The goals of treatment are to rapidly control the disease; slow the progression to the whole body; reduce symptoms such as erythema, scaling, and thickening of local patches; stabilize the disease and avoid recurrence; avoid side effects as much as possible; and improve the patient’s quality of life. It is usually unrealistic to completely clear the skin lesions. Communication with the patient and assessment of the patient’s condition during treatment is an important part of treatment. When single therapy is not effective in patients with moderate or severe psoriasis, combined, rotating or sequential therapy should be given. There are various treatment methods for psoriasis such as topical medication, internal medication and physical therapy, which should follow the principles of formal, safe and individualized treatment. Formal: Emphasis should be placed on the use of currently accepted therapeutic drugs and methods in the dermatological sciences. Safety: All treatment methods should ensure the safety of the patient as the first priority. The pursuit of immediate efficacy should not lead to the occurrence of serious adverse reactions. Individualization: When choosing a treatment plan, the patient’s condition, needs, tolerance, affordability, previous treatment history and adverse reactions to drugs should be taken into account in a comprehensive manner to reasonably formulate a treatment plan. Topical drug treatment is still the main method of psoriasis treatment. However, no matter what treatment method is chosen, clinicians should weigh the pros and cons and determine it according to the type, manifestation and severity of psoriasis as well as the patient’s choice. The choice of psoriasis treatment (a) Classification of psoriasis severity: Before formulating a reasonable treatment plan for psoriasis patients, clinicians need to assess the severity of psoriasis. A simple way to define severe psoriasis is called the 10-point rule: i.e., BSA (body surface area involved) >10% (area of 10 palms), or PASI >10, or DLQI (dermatologic quality of life index) >10 is considered severe psoriasis. (2) The choice of treatment plan for each type of psoriasis: Treatment of mild psoriasis External drug therapy is the main treatment, and the strategy of combination, rotation and sequence can be considered Phototherapy Internal treatment with Chinese and Western drugs when necessary, but possible adverse drug reactions must be considered Treatment of moderate to severe psoriasis Chinese medicine Ultraviolet light Photochemotherapy Methotrexate Cyclosporine Vitamin A acid Biological agents Combination therapy (3) Combination, rotation and sequence therapy 1. The basis of combination therapy for psoriasis is that different drugs have different mechanisms of action, and they synergize or add up to each other at the smallest dose to achieve the best effect with the least adverse effects. Once the psoriasis lesions are effectively cleared, the number of combination therapy drugs should be gradually reduced and one of the drugs should be used to maintain the treatment. Commonly used combination therapies: ? Chinese herbal medicine plus topical medication/phototherapy;? Avelox plus UVB/PUVA/cyclosporine/biologics; cyclosporine and methotrexate (both in small doses) plus phototherapy/biologics; mycophenolate and cyclosporine (gradually reduce the dose of cyclosporine); topical medication plus Avelox/phototherapy. 2. Rotational therapy The main purpose of rotational therapy is to minimize cumulative toxicity by switching from one therapy to another before the initial therapy reaches toxicity levels; or by switching due to a gradual decrease in the effect of the initial therapy and an increase in adverse effects. Topical drugs, internal drugs and phototherapy can be used alternately. 3.Sequential treatment In sequential treatment, clinicians sequence specific treatments to achieve the best effect of the initial treatment and to reduce long-term adverse effects. Sequential therapy consists of three phases: Clearance phase: selection of fast-acting drugs, but often have greater adverse effects; ? Transition phase: Once the patient improves, maintenance drugs are used and the dose of fast-acting drugs is gradually reduced; Maintenance phase: Only maintenance drugs are used. Rapid-acting drugs and maintenance drugs can be applied in combination during the clearing phase, aiming to improve the efficacy. The various current treatments for psoriasis can only achieve near-term efficacy and cannot prevent relapse. The following points should be noted in treatment: ① Explain the condition and basic knowledge to patients, cooperate with psychotherapy, relieve mental burden and try to avoid various triggering factors. ②Unusual psoriasis is not harmful to health, so do not blindly pursue complete treatment and adopt drugs that can lead to serious toxic side effects, such as systemic use of corticosteroids and immunosuppressants, which will worsen the condition and transform into pustular or erythrodermic psoriasis. (3) For psoriasis vulgaris, acute punctate psoriasis, erythrodermic psoriasis and pustular psoriasis that are in progress, mild drugs should be used externally, and topical drugs with strong irritation are prohibited.