Stopping or tapering systemic corticosteroids in a patient with psoriasis is a recognised trigger of generalised pustular psoriasis. Before prescribing oral steroids for another condition, ask about psoriasis. If a steroid course is unavoidable, plan the taper with the dermatologist and warn the patient to report widespread pustules or fever promptly.
- Ask about psoriasis before prescribing oral corticosteroids.
- Avoid systemic steroids for psoriasis itself.
- If steroids are needed for another reason, taper slowly and review the skin.
- Warn patients to seek help for sudden pustules with fever.
Why it matters
A short steroid course given elsewhere can end in a dermatology admission.
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