I. Treatment principles of psoriasis and the choice of treatment methods
Determine the goals of treatment.
(1) Strive for long-term remission in patients with initial onset;
(2) Chronic relapsing psoriasis treatment aims to improve patients’ quality of life and enhance psychotherapy;
(3) Patients with long-term flare-ups to induce remission and prolong the remission period, or to maintain the disease in a milder state.
Choice of treatment plan.
1, all patients should pay attention to psychological treatment.
2. Those with lesions less than 10% of the total body surface area should be treated with psychotherapy + topical medication. Tar, anthralin, retinoids, glucocorticoids and herbal medicines can be chosen. After the lesions are controlled, the number of medications can be reduced and the medications can be gradually stopped after maintaining the efficacy for a period of time in order to prolong the remission period or reduce the recurrence.
3.In the case of the first episode or sudden recurrence of long-term remission, possible triggering factors such as infection and mental stimulation should be actively searched for, so that the corresponding treatment can be taken. Antibiotics, vitamins, heavy metal-free herbal preparations, etc. can be applied, and glucocorticoids and immunosuppressants are prohibited or used with caution to avoid affecting the prognosis. Each recurrence is closely related to tonsillitis, tonsil removal can be done.
4, for long-term recurrent and heavy rash, rash area greater than 30% of the body surface area, should be a detailed analysis of the condition, with the general treatment methods are not effective, can be carefully selected methotrexate, retinoic acid drugs, phototherapy, hot spring bath therapy, etc.. The narrow-wave UVB phototherapy developed in recent years has achieved better efficacy in the treatment of psoriasis, and the side effects are small.
5.Joint therapy: In order to strengthen the therapeutic effect and shorten the course of the disease, joint medication is often used. Such as internal medicine + external medicine, external medicine + mineral bath + phototherapy, etc.
In the process of psoriasis treatment, most of them adopt ladder therapy, that is, the treatment is like going up the stairs, from the most ground level step by step, starting from the simplest life and skin care, and according to the development of the disease change to give skin topical drugs, topical drugs + phototherapy, topical drugs + Chinese medicine internal
Second, psoriasis should also pay attention to “three points of treatment, seven points of nourishment”
Psoriasis is a common chronic recurrent inflammatory skin disease. As the exact cause of psoriasis is not yet known, there is no special treatment to control its recurrence. For a few patients, psoriasis is a stubborn skin disease that requires lifelong treatment. Clinical observation shows that many patients have a hair once in several years or once in a dozen years, and some patients even get only once in a lifetime. 70% or so of patients are more satisfied after treatment, and it is quite important to pay attention to nurturing in ordinary life to reduce the recurrence of psoriasis.
Third, what is the hair of psoriasis
Hair products generally refer to the food that can cause the recurrence of old diseases and aggravation of new diseases after ingestion. The following types of food should be avoided in the course of the disease.
1.Vegetables: such as ginger, coriander, garlic, spices and benzene
2, meat: such as beef, donkey meat, mutton, dog meat, duck meat, pigeon meat, bird meat and its soup.
3, seafood category: in addition to fish, sea cucumber, crab, shrimp, etc.
4, spices category: pepper, pepper, fennel, cinnamon, mustard, mustard oil, chili sauce, instant noodle seasoning, etc.
5, all kinds of alcohol (including white wine, beer, wine).
Patients with psoriasis should have a high-protein, low-fat diet, and it is advisable to eat more beans, coarse grains, fresh vegetables and fruits; umeboshi and grapefruit have preventive and curative effects and can be eaten more often. There are individual patients who have aggravated their disease after consuming certain foods, which are mostly related to the differences in the organism and cause allergic reactions, and these patients should avoid eating accordingly. Some people advocate that general food can be eaten, just what food sensitivity to what to avoid, can not be generalized.
Fourth, psoriasis patients how to properly bath
For patients with common psoriasis, they should generally bathe diligently and use warm water and general soap for daily bathing. Each bath should gently wipe off some of the white scales on the lesions, which helps to strengthen the efficacy of topical medication when applied, but of course, it is also beneficial to patients who do not use topical medication. If you have the conditions, you can also take a mineral bath or medicinal bath.
V. Why not to abuse hormones
The application of (oral, injectable) glucocorticosteroids for the treatment of psoriasis vulgaris has a “good” recent efficacy on the surface, but the rash rapidly occurs and spreads after stopping the drug, and even induces erythrodermic type, pustular psoriasis, which aggravates the disease.
Sixth, avoid the application of toxic prescriptions
Some people believe that psoriasis is toxic to the presence of evil, and should take the treatment of “attacking poison with poison” to be effective. Mercury, light powder, huangdan, xionghuang, spotted vine, toadstools, aconite and other highly toxic drugs are formulated into various tinctures and creams, which are used to treat psoriasis externally. Large-scale use of the above drugs can cause damage to the liver and kidney functions and blood system of patients. Director Wang Junwei of the Department of Dermatology of the Second Affiliated Hospital of Henan University of Science and Technology advises you that it is best to go to a regular dermatology department to treat psoriasis.
VII. What issues should be noted in local treatment? Use irritating drugs cautiously in the acute progressive stage
Topical drugs are effective and economical in the treatment of psoriasis and avoid the side effects of systemic application, so they are a common treatment method for psoriasis. The following points should be noted when using them.
1, wash away the scales with hot water soap before applying the medicine so that the topical medicine can play a better role.
2, common psoriasis in the progressive stage, acute punctate psoriasis, erythrodermic psoriasis and pustular psoriasis to avoid the use of irritating topical drugs, so as not to aggravate the disease, or make the common psoriasis into erythrodermic psoriasis. Cause irritant dermatitis induced erythrodermic psoriasis occur.
3, when the lesions are extensive, low concentration of drugs should be used, and different drugs can be applied in different areas to reduce the excessive absorption of a single drug.
4.After the skin lesions are controlled, the number of drugs can be reduced to maintain the efficacy and prolong the remission period of the disease.
Avoid using drugs that induce or aggravate psoriasis
Clinical research has found that β-blockers (such as insulin, insulin), antimalarial drugs (such as chloroquine, borneoquine), lithium metal-containing drugs (such as lithium carbonate, lithium acetate), non-steroidal anti-inflammatory drugs (such as anti-inflammatory pain, pautazone, ibuprofen), cardiovascular drugs (such as digoxin, amiodarone), etc. can induce and aggravate psoriasis, making psoriasis stubborn and difficult to treat. Therefore, patients with psoriasis combined with other diseases should avoid using the above-mentioned drugs when using them clinically.