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Psoriasis affects 1 to 2 percent of the population in some form. The most severe is erythrodermic psoriasis which covers all or almost all of the body, according to dermatologist Dr. Richard Langley of Dalhousie University, Nova Scotia, Canada, author of the book "Psoriasis; Everything You Need To Know." Erythrodermic psoriasis usually appears in two ways--as a gradual increase in longstanding laque psoriasis, or as a sudden flare-up of unstable psoriasis, triggered by illness, stress or medication withdrawal, says Dr. Langley. The first step to treating erythrodermic psoriasis is to stabilize the patient, usually in the hospital, and to refer them to a dermatologist.They might have a high temperature and heart rate from the increased blood flowing through the severely inflamed skin. The patient in the BBC drama series, "The Singing Detective," later a movie, suffered erythrodermic psoriasis and sources say the filmed treatments were accurate. In real life a patient will have already tried a range of moisturizers, topical therapy, phototherapy, oral medications and biological therapy before they are hospitalized. Dr. Langley says doctors will apply strong doses of topical steroids as well as various treatments that involve a combination of topical steroids and ultraviolet light treatments. A systemic therapy, methotrexate, which could damage the liver if taken with alcohol, is an effective remedy if all else has fails, according to Dr. Langley. Early 21st century researchers were excited about the potential of the biologic drug entanercept, says Dr. Langley. "Psoriasis; Everything You Need To Know"; Dr. Richard Langley; Firefly Books; 2005Identification
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