ABSTRACT
This chapter provides a case study of 50-year-old man who presents the on-call dermatologist with a 3-day history of rigors, feeling generally unwell and redness of all his skin associated with scaling. Since his teenage years he has suffered with a scaly scalp and occasional dry patches on the elbows. There is widespread erythema affecting the face, trunk and limbs with thickening of the skin and associated widespread scale. The most likely diagnosis is erythrodermic psoriasis. Erythroderma is when almost the entire skin becomes red; in the case of psoriasis the skin is also thickened and scaly. Erythrodermic skin is associated with fever, rigors and lymphadenopathy. Cutaneous inflammation may mask concurrent secondary skin infection and blood cultures may be positive owing to their easy contamination with normal skin flora. Hypoalbuminaemia and cardiac failure are serious complications that particularly affect the elderly.
