Thai Lun Tan Wai Mun Chung Ihsan Ismail



Erythroderma is a dermatological emergency defined as erythema and scaling occurring in a generalized distribution involving more than 90% of the total body surface area. Widespread alterations of the skin functions could result in a number of complications which are known collectively as acute skin failure.


We report a case of erythrodermic psoriasis in a 37 year old Malay male prisoner with underlying Hepatitis C Virus infection and unstable plaque psoriasis. He presented with rapid worsening of his psoriatic lesions which eventually affecting his entire body surface area associated with pruritus and erythema within one week duration. Patient was admitted for medical stabilization. He was eventually discharged well at day 13 of admission and PASI was reduced from 72.0 to 2.7. (PASI: Psoriatic Area Severity Index)


Erythroderma can be lifethreatening, primarily because of its metabolic burden and complications. Hence, it is mandatory to establish it’s etiopathology in order to facilitate precise management. This disorder may be the morphologic presentation of a variety of cutaneous and systemic diseases, and a thorough workup is essential. A pre-existing dermatosis is the single most common cause of adult erythroderma. Pathogenesis of acute skin failure involves failure of the skin to perform its multiple functions which would result in the potentially fatal syndrome of acute skin failure. This case report underscores the importance of understanding the etiopathogenesis of various systemic complications of acute skin failure which require prompt treatment. Speculative mechanisms for complications of acute skin failure and the implications for clinical practice are discussed.


Supplementary Issue