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Related Experiment Videos

Psoriasis-induced postoperative cardiac failure.

Pankaj K Jha1, Satish R Das, Ghassan S Musleh

  • 1Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester, United Kingdom. p1jha@aol.com

The Annals of Thoracic Surgery
|March 31, 2005
PubMed
Summary

Erythrodermic psoriasis can cause severe vasodilatation, a rare complication. Prompt reinstitution of methotrexate treatment resolved this condition in a post-cardiac surgery patient.

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Area of Science:

  • Dermatology
  • Cardiology
  • Pharmacology

Background:

  • Erythrodermic psoriasis is an aggressive skin condition that can lead to systemic complications.
  • Cardiogenic shock is a rare but recognized manifestation of severe erythrodermic psoriasis.
  • Managing psoriasis flares perioperatively is crucial, especially in patients with cardiovascular conditions.

Observation:

  • A case of persistent severe vasodilatation occurred post-coronary artery bypass surgery.
  • The vasodilatation was attributed to a flare-up of erythrodermic psoriasis.
  • The patient's psoriasis was previously managed with methotrexate, which was omitted during the perioperative period.

Findings:

  • Severe vasodilatation in this patient was directly linked to the erythrodermic psoriasis flare.

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  • Discontinuation of methotrexate perioperatively likely precipitated the psoriasis exacerbation.
  • Resumption of methotrexate treatment led to the resolution of the vasodilatation.

    • Implications:

    • This case highlights the importance of continuous psoriasis management, including methotrexate, in patients undergoing major surgery.
    • Aggressive psoriasis flares can have significant systemic hemodynamic consequences, including vasodilatation.
    • Close collaboration between dermatology and cardiology is essential for managing complex cases involving psoriasis and cardiovascular surgery.