Despite diverse etiologies in erythroderma , the end stage immunologic pathways are similar. As results there are similar clinical findings irrespective of causes. But in some cases systemic corticosteroids are indicated. Is there any logic of not prescribing systemic corticosteroids in all cases of erythroderma?
Topical steroids are effective treatment for localized eczema; however, oral steroids may be necessary for acute contact dermatitis with erythroderma,
In patients with psoriasis, triggers of erythroderma include the abrupt discontinuation of systemic corticosteroids or other immunosuppressant therapy, systemic illnesses, phototherapy burns, medications (eg, lithium, antimalarials), or HIV infection
In Psoriatic patients discontinuation of potent topical or systemic corticosteroids, methotrexate etc can trigger Erythroderma. What would be the consequences if I treat a case of Erythroderma with low dose systemic corticosteroid (Prednisolone)?
I am in favor of prescribing steroids and primary cause must be considered to treat also. Harasit Kumar Paul
This might be a bit out of topic, but erythroderma and bullous diseases appear to have some similarities.
For the latter, Lehman et al. 2013 found a high incidence of infections:
DOI: 10.1111/1346-8138.12175
and in 2015 this group also found that infections are the main cause of death in such patients.
doi: 10.1111/ijd.12243.
The infection-problem appears to be smaller in patients treated with dapsone and larger in patients treated with systemic corticosteroids.
For me this is (pharmaco-)logic.
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