Erythrodermic psoriasis: pathophysiology and current treatment perspectives

Rasnik K Singh,1 Kristina M Lee,2 Derya Ucmak,2 Merrick Brodsky,3 Zaza Atanelov,4 Benjamin Farahnik,5 Michael Abrouk,3 Mio Nakamura,2 Tian Hao Zhu,6 Wilson Liao2 1Department of Medicine, University of California – Los Angeles, David Geffen School of Medicine, Los Angeles,...

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Autores principales:	Singh RK, Lee KM, Ucmak D, Brodsky M, Atanelov Z, Farahnik B, Abrouk M, Nakamura M, Zhu TH, Liao W
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	erythrodermic psoriasis EP pathogenesis pathophysiology treatment Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/e4f6ba855f2848769af8d21e62acbdaf
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spelling	oai:doaj.org-article:e4f6ba855f2848769af8d21e62acbdaf2021-12-02T07:31:41ZErythrodermic psoriasis: pathophysiology and current treatment perspectives2230-326Xhttps://doaj.org/article/e4f6ba855f2848769af8d21e62acbdaf2016-07-01T00:00:00Zhttps://www.dovepress.com/erythrodermic-psoriasis-pathophysiology-and-current-treatment-perspect-peer-reviewed-article-PTThttps://doaj.org/toc/2230-326XRasnik K Singh,1 Kristina M Lee,2 Derya Ucmak,2 Merrick Brodsky,3 Zaza Atanelov,4 Benjamin Farahnik,5 Michael Abrouk,3 Mio Nakamura,2 Tian Hao Zhu,6 Wilson Liao2 1Department of Medicine, University of California – Los Angeles, David Geffen School of Medicine, Los Angeles, 2Department of Dermatology, University of California – San Francisco, San Francisco, 3Department of Medicine, University of California – Irvine, School of Medicine, Irvine, CA, 4Department of Medicine, New York Medical College, Valhalla, NY, 5Department of Medicine, University of Vermont College of Medicine, Burlington, VT, 6Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA Abstract: Erythrodermic psoriasis (EP) is a rare and severe variant of psoriasis vulgaris, with an estimated prevalence of 1%–2.25% among psoriatic patients. The condition presents with distinct histopathologic and clinical findings, which include a generalized inflammatory erythema involving at least 75% of the body surface area. The pathogenesis of EP is not well understood; however, several studies suggest that the disease is associated with a predominantly T helper 2 (Th2) phenotype. Given the morbidity and potential mortality associated with the condition, there is a need for a better understanding of its pathophysiology. The management of EP begins with a comprehensive assessment of the patient’s presentation and often requires multidisciplinary supportive measures. In 2010, the medical board of the US National Psoriasis Foundation published consensus guidelines advocating the use of cyclosporine or infliximab as first-line therapy in unstable cases, with acitretin and methotrexate reserved for more stable cases. Since the time of that publication, additional information regarding the efficacy of newer agents has emerged. We review the latest data with regard to the treatment of EP, which includes biologic therapies such as ustekinumab and ixekizumab. Keywords: erythrodermic psoriasis, EP, pathogenesis, pathophysiology, treatment, biologicsSingh RKLee KMUcmak DBrodsky MAtanelov ZFarahnik BAbrouk MNakamura MZhu THLiao WDove Medical Pressarticleerythrodermic psoriasisEPpathogenesispathophysiologytreatmentDermatologyRL1-803ENPsoriasis: Targets and Therapy, Vol 2016, Iss Issue 1, Pp 93-104 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	erythrodermic psoriasis EP pathogenesis pathophysiology treatment Dermatology RL1-803
spellingShingle	erythrodermic psoriasis EP pathogenesis pathophysiology treatment Dermatology RL1-803 Singh RK Lee KM Ucmak D Brodsky M Atanelov Z Farahnik B Abrouk M Nakamura M Zhu TH Liao W Erythrodermic psoriasis: pathophysiology and current treatment perspectives
description	Rasnik K Singh,1 Kristina M Lee,2 Derya Ucmak,2 Merrick Brodsky,3 Zaza Atanelov,4 Benjamin Farahnik,5 Michael Abrouk,3 Mio Nakamura,2 Tian Hao Zhu,6 Wilson Liao2 1Department of Medicine, University of California – Los Angeles, David Geffen School of Medicine, Los Angeles, 2Department of Dermatology, University of California – San Francisco, San Francisco, 3Department of Medicine, University of California – Irvine, School of Medicine, Irvine, CA, 4Department of Medicine, New York Medical College, Valhalla, NY, 5Department of Medicine, University of Vermont College of Medicine, Burlington, VT, 6Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA Abstract: Erythrodermic psoriasis (EP) is a rare and severe variant of psoriasis vulgaris, with an estimated prevalence of 1%–2.25% among psoriatic patients. The condition presents with distinct histopathologic and clinical findings, which include a generalized inflammatory erythema involving at least 75% of the body surface area. The pathogenesis of EP is not well understood; however, several studies suggest that the disease is associated with a predominantly T helper 2 (Th2) phenotype. Given the morbidity and potential mortality associated with the condition, there is a need for a better understanding of its pathophysiology. The management of EP begins with a comprehensive assessment of the patient’s presentation and often requires multidisciplinary supportive measures. In 2010, the medical board of the US National Psoriasis Foundation published consensus guidelines advocating the use of cyclosporine or infliximab as first-line therapy in unstable cases, with acitretin and methotrexate reserved for more stable cases. Since the time of that publication, additional information regarding the efficacy of newer agents has emerged. We review the latest data with regard to the treatment of EP, which includes biologic therapies such as ustekinumab and ixekizumab. Keywords: erythrodermic psoriasis, EP, pathogenesis, pathophysiology, treatment, biologics
format	article
author	Singh RK Lee KM Ucmak D Brodsky M Atanelov Z Farahnik B Abrouk M Nakamura M Zhu TH Liao W
author_facet	Singh RK Lee KM Ucmak D Brodsky M Atanelov Z Farahnik B Abrouk M Nakamura M Zhu TH Liao W
author_sort	Singh RK
title	Erythrodermic psoriasis: pathophysiology and current treatment perspectives
title_short	Erythrodermic psoriasis: pathophysiology and current treatment perspectives
title_full	Erythrodermic psoriasis: pathophysiology and current treatment perspectives
title_fullStr	Erythrodermic psoriasis: pathophysiology and current treatment perspectives
title_full_unstemmed	Erythrodermic psoriasis: pathophysiology and current treatment perspectives
title_sort	erythrodermic psoriasis: pathophysiology and current treatment perspectives
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/e4f6ba855f2848769af8d21e62acbdaf
work_keys_str_mv	AT singhrk erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives AT leekm erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives AT ucmakd erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives AT brodskym erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives AT atanelovz erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives AT farahnikb erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives AT abroukm erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives AT nakamuram erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives AT zhuth erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives AT liaow erythrodermicpsoriasispathophysiologyandcurrenttreatmentperspectives
_version_	1718399432724054016

Erythrodermic psoriasis: pathophysiology and current treatment perspectives

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