Erythrodermic Psoriasis in Medico-Legal Practice: An Overview of a Case

Abstract

Abstract Psoriasis represents a chronic autoimmune disease of great interest as its incidence has increased over the last decades. It encompasses a multitude of subtypes with various manifestations and complications. Erythrodermic psoriasis represents one of the most severe forms of the disease and is characterized by the appearance of a generalized erythematous rash on top of pre-existing lesions. We present the case of a 71-year-old patient with history of arthropathic psoriasis who is admitted to the dermatovenerology clinic for deterioration of his general condition, exacerbated pre-existing cardiovascular conditions, a diffuse generalized erythematous skin rash, pronounced leg edema and nail changes. After following topical and systemic treatment, the patient was discharged in an improved condition. Two weeks later the woman is found dead in their home. An autopsy was performed and the necropsy examination describes the skin lesions presented before but in an aggravated form and the histopathological examination establishes the cause of death which is represented by acute heart failure, the consequence of lymphocytic interstitial myocarditis. The particularity of the case is represented by the simultaneous exacerbation of cardiac and skin pathology, both having autoimmune components and an inflammatory substrate.