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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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Systemic Treatment and Outcome in Erythrodermic Psoriasis: A Retrospective Multicenter Study.

Julian Kögel1, Sandra Schuh2, Julia Welzel2

  • 1Department of Dermatology, University Hospital Regensburg, Regensburg, Germany.

International Journal of Dermatology
|April 18, 2026
PubMed
Summary

Erythrodermic psoriasis treatment varies widely. Biologic therapies, particularly IL-17 and IL-23 inhibitors, show promising results for severe psoriasis, suggesting a need for updated guidelines.

Keywords:
Germanyantirheumatic drugsbiologicscomorbiditydrugserythrodermafumaratesoutcomepsoriasistreatment

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Area of Science:

  • Dermatology
  • Rheumatology
  • Clinical Pharmacology

Background:

  • Erythrodermic psoriasis (EP) is a rare, severe skin condition lacking standardized treatment guidelines.
  • Current guidelines are outdated, focusing on conventional disease-modifying antirheumatic drugs (cDMARDs) and TNF-α inhibitors.
  • Limited research exists on optimal systemic therapies for EP due to its low prevalence.

Purpose of the Study:

  • To analyze current systemic treatment approaches for erythrodermic psoriasis.
  • To evaluate the efficacy and safety of different therapies in EP patients.
  • To identify potential areas for guideline development in EP management.

Main Methods:

  • Multicenter retrospective chart analysis of 29 EP patients treated between 2019-2024.
  • Inclusion criteria: diagnosis of EP and receipt of systemic treatment.
  • Data collected on therapies used, Psoriasis Area and Severity Index (PASI) scores, and adverse events.

Main Results:

  • Biologic therapies were used in 72.4% of patients, while cDMARDs were used in 27.6%.
  • Significant reduction in PASI scores from 31.9 to 10.8 (p < 0.001) across all treatments.
  • Higher incidence of adverse events observed with cDMARDs compared to biologics.

Conclusions:

  • Current EP treatment is diverse, highlighting the need for standardized guidelines.
  • Biologic therapies, especially IL-17 and IL-23 inhibitors, demonstrated favorable outcomes.
  • Prospective studies are warranted to confirm the efficacy of biologics in erythrodermic psoriasis.