From the Research
There is a significant association between erythroderma and heart failure, with erythroderma potentially leading to high-output cardiac failure due to increased cardiac workload and fluid loss through the damaged skin barrier. This association is supported by a recent study published in 2023, which found that 11.1% of patients with erythrodermic psoriasis developed heart failure during their hospital stay 1. The study also identified several risk factors for heart failure in patients with erythroderma, including advanced age, history of coronary heart disease, severe systemic symptoms, high concentrations of inflammatory biomarkers, and poor nutritional status.
Key factors that contribute to the development of heart failure in patients with erythroderma include:
- Increased blood flow to the skin, causing peripheral vasodilation and requiring the heart to pump more blood to maintain adequate circulation
- Fluid loss through the damaged skin barrier, leading to dehydration and electrolyte imbalances that further stress the cardiovascular system
- Potential for patients with erythroderma to develop tachycardia, hypotension, and edema as signs of developing heart failure
Management of erythroderma requires a comprehensive approach that includes:
- Treating the underlying cause of erythroderma, such as psoriasis, drug reactions, or cutaneous T-cell lymphoma
- Monitoring cardiac function and providing supportive care, including fluid management, temperature regulation, and sometimes cardiac medications if heart failure develops
- Addressing potential complications, such as sepsis, cardiac failure, adult respiratory distress syndrome, and capillary leak syndrome, which can be life-threatening if not recognized and treated promptly 2.
Overall, the association between erythroderma and heart failure highlights the importance of careful monitoring and management of patients with erythroderma to prevent and treat potential cardiovascular complications.