History:

This man has had psoriasis vulgaris since 1990 started as localized psoriatic plaques on the extremities. The disease has progressed with time as more lesions appeared on other body regions like the trunk and scalp. Three years later, he developed psoriatic erythroderma with > 90% of the body areas were involved. It was controlled at that time with oral methotrexate and emollients and after 6 months he became well with disappearance of most lesions. Now, he presents with another attack of erythroderma involving almost all body regions as the pictures show. The rash associated with moderate pruritus but no systemic symptoms.