Clinical features:
(1) diffuse psoriasis with diffuse erythroderma (exfoliative dermatitis)
(2) systemic symptoms with chills, fever, malaise and/or fatigue
(3) increased skin temperature
(4) variable pustule formation
(5) lymphadenopathy
(6) variable pruritus, which may be severe
(7) variable nail involvement
(8) variable heart failure, especially if there is pre-existing heart disease
(9) anxiety and emotional stress (which may also trigger an episode)
(10) variable leukocytosis
(11) significant loss of body water and protein, resulting in dehydration and/or protein malnutrition
(12) variable pneumonia or secondary infection
Some patients have only 1 episode while others may experience one or more subsequent flares.
Comorbid conditions (alcoholic liver disease, atherosclerosis, COPD, other) may be important in determining prognosis, especially if systemic symptoms are severe.
Differential diagnosis:
(1) erythroderma secondary to contact allergy with topical therapy
