Clinical Improvement of Erythrodermic Psoriasis Patient Treated with Methotrexate: A Case Report
Erythrodermic psoriasis (EP) is a rare form of psoriasis but has a high mortality and morbidity rate. The management of erythrodermic psoriasis includes prevention of complications and administration of immunosuppressant drugs such as methotrexate. This article reports the case of a 37-year-old man...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
University of Jember, Faculty of Medicine
2023-06-01
|
| Series: | Journal of Agromedicine and Medical Sciences (AMS) |
| Online Access: | https://jurnal.unej.ac.id/index.php/JAMS/article/view/38317 |
| _version_ | 1797773230434418688 |
|---|---|
| author | Cagar Irwin Taufan Pamungkas Asri Ayu Firdausi Agnellia Maulidya Utami Elfindri Okgandita Veranie Anselma Dyah Kartika Hadi |
| author_facet | Cagar Irwin Taufan Pamungkas Asri Ayu Firdausi Agnellia Maulidya Utami Elfindri Okgandita Veranie Anselma Dyah Kartika Hadi |
| author_sort | Cagar Irwin Taufan Pamungkas |
| collection | DOAJ |
| description | Erythrodermic psoriasis (EP) is a rare form of psoriasis but has a high mortality and morbidity rate. The management of erythrodermic psoriasis includes prevention of complications and administration of immunosuppressant drugs such as methotrexate. This article reports the case of a 37-year-old man with complaints of red, scaly spots almost all over his body since the past month. Initially, the red spots only appeared on the right and left arms and legs. On dermatological examination found lesions on >90% of the patient's total body area in the form of erythematous patches, well-defined, irregular shape and covered with thick scales, there was onycholysis of the toenails, and the Karvslek phenomenon in the patient. Based on the history and physical examination, the patient was diagnosed with erythrodermic psoriasis with a PASI score of 60.2. The patient received oral methotrexate therapy 7.5 mg/week, folic acid once daily, cetirizine 10 mg twice daily, and topical therapy with desoximetasone cream 0.25%. Methotrexate is taken alternately with a single dose of 2.5 mg. Evaluation of patients at 1 month after therapy showed improvement in clinical symptoms with reduced subjective symptoms followed by a change in the PASI score to 45.8. Proper diagnosis and management as well as monitoring for side effects of medication can reduce morbidity and prevent complications from EP.
Keywords: Erythrodermic psoriasis, treatment, methothrexate. |
| first_indexed | 2024-03-12T22:02:24Z |
| format | Article |
| id | doaj.art-b059c3b02bd847b4ad7d7d6d69eaedfe |
| institution | Directory Open Access Journal |
| issn | 2460-9048 2714-5654 |
| language | English |
| last_indexed | 2024-03-12T22:02:24Z |
| publishDate | 2023-06-01 |
| publisher | University of Jember, Faculty of Medicine |
| record_format | Article |
| series | Journal of Agromedicine and Medical Sciences (AMS) |
| spelling | doaj.art-b059c3b02bd847b4ad7d7d6d69eaedfe2023-07-25T04:26:34ZengUniversity of Jember, Faculty of MedicineJournal of Agromedicine and Medical Sciences (AMS)2460-90482714-56542023-06-0192596310.19184/ams.v9i2.3831738317Clinical Improvement of Erythrodermic Psoriasis Patient Treated with Methotrexate: A Case ReportCagar Irwin Taufan Pamungkas0Asri Ayu Firdausi1Agnellia Maulidya Utami2Elfindri Okgandita Veranie3Anselma Dyah Kartika Hadi4dr. Soebandi Regional Hospital Jember, Jember, IndonesiaCitra Husada Hospital, Jember, IndonesiaBina Sehat Hospital, Jember, IndonesiaFaculty of Medicine, University of Jember, Jember, IndonesiaDepartement of Dermatology and Venereology, dr. Soebandi Regional Hospital Jember, Jember, IndonesiaErythrodermic psoriasis (EP) is a rare form of psoriasis but has a high mortality and morbidity rate. The management of erythrodermic psoriasis includes prevention of complications and administration of immunosuppressant drugs such as methotrexate. This article reports the case of a 37-year-old man with complaints of red, scaly spots almost all over his body since the past month. Initially, the red spots only appeared on the right and left arms and legs. On dermatological examination found lesions on >90% of the patient's total body area in the form of erythematous patches, well-defined, irregular shape and covered with thick scales, there was onycholysis of the toenails, and the Karvslek phenomenon in the patient. Based on the history and physical examination, the patient was diagnosed with erythrodermic psoriasis with a PASI score of 60.2. The patient received oral methotrexate therapy 7.5 mg/week, folic acid once daily, cetirizine 10 mg twice daily, and topical therapy with desoximetasone cream 0.25%. Methotrexate is taken alternately with a single dose of 2.5 mg. Evaluation of patients at 1 month after therapy showed improvement in clinical symptoms with reduced subjective symptoms followed by a change in the PASI score to 45.8. Proper diagnosis and management as well as monitoring for side effects of medication can reduce morbidity and prevent complications from EP. Keywords: Erythrodermic psoriasis, treatment, methothrexate.https://jurnal.unej.ac.id/index.php/JAMS/article/view/38317 |
| spellingShingle | Cagar Irwin Taufan Pamungkas Asri Ayu Firdausi Agnellia Maulidya Utami Elfindri Okgandita Veranie Anselma Dyah Kartika Hadi Clinical Improvement of Erythrodermic Psoriasis Patient Treated with Methotrexate: A Case Report Journal of Agromedicine and Medical Sciences (AMS) |
| title | Clinical Improvement of Erythrodermic Psoriasis Patient Treated with Methotrexate: A Case Report |
| title_full | Clinical Improvement of Erythrodermic Psoriasis Patient Treated with Methotrexate: A Case Report |
| title_fullStr | Clinical Improvement of Erythrodermic Psoriasis Patient Treated with Methotrexate: A Case Report |
| title_full_unstemmed | Clinical Improvement of Erythrodermic Psoriasis Patient Treated with Methotrexate: A Case Report |
| title_short | Clinical Improvement of Erythrodermic Psoriasis Patient Treated with Methotrexate: A Case Report |
| title_sort | clinical improvement of erythrodermic psoriasis patient treated with methotrexate a case report |
| url | https://jurnal.unej.ac.id/index.php/JAMS/article/view/38317 |
| work_keys_str_mv | AT cagarirwintaufanpamungkas clinicalimprovementoferythrodermicpsoriasispatienttreatedwithmethotrexateacasereport AT asriayufirdausi clinicalimprovementoferythrodermicpsoriasispatienttreatedwithmethotrexateacasereport AT agnelliamaulidyautami clinicalimprovementoferythrodermicpsoriasispatienttreatedwithmethotrexateacasereport AT elfindriokganditaveranie clinicalimprovementoferythrodermicpsoriasispatienttreatedwithmethotrexateacasereport AT anselmadyahkartikahadi clinicalimprovementoferythrodermicpsoriasispatienttreatedwithmethotrexateacasereport |