Systemic steroids are only used in the acute setting, but should not be used as chronic management due to the rebound after withdrawal and the medium to long term side effects. Patients with erythrodermic or pustular psoriasis are controlled with steroids, but additional anti psoriatic treatment should be commenced at the same time.

These conditions are very severe and probably life-Threatening. We use systemic steroid to reduce the severe complaint of the patient and as life-threatening treatment.

Pustular psoriasis, or psoriatic arthropathy is a variant of psoriaisis, so also erytroderma.

Not all cases need systemic steroids.

Reason 1. Though the response is fast recurrence is equally fast.

Arthropathy in most cases is responsive to non steroidal treatment.

Erythroderma is better treated with regular psoritic medications rather than steroids and only if necessary add steroids