Unveiling the Culprit: Psoriatic Erythroderma Responding to Anti-tubercular Therapy
Erythroderma is the generalized erythema and scaling of skin affecting at least 90% of body surface area. Understanding and correcting the underlying cause and precipitating factors are important in the management of erythroderma. Here, we report a case of treatment-resistant psoriatic erythroderma,...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-04-01
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| Series: | Clinical Dermatology Review |
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| Online Access: | https://journals.lww.com/10.4103/cdr.cdr_90_24 |
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| author | Hitha Alu James Kathi Sowmya Sathaiah Sudhamalla Sudha Rani Chintagunta |
| author_facet | Hitha Alu James Kathi Sowmya Sathaiah Sudhamalla Sudha Rani Chintagunta |
| author_sort | Hitha Alu James |
| collection | DOAJ |
| description | Erythroderma is the generalized erythema and scaling of skin affecting at least 90% of body surface area. Understanding and correcting the underlying cause and precipitating factors are important in the management of erythroderma. Here, we report a case of treatment-resistant psoriatic erythroderma, which responded to anti-tubercular therapy (ATT). A 55-year-old male who is a known case of psoriasis presented with generalized erythema and scaling all over the body for 2 months, preceded by intake of herbal medications. On examination, erythroderma involving the trunk, upper and lower extremities, scalp, face, palms, and soles was present. Diagnosis of psoriatic erythroderma precipitated by herbal medications was made. The patient was started on cyclosporine and thereafter, acitretin was added, but there was a suboptimal response. We observed better response when prophylactic antibiotics were added, which gave a clue on a hidden infection triggering the erythroderma, that is yet to be addressed. On further evaluation, Mantoux test was positive and high-resolution computed tomography chest revealed lesions suggestive of pulmonary tuberculosis (TB). The patient was started on standard ATT and a Near-complete resolution of the erythroderma was observed in 2 weeks. To the best of our knowledge, there are not many reports of erythroderma in preexisting dermatosis triggered by TB in the literature. We put forward this case report as an attempt to stress the fact that a meticulous search for the precipitating factors is important in the management of erythroderma. |
| format | Article |
| id | doaj-art-3e617ba6400a466693dd62bb46174393 |
| institution | DOAJ |
| issn | 2542-551X 2542-5528 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Clinical Dermatology Review |
| spelling | doaj-art-3e617ba6400a466693dd62bb461743932025-08-20T02:55:28ZengWolters Kluwer Medknow PublicationsClinical Dermatology Review2542-551X2542-55282025-04-019219619810.4103/cdr.cdr_90_24Unveiling the Culprit: Psoriatic Erythroderma Responding to Anti-tubercular TherapyHitha Alu JamesKathi SowmyaSathaiah SudhamallaSudha Rani ChintaguntaErythroderma is the generalized erythema and scaling of skin affecting at least 90% of body surface area. Understanding and correcting the underlying cause and precipitating factors are important in the management of erythroderma. Here, we report a case of treatment-resistant psoriatic erythroderma, which responded to anti-tubercular therapy (ATT). A 55-year-old male who is a known case of psoriasis presented with generalized erythema and scaling all over the body for 2 months, preceded by intake of herbal medications. On examination, erythroderma involving the trunk, upper and lower extremities, scalp, face, palms, and soles was present. Diagnosis of psoriatic erythroderma precipitated by herbal medications was made. The patient was started on cyclosporine and thereafter, acitretin was added, but there was a suboptimal response. We observed better response when prophylactic antibiotics were added, which gave a clue on a hidden infection triggering the erythroderma, that is yet to be addressed. On further evaluation, Mantoux test was positive and high-resolution computed tomography chest revealed lesions suggestive of pulmonary tuberculosis (TB). The patient was started on standard ATT and a Near-complete resolution of the erythroderma was observed in 2 weeks. To the best of our knowledge, there are not many reports of erythroderma in preexisting dermatosis triggered by TB in the literature. We put forward this case report as an attempt to stress the fact that a meticulous search for the precipitating factors is important in the management of erythroderma.https://journals.lww.com/10.4103/cdr.cdr_90_24anti-tubercular therapyerythrodermapsoriasistuberculosis |
| spellingShingle | Hitha Alu James Kathi Sowmya Sathaiah Sudhamalla Sudha Rani Chintagunta Unveiling the Culprit: Psoriatic Erythroderma Responding to Anti-tubercular Therapy Clinical Dermatology Review anti-tubercular therapy erythroderma psoriasis tuberculosis |
| title | Unveiling the Culprit: Psoriatic Erythroderma Responding to Anti-tubercular Therapy |
| title_full | Unveiling the Culprit: Psoriatic Erythroderma Responding to Anti-tubercular Therapy |
| title_fullStr | Unveiling the Culprit: Psoriatic Erythroderma Responding to Anti-tubercular Therapy |
| title_full_unstemmed | Unveiling the Culprit: Psoriatic Erythroderma Responding to Anti-tubercular Therapy |
| title_short | Unveiling the Culprit: Psoriatic Erythroderma Responding to Anti-tubercular Therapy |
| title_sort | unveiling the culprit psoriatic erythroderma responding to anti tubercular therapy |
| topic | anti-tubercular therapy erythroderma psoriasis tuberculosis |
| url | https://journals.lww.com/10.4103/cdr.cdr_90_24 |
| work_keys_str_mv | AT hithaalujames unveilingtheculpritpsoriaticerythrodermarespondingtoantituberculartherapy AT kathisowmya unveilingtheculpritpsoriaticerythrodermarespondingtoantituberculartherapy AT sathaiahsudhamalla unveilingtheculpritpsoriaticerythrodermarespondingtoantituberculartherapy AT sudharanichintagunta unveilingtheculpritpsoriaticerythrodermarespondingtoantituberculartherapy |