Abstract
A woman in her sixties with a 20-year history of psoriasis vulgaris, which had been occasionally treated with OTC cream, was transported to our hospital by ambulance. She had widespread erythema, edema, and exfoliation, which had suddenly developed following cold symptoms 10 days previously. Due to severe cutaneous pain, she was unable to move and had difficulty eating. On admission, her Psoriasis Area and Severity index (PASI) score was 58.8 and her CRP levels had increased to 7.5mg/dl. After excluding severe bacterial infection and the past history of tuberculosis, infliximab was administered. One week after commencement of therapy, she showed rapid improvement of the symptoms including clearing of erythema and cutaneous pain, and became able to eat by herself. Treatment guidelines for psoriatic erythroderma in the United States recommend infliximab or cyclosporine as the first-line treatment. Since our patient showed marked hypertension, infliximab was selected instead of cyclosporine. Our case demonstrated that infliximab is useful for emergency cases demonstrating severe and rapidly aggravating psoriatic erythroderma.Skin Research, 10: 209-213, 2011
