What is Psoriatic Erytrhroderma?
Psoriatic erythroderma is an extreme complication of psoriasis. It is a major health emergency and requires immediate medical intervention in all circumstances. Psoriatic erythroderma is painful and can be quite horrifying. Psoriatic erythroderma is a dangerous condition that can occur when psoriasis has spread to nearly the entirety of the skin. Psoriatic erythroderma causes the skin to flake away rapidly, preventing the skin from functioning as a proper barrier against environmental influences and destroying a body’s ability to regulate its own temperature and removing any external protection against infection. Psoriatic erythroderma has the potential to be maiming or fatal if it is not treated properly.
Psoriatic erythroderma is far rarer than psoriasis. More than 60% of psoriasis cases only cover about 10% of the surface area of the skin. Psoriatic erythroderma frequently covers 90% or more of the skin, and it most frequently occurs in individuals already suffering from very widespread, severe psoriasis.
Who gets Psoriatic Erytrhroderma?
Psoriatic erythroderma only afflicts those who are already suffering from protracted, severe psoriasis. It is an advanced complication of psoriasis, and requires a severe, pre-existing case of psoriasis to become a possibility. This cannot be overstated: psoriatic erythroderma does not occur without a pre-existing case of psoriasis. No one that is not already suffering from psoriasis will immediately or quickly begin to suffer from psoriatic erythdroderma. While psoriatic erythroderma can be very swift-spreading and problematic, individuals not already suffering from severe psoriasis have nothing to fear and should not panic. Additionally, individuals who find that their psoriasis is spreading should not assume psoriatic erythroderma is the cause. It is a very rare complication that applies only to the rarest cases of psoriasis. Nevertheless, the same predisposing factors that apply to psoriasis apply to psoriatic erythroderma, as do the same ambiguities.
Men and women are equally likely to suffer from psoriatic erythroderma. Like psoriasis, it may occur at any age. Psoriatic erythdorerma is a complication of psoriasis. As psoriasis is an autoimmune condition, so is psoriatic erythroderma. Thus, individuals suffering from an autoimmune condition are more likely to suffer from psoriasis and, subsequently, psoriatic erythroderma.
Older individuals are not necessarily more likely to suffer from psoriatic erythroderma. However, they are more likely to suffer from extensive complications as a result of psoriatic erythroderma. The same applies to younger individuals, although psoriasis (and thus, psoriatic erythroderma) is more likely to develop in individuals approaching middle age.
What causes Psoriatic Erytrhroderma?
The cause of psoriatic erythroderma is not completely understood. It is deeply linked to psoriasis, as a complication; it is impossible to develop psoriatic erythroderma without a pre-existing case of psoriasis. Thus, it is necessarily an autoimmune condition. Psoriatic erythroderma occurs when psoriasis is left completely unchecked and spirals out of control. Under these circumstances, the skin loses any ability to heal itself, which allows it to spread even faster and more aggressively, quickly encompassing all of the skin.
Much like psoriasis, it is not completely clear what the origin of psoriatic erythroderma is. There is almost assuredly an autoimmune component, as indicated by the effectiveness of immunosupressants in locking down the spread of psoriasis plaques. However, psoriasis (and psoriatic erythroderma) are more common in individuals with HIV and other immunocompromising conditions, rendering this something of a paradox. In addition to whatever autoimmune component exists, there is likely a component of cell dysfunction, as well, likely related to how the cells rebuild and replicate themselves.
The distinct difference between the mechanics of psoriasis and psoriatic erythroderma, however, is related to the amount of skin affected and damaged by the progression of psoriatic erythroderma. In psoriasis, the skin is still left largely intact, with uncomfortable and unsightly plaques forming and flaking away. Psoriatic erythroderma occurs when these plaques have subsumed the majority of the skin and led to the skin’s widespread destruction, which in turn causes severe complications.
What does Psoriatic Erytrhroderma cause?
Psoriatic erythroderma is an extremely dangerous condition. The symptoms of psoriasis are primarily uncomfortable and painful, inflicting suffering and not much else. Psoriatic erythroderma carries with it significant health risks that require medical intervention; without proper medical intervention, psoriatic erythroderma may be fatal.
Psoriatic erythroderma occurs when the majority of the skin is overtaken by psoriasis plaques. This causes the skin to flake away, leaving areas skinless and exposed. This is naturally very painful, but it carries serious health implications.
This skin damage prevents the skin from behaving as skin. Psoriatic erythroderma destroys the skin’s ability to act as a barrier. Under normal circumstance, the body is protected against various infectious agents by its function as a barrier—a physical obstacle that keeps toxins and other unwanted substances from being introduced to the system. This is, in fact, the entire reason why scabs exist: blood coagulates and scabs form to keep foreign material on the outside of the system where it belongs. Psoriatic erythroderma violates this barrier function by stripping away too much of the skin for any scabs to form or defensive measures to be deployed. Paired with the potentiality of a compromised immune system (in patients suffering from late-stage HIV) or a suppressed immune system (in individuals who were previously controlling their psoriasis with immunosupressants), this can lead to very severe complications—sometimes fatal complications—due to the invasion of various infectious agents.
Psoriatic erythroderma’s damage to the skin also causes the body to lose the ability to regulate its own temperature. Ordinarily, skin is used to hold in large quantities of moisture. Water has a high specific heat and is resistant to rapid temperature changes. This is one component. Another component is the body’s ability to sweat. However, psoriasis plaques prevent sweating, and the flaking away of the skin destroys the skin’s ability to function as a moisture barrier, resulting in the body’s inability to stay warm and the body’s inability to cool itself. This can cause extreme harm to the body, which is not designed to withstand prolonged temperatures outside certain parameters.
If left untreated, psoriatic erythroderma can be fatal. The damage to the skin may be completely irreparable without medical intervention.
How serious is Psoriatic Erytrhroderma?
Psoriatic erythroderma is a very serious medical condition. It is, in fact, a medical emergency. Psoriatic erythroderma involves the override and shutdown of multiple critical systems. Individuals suffering from psoriatic erythroderma lose their ability to defend against most vectors of infection and lose their ability to regulate their own body temperature. This leaves them extremely vulnerable to infections from all sources and can cause them to dehydrate easily and leave them prone to hyperthermia.
Psoriatic erythroderma requires timely medical intervention to have a shadow of a hope of full recovery, and is frequently fatal without medical intervention. The list of complications is simply too long for it to be treated as anything but a full-blown medical emergency, owing to the painful gestalt of symptoms it leaves one saddled with.
What does Psoriatic Erytrhroderma treatment look like?
Treatment for psoriatic erythroderma is difficult and depends in large part on the degree of damage done already. Treatment is primarily symptomatic; psoriatic erythroderma indicates a case of psoriasis that has defied treatment previously, and attempting to treat the psoriasis to cut off the psoriatic erythroderma is effectively redundant if psoriatic erythroderma has come to the fore as a relevant issue.
Fluids may be replenished by means of oral ingestion or by means of intravenous feed, depending upon the severity of the dehydration that has occurred.
Infections may be fought off with strong antibiotics. This is frequently necessary due to the individuals extreme vulnerability to infection, although the antibiotics and their quantity required will vary from case to case.
Skin grafts may be necessary to repair the skin, which are an ordeal in and of themselves. Due to the nature of psoriasitic erythroderma, the skin is unable to heal itself and consequently must be grafted back together for the skin to again function as a barrier.
How do I know if I have Psoriatic Erytrhroderma?
Psoriatic erythroderma can be identified by its symptoms. Suffering from a sudden fever or hypothermia means that psoriatic erythroderma is already well underway and that emergency treatment is immediately necessary. Psoriatic erythroderma is characterized by its only appearing as a complication of cases of extreme psoriasis. If there is no case of extreme psoriasis in place, there is absolutely no risk of psoriatic erythroderma.
Psoriasis may spread somewhat. The spread of psoriasis does not indicate psoriatic erythroderma. An individual suffering from one of the more common cases of psoriasis that has very little of their skin covered in psoriasis plaques should not panic because another plaque has formed. However, an individual with an extreme case of psoriasis should already be in touch with a medical professional about their situation, lest their psoriasis get out of hand.
Psoriatic erythroderma should not be diagnosed and then treated after the fact; any individual suffering from psoriasis bad enough that it may bring about psoriatic erythroderma should already be monitored by a medical professional and treated accordingly.