new_n_lost
Politically InCorrect
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This Topic has been been hit Multiple of times of the Exms REcently
A 74-year-old man with a thirty year history of psoriasis presented with generalized erythroderma of 3 days duration. Examination reveals him to be shivering but otherwise is well. He was treated as an inpatient with emollients and attention to fluid replacement and temperature control but failed to improve after five days.
What is the most appropriate next treatment?
1) Oral hydroxychloroquine
2) Oral methotrexate
3) Oral prednisolone
4) Topical coal tar
5) Topical dithranol
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| keepgoing
Forum Guru
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2) Oral methotrexate ??
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| new_n_lost
Politically InCorrect
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Posts: 6,070
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Erythroderma is an emergency as patients are susceptible to profound dehydration, infection and hypothermia. Methotrexate would be the only correct treatment for someone with erythrodermic psoriasis.
Steroids could lead to unstable pustular psoriasis and would not generally work.
Hydroxychloroquine has little effect on psoriasis.
Topical coal tar and dithranol are good treatments for chronic plaque psoriasis but are highly irritant and would make the erythroderma much more inflamed and deteriorate his condition
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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