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,...

Full description

Saved in:
Bibliographic Details
Main Authors: Hitha Alu James, Kathi Sowmya, Sathaiah Sudhamalla, Sudha Rani Chintagunta
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Clinical Dermatology Review
Subjects:
Online Access:https://journals.lww.com/10.4103/cdr.cdr_90_24
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850042708414955520
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