Etanercept therapy for difficult-to-control erythrodermic psoriasis. A case report

Background: Erythrodermic Psoriasis affects less than 2% of Psoriasis patients and is defined by erythema and hyperkeratosis that affects at least 90% of the total body surface. Due to the extensive skin involvement, patients may present systemic symptoms, making this pathology a risk to life. The case of a 68-year-old female patient with Erythrodermic Psoriasis is presented, who had intolerance to conventional treatments and multiple comorbidities. The patients history reveals a progression of two months with the presence of diffuse erythema, peeling, pruritus, skin ardor, fever, chills and general discomfort. Physical examination reveals erythematous lesions, desquamative with hyperkeratosis that converge with each other, causing pain and intense itching. Skin biopsies confirmed the presumptive diagnosis. IL-6 and IL-8 participate in hyperkeratosis and formation of new vessels; their elevated levels are related to the severity of the pathology. ELISA and RT-qPCR results have shown that Etanercept decreased the production of these cytokines. Following a comprehensive analysis, management with Etanercept was initiated, resulting in significant clinical improvement. The use of these agents should be individualized and tailored to each patient's characteristics.