New-onset erythrodermic psoriasis associated with antiepileptic drug use

Abstract

Erythrodermic psoriasis is a severe and potentially life-threatening dermatologic condition that can be triggered or unmasked by medications. We report the case of a 73-year-old patient who developed new-onset erythrodermic psoriasis following treatment with antiepileptic drugs (AEDs), specifically carbamazepine and levetiracetam, for autoimmune encephalitis. Despite discontinuation of the AEDs, the patient’s condition persisted and improved only after systemic biological therapy. Clinical presentation, together with histopathologic findings, supported a diagnosis of new-onset psoriasis rather than a drug-induced psoriasiform reaction. This case highlights the importance of recognizing AEDs as potential triggers for psoriasis in patients with no prior history. Given the severe complications associated with erythroderma, timely diagnosis and initiation of appropriate therapy are essential. Clinicians should maintain a high index of suspicion for medication-induced dermatologic conditions in patients presenting with new or progressive skin eruptions.