Psoriasis is one of the most common causes of erythroderma. When first-line systemic treatment fails to produce clinical remission of the erythroderma, a specific second-line approach is indicated.
This protocol is for erythroderma arising in the context of psoriasis. Psoriasis is the most frequent underlying cause of exfoliative dermatitis, representing 25–50% of cases in some studies.
This protocol applies when prior first-line systemic treatment did not achieve clinical remission of erythroderma. First-line agents that may have been used include:
When first-line agents fail, a second-line biologic therapy — etanercept, given by subcutaneous injection — has evidence from case series (Evidence level IIB). The full dosing schedule, reduction protocol, and sequencing criteria are contained in the complete regimen.