Psoriasis is irritating, stressful, even debilitating, but it is seldom thought of as life-threatening. However, there are rare cases where a flare-up can be a medical emergency. Two very rare types of psoriasis, erythrodermic psoriasis and generalized pustular psoriasis, can cause fever, fluid loss and other dangerous problems.
Erythrodermic psoriasis tends to produce large, red patches, often covering nearly all of the skin surface. It may be accompanied by severe itching and pain. It can occur suddenly as the first sign that a person has psoriasis or occur more gradually and affect people who already have plaque psoriasis. It can be brought on by:
- an infection
- low levels of calcium in the blood
- suddenly stopping the use of corticosteroids
- strong coal tar preparations
- some medications, including lithium, interleukin-II, and drugs to treat or prevent malaria
Erythrodermic psoriasis is dangerous because it can disrupt your body's ability to control its temperature and can lead to dehydration and heart failure.
Generalized pustular psoriasis
If you develop generalized pustular psoriasis, also known as von Zumbusch psoriasis, you'll certainly want to see a doctor - you won't need to be told to do so. It comes on quickly (in as little as a few hours) and produces the following symptoms:
- widespread areas of red skin
- pain and tenderness
- blisters filled with non-infectious pus that will dry and peel within a day or two, leaving the skin smooth and shiny - they may start as small blisters and then join together to form larger blisters
You may also experience the following:
- severe itching
- rapid heartbeat
- muscle weakness
- loss of appetite
Generalized pustular psoriasis may occur in people who have a history of plaque psoriasis, but it may also affect people who have not previously had psoriasis. Many times, there is no identifiable cause for the flare-up, but some possible triggers include:
- sudden stopping of steroid use
- some medications, such as lithium, indomethacin, propranolol, iodides, and some beta-blockers
- topical medications (medications that are applied to the skin) that have strong irritating effects, including some psoriasis treatments
Generalized pustular psoriasis can severely affect the heart and lungs, especially if the person is elderly. It can also affect the liver and kidney and disturb the body's fluid balance. Anyone experiencing it should go to an emergency room immediately.
Fortunately, both of these forms of psoriasis are very rare.
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