Erythrodermic Psoriasis in a 13-Year-Old Girl

Abstract

Erythrodermic psoriasis is a rare yet severe form of psoriasis in children. The National Psoriasis Foundation recently published treatment guidelines for erythrodermic psoriasis in adults recommending systemic medications such as infliximab, cyclosporine, methotrexate, and acitretin as first-line agents for this disorder. However, the evidence on the safety and efficacy of these medications in children is limited, and the management of pediatric erythrodermic psoriasis remains a therapeutic challenge. We present a case of a 13-year-old girl with a 10-month history of severe refractory erythrodermic psoriasis. Initial treatment with cyclosporine was complicated by the development of H1N1 influenza infection and hospitalization in the intensive care unit. She was subsequently administered methotrexate, acitretin, and oral steroids, but her symptoms have persisted, with erythema and scaling involving nearly her entire body surface area.