Pustular and Erythrodermic Psoriasis in Patients Treated With Oral Glucocorticoids: A Survey of United States Dermatologists

April 2022 | Volume 21 | Issue 4 | Features | 427 | Copyright © April 2022


Published online March 25, 2022

Katherine C. Awh BA,a Christian A. Albornoz MD,a Kumar S. Nadhan MD,b Meghan Buckley MS,c Steven R. Feldman MD,d M. Anthony Albornoz MDe

aThomas Jefferson University, Philadelphia, PA
bCook County Health, Chicago, IL
cLankenau Institute for Medical Research, Wynnewood, PA
dWake Forest School of Medicine, Winston-Salem, NC
eRiddle Memorial Hospital, Media, PA



0-10 years. The most common indication for the use of OAG was as bridge therapy to DMARD/biologics, with prednisone as the OAG of choice. The most popular regimen was daily shortterm therapy (<6 weeks), dose >10 mg/day with an intermediate taper of 3-6 weeks (Figure 1-C, D). PAG usage was reported by 32% (16/50) of respondents, typically in 1-10% of patients.

Among respondents, 16% (8/50) had experienced one or more patients developing GPP/EP in the presence of OAG treatment. GPP/EP was reported more frequently in the context of tapering than without tapering (12% vs 8%, Figure 2-A). Nearly all respondents (98%) were aware of the risk in patients with psoriasis of developing GPP and EP in the context of OAG wean. GPP was most commonly seen, while EP was not noted. Critical illness was infrequently encountered (6%, Figure 2-B), and no deaths were reported (Figure 2-B).