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Erythrodermic Psoriasis — SCE Dermatology MCQ

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ModerateInflammatory DermatosesErythrodermic PsoriasisSCE Dermatology

A 45-year-old man with erythrodermic psoriasis is admitted to hospital. He is haemodynamically unstable with temperature dysregulation, peripheral oedema, and high-output cardiac failure. What is the initial priority management?

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Correct answer: A — Supportive care: fluid resuscitation, temperature control, nutritional support and electrolyte correction

Erythrodermic psoriasis is a medical emergency. The initial priority is supportive care: haemodynamic stabilisation with IV fluid resuscitation, temperature regulation (erythroderma causes excessive heat loss), correction of electrolyte imbalances and hypoalbuminaemia, nutritional support, and monitoring for secondary infection and thromboembolism. Specific anti-psoriatic therapy (Ciclosporin or Infliximab are preferred for rapid control) is initiated once the patient is stabilised. Applying potent topical steroids over large BSA risks systemic absorption. Methotrexate is slower-acting and not ideal for acute rescue.

Reference: BAD 2020 Psoriasis Guidelines; NICE