erythrodermic psoriasis
Introduction
Introduction to erythrodermic psoriasis Psoriatic psoriasis is caused by improper treatment of psoriasis, especially in the acute stage of psoriasis vulgaris, or long-term use of corticosteroids, improper withdrawal or reduction methods. In addition, pustular psoriasis can also occur in the process of pustule regression. The disease accounts for about 1% of psoriasis. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: headache
Cause
Causes of erythrodermic psoriasis
1. erythroderous psoriasis is often caused by certain stimulating factors of psoriasis in the acute stage, such as topical irritating or inappropriate drugs;
2, a small number can be derived from psoriasis vulgaris;
3, after a large number of long-term application of corticosteroids, such as sudden withdrawal or reduction is too fast, and the symptoms recurrence and increase the joints;
4, pustular psoriasis in the process of pustular regression, joint changes may also occur.
Prevention
Red skin psoriasis prevention
Avoid drug abuse, do not use irritating drugs for other skin diseases in the acute phase.
Complication
Complications of erythrodermic psoriasis Complications
First, in the original psoriasis lesions appear flushing, and quickly spread into large pieces, and finally the whole body showed diffuse flushing infiltration.
Second, a large number of scales fall off every day during the onset of the disease, and the scalp has thick squama. In the later stages, there was a large piece of skin peeling off the hands and feet.
Third, the finger (toe) A turbidity is thick and deformed, and the nail can fall off.
4. The mouth, pharynx and nasal cavity as well as the conjunctiva are both congested and reddened. Often accompanied by fever, chills, headache, general malaise and so on.
Symptom
Symptoms of erythrodermic psoriasis Common symptoms Fatigue chills fever scaly
The erythrodermic psoriasis often affects more than 75% of the body expression. When the unstable psoriasis vulgaris is out of control, the skin lesion can be further developed to cover most of the skin, causing erythroderma; It involves a wide range of skin, and pustules coexist with skin inflammation. If skin redness is dominant, it can also be called erythrodermic psoriasis. Erythrodermic psoriasis is a special type of psoriasis that affects most of the skin, but the incidence is the lowest in psoriasis. The erythrodermic psoriasis is often secondary to some uncontrollable plaque psoriasis. The patient develops a wide range of skin redness on a periodic basis, and the skin of the patient is often accompanied by severe desquamation and itching pain.
(1) Systemic symptoms: patients with erythrodermic psoriasis may have fever, chills, headache, fatigue and other discomfort, and the subcutaneous lymph nodes may be swollen. The whole body skin is in the process of active inflammation, so some complications arising from its pathophysiological changes and metabolic abnormalities should be taken seriously. Especially elderly patients should pay special attention to the condition of heart function, dehydration, anemia and hypoproteinemia. Patients may also have abnormal liver and kidney function.
(2) Skin damage: If it is changed from the vulgaris type, the initial skin lesions will appear flushed and rapidly expand. Finally, the skin of the whole body will be diffuse red or dark red, and the inflammation will be obvious; Sexual redness and desquamation of erythroderma manifestations, a large amount of bran-like scales on the surface of the skin, and constantly falling off. Normal skin is distributed between skin lesions like an island. Patients with hand and foot involvement can often see the whole piece of horny exfoliation, and A is often involved, showing turbidity, hypertrophy, deformation, and even exfoliation and shedding. The oral cavity, nasal cavity, pharyngeal mucosa and conjunctiva can be reddened and red, and there may be gray-white keratinized infiltrating patches in the mouth.
Examine
Examination of erythrodermic psoriasis
According to the diffuse flushing, edema, infiltration and desquamation of the whole skin, the itching is severe and the course is long. The physical examination can be diagnosed. Generally no other inspection is required.
Plasma protein can be reduced.
Pathological examination: mainly non-specific acute or subacute inflammatory changes. Excessive keratinization, parakeratosis, hypertrophy of the spinous cell layer, intercellular and intracellular edema, edema of the dermis, and infiltration of lymphocytes, tissue cells and eosinophils. In addition, specific or non-specific changes can occur in lymph nodes. Non-specific expression is thickening of the capsule, inflammatory cell infiltration mainly composed of tissue cells and plasma cells, and specificity may be histological changes of lymphoma. The erythroderma caused by different causes may have a special change in its pathogenesis in pathology.
Diagnosis
Diagnosis and diagnosis of erythrodermic psoriasis
diagnosis
Psoricarpal psoriasis is similar to psoriasis vulgaris, but inflammation is more severe. The main basis is the systemic diffuse infiltration of flushing, a large number of bran-like scales and residual normal "Pice Island", with a history of psoriasis. Many patients with psoriasis vulgaris use stimulating drugs in the acute stage, corticosteroid drugs for a long time, improper drug withdrawal or reduction methods, there will be red skin psoriasis, its incidence is only 1%. At the beginning, flushing occurred in the original psoriasis lesions, and it quickly expanded into large pieces. Finally, the whole body showed diffuse flushing infiltration. In the diffuse flushing infiltration, there were often normal flaky "peel islands", which were the main type of red skin. One of the features.
Differential diagnosis
It is differentiated from neurodermatitis and exfoliative dermatitis.
