ABSTRACT
Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality,of which the incidence was 0.5％-1.5％ in skin diseases.Erythrodermic psoriasis (EP) is the commonest type of erythroderma.In addition,there are drug-induced erythroderma,erythroderma secondary to preexisting dermatoses,malignancy-related erythroderma,and idiopathic erythroderma of unknown etiology.Erythroderma of different etiologies has various clinical manifestations,resulting in relevant curative effects and outcomes.In this article,we retrospectively investigated 205 erythroderma patients about clinical symptoms,auxiliary examination and treatments,and evaluated the efficacy and prognosis.There were 84 cases of EP among 205 patients,10 cases of erythroderma caused by specific drugs,77 cases of erythroderma secondary to preexisting dermatoses (excluding psoriasis),7 cases of erythroderma patients suffering from malignancy and 27 cases with unknown causes.We concluded that the etiology of male patients in different age groups had significant difference.The incidence of EP was the highest among all types.The EP was commonly accompanied with hypoproteinemia,and changed into psoriasis vulgaris after treatment.Drug-induced erythroderma was commonly accompanied with fever,and mostly cured by systematic steroid therapy.For erythroderma secondary to preexisting der matoses,the original dermatoses must be actively treated to achieve a satisfying prognosis.Erythroderma with malignancy or unknown causes had long-term duration,poor response to the treatment,and high potential to relapse.Therefore,clarifying the etiology,providing an appropiate and individual regimen,and regular follow-up are crucial for the successful treatment of erythroderma with unknown causes.
ABSTRACT
OBJECTIVE:To observe therapeutic efficacy and safety of Calcipotriol betamethasone ointment combined with Compound glycyrrhizin injection in the treatment of erythrodermic psoriasis. METHODS:120 cases of erythrodermic psoriasis were randomly divided into observation group and control group,60 cases in each. Control group received Calcipotriol betamethasone ointment topical,2 times a day,for 6 weeks. Observation group was additionally given Compound glycyrrhizin injection 80 ml add-ed into 250 ml Glucose solution intravenously,once a day,on the basis of control group. PASI score,VAS score,DLQI score, Clinical efficacy and ADR of 2 groups were observed. RESULTS:Two groups of patients after treatment,PASI score,VAS score, lesion area and DLQI score were significantly decreased,the observation group decreased more significantly,the difference was sta-tistically significant (P0.05). CONCLUSIONS:Calcipotriol betamethasone ointment combined with Compound glycyrrhizin injection can effectively alleviate the clinical symptoms of psoriasis erythrodermic,improve their quality of life,has a definite curative effect and ADR.
ABSTRACT
Erythrodermic psoriasis (EP) is a very severe variant of psoriasis whose management poses a challenge to physicians, as currently available therapies often provide unsatisfactory results. Many biologics have been used to treat chronic plaque psoriasis, the most common form of psoriasis; however, their effectiveness for EP is poorly understood. A recently developed biologic, golimumab, has been extensively studied for the treatment of moderate-to-severe active rheumatoid arthritis, psoriatic arthritis, active ankylosing spondylitis, and chronic plaque psoriasis. However, no clinical trials have been performed for EP. Here, we report the case of a 32-year-old man who presented with severe psoriasis that previously failed to respond satisfactorily to methotrexate, cyclosporine, retinoid, narrow-band ultraviolet B phototherapy, and topical agents (i.e., steroids and calcipotriol). Skin lesions worsened progressively and developed into erythroderma. Psoriatic arthritis was also detected. Conventional therapies lacked efficacy. Therefore, we administered golimumab 50 mg. The skin lesions improved significantly according to the Psoriasis Area and Severity Index score after the first administration; lesions improved further throughout the treatment course. Although additional studies are required to fully evaluate the efficacy and safety of golimumab, this agent may be an alternative treatment strategy for some patients with recalcitrant EP.
Subject(s)
Adult , Humans , Arthritis, Psoriatic , Arthritis, Rheumatoid , Biological Products , Cyclosporine , Dermatitis, Exfoliative , Methotrexate , Phototherapy , Psoriasis , Skin , Spondylitis, Ankylosing , SteroidsABSTRACT
We have investigated the clinical response of 12 patients with erythrodermic psoriasis to therapy with etretinate. Initial dosage of etretinate was 20-60mg/day. The time for complete disappearance of scales averaged 19.9 days. In 10 of 12 patients(83.3%) satisfactory results were obtained after 2 to 11 months of treatment. Cheilitis was the most common side effect. Three patients had mild elevation of blood lipids, which was corrected by dose reduction. Remission period, of ten patients who showed good result, averaged 4.2 months.