Improvement of Psoriatic Erythroderma by Combination Therapy Consisting of Systemic Etretinate and a Corticosteroid, Photochemotherapy, and a Topical Corticosteroid and Vitamin D3
A 31-year-old Japanese woman was admitted to our hospital with diffuse erythroderma with generalized desquamation and arthritis in the ankle joints. Based on a skin biopsy specimen which revealed the histological picture of psoriasis, a diagnosis of psoriatic erythroderma was made. Treatment with a topical corticosteroid and systemic methotrexate was ineffective. Oral cyclosporine was effective, but it was discontinued because of exacerbation of a respiratory tract infection. Treatment with oral prednisolone relieved her joint pain, but manic-depressive psychosis developed, and lithium carbonate was given orally. Topical psoralen with ultraviolet A radiation (PUVA) treatment in combination with the systemic and topical corticosteroids, topical vitamin D3, and systemic etretinate controlled her psoriasis and arthritis.
