Diffuse rash with silvery scales and anasarca

Abstract

A 67-year-old African American female with a history of psoriasis presented with a rash for 9 months. The rash began on her back and limbs, did not resolve after a short course of oral steroids, and expanded. Review of systems was positive for edema of all limbs and hair loss. She denied any precipitating illness/injury, changes in medication, or substance use. She received topical triamcinolone and intravenous antibiotics with minimal improvement. Exam was significant for diffuse rash with silvery scales, with flakes covering her entire body and anasarca particularly in her limbs (Fig 1).