, pustular eruption that occurs shortly after drug administration (fewer than 2 days), marked serum leukocytosis with neutrophilia, and associated petechiae, purpura, and vesicles in AGEP.
  • Drug-induced hypersensitivity syndrome – May rarely present with pustules.
  • Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) – Rarely erythrodermic.
  • Disseminated herpes simplex virus

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Last Reviewed:09/22/2019
Last Updated:03/05/2023
Copyright © 2024 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Erythrodermic psoriasis in Adult
A medical illustration showing key findings of Erythrodermic psoriasis : Chills, Confluent configuration, Desquamation, Erythroderma, Widespread distribution
Clinical image of Erythrodermic psoriasis - imageId=784383. Click to open in gallery.  caption: 'Diffuse erythema and thick scales over the dorsal hand in a patient with erythrodermic psoriasis.'
Diffuse erythema and thick scales over the dorsal hand in a patient with erythrodermic psoriasis.
Copyright © 2024 VisualDx®. All rights reserved.