Erythrodermic psoriasis in post-coronavirus disease 2019 patient
Asia Pacific Allergy 2022³â 12±Ç 2È£ p.16 ~ p.16
(Batubara Irwan Saputra) - Universitas Indonesia Faculty of Medicine Department of Dermatology and Venereology
(Budianti Windy Keumala) - Universitas Indonesia Faculty of Medicine Department of Dermatology and Venereology
Abstract
Erythrodermic psoriasis (EP) is characterized by generalized erythema and desquamation affecting more than 75% of body surface area and usually accompanied by systemic symptoms. The triggers are medication withdrawal, drugs reactions, and systemic infections including coronavirus disease 2019 (COVID-19). A 46-year-old man with plaque psoriasis suffered from EP following the sudden discontinuation of medications. He was diagnosed with COVID-19 one month before erythroderma appeared. The body surface area involvement was 96% and psoriasis area severity index was 49.8. His general condition and laboratory examination were within normal limits. He was treated with cyclosporine-A for one month after being healed from COVID-19 with significant improvement. Excessive production of proinflammatory cytokines in COVID-19 plays a role in the pathogenesis of psoriasis. This condition should be managed appropriately to minimize the complication. Cyclosporine-A is the first-line therapy for EP because of its effectiveness and good safety profile. It is also shown a beneficial effect in COVID-19 infection in vitro.
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Erythrodermic psoriasis, COVID-19, Cyclosporine-A, Phototherapy, Cytokines, Hyperinflammatory
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The body surface area involvement was 96% and psoriasis area severity index was 49.8. CyA was shown to be rapidly effective and well tolerated for therapy of EP in the post-COVID-19 patient.