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June 1994

Use of Short-Course Class 1 Topical Glucocorticoid Under Occlusion for the Rapid Control of Erythrodermic Psoriasis

Author Affiliations

Harvard Medical School, Boston, Mass; Harvard Medical School, Boston; Massachusetts General Hospital, Boston; Beth Israel Hospital, Boston

Arch Dermatol. 1994;130(6):704-706. doi:10.1001/archderm.1994.01690060034003


CASE 1  The patient was a 32-year-old man with a 15-year history of psoriasis, psoriatic arthritis, and multiple dermatologic hospitalizations. His psoriasis had been controlled by methotrexate intermittently over the past 10 years but was discontinued due to elevated liver function test results and the presence of positive serologic findings for hepatitis C. One week before admission, the patient discontinued his home UV-B therapy, and psoriatic erythroderma developed covering 70% to 80% of his total body surface area, with diffuse involvement of his scalp, trunk, and extremities. At the time of admission, the patient was an ill-appearing man complaining of chills, with a temperature of 37.5°C and a pulse rate of 100 beats per minute. Notable laboratory values were as follows: leukocytes, 13.9X109/L; hematocrit, 0.39; and platelets, 621X 109/L. Laboratory tests for electrolytes, serum urea nitrogen, and creatinine showed findings within normal limits.

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