Psoriasis is one of the common and difficult diseases in dermatology, and has become one of the key research diseases in dermatology because of its stubbornness and difficulty in healing and easy recurrence. Modern medicine is still unclear about its etiology and pathogenesis, especially in severe psoriasis, such as erythrodermic and pustular psoriasis, where patients are often accompanied by high fever and obvious systemic symptoms and are prone to change of evidence, which is also a problem in western dermatology. Hormonal drugs and immunosuppressants are commonly used to control the disease, but the disease will rebound in the process of reducing the dosage, and a large number of long-term applications will also have serious side effects and cannot control its recurrence, so it is of great clinical value to explore characteristic Chinese medicine treatment methods. Five years of clinical practice has proved that the use of acupuncture and bloodletting cupping and pure Chinese medicine therapy can control the clinical symptoms, improve the function of the skin, and achieve clinical healing, which is introduced as follows for sharing. I. Treatment of high fever In addition to external infection and other factors, high fever is the most common symptom of severe psoriasis, and it is often immune fever. Many doctors directly use hormones or immunosuppressants to control the disease, but the disease is difficult to heal, and even die because of complications. The following comprehensive treatment methods can often control the high fever. 1.Puncture and bloodletting cupping: select Dazhi, Lung Yu, Lingtai, and Guizhong, puncture and release blood with a trigeminal needle, and leave the cupping for 10 minutes to release blood and heat. 1 time a day, 7 days treatment course. 2, Chinese medicine static point: static point Qing Kai Ling injection 30ml added to 5% glucose static point, 1 time a day. Qingkailing is a modified preparation of Angong Niuhuang Pill, which has the function of clearing heat and detoxifying, resolving phlegm and clearing the ligaments, waking up the mind and opening the orifices. 3, oral Chinese medicine soup: Chinese medicine soup should be Rhinoceros horn Dihuang Tang as the main formula, the formula reuses raw gypsum 50g or more, and adds antelope horn silk 10g and tortoiseshell 10g to reduce fever and fix the womb. If the high fever persists, you can also add the Chinese medicine Angong Niuhuang Wan orally, clinical evidence, generally 7 days can make the high fever recede. Second, the treatment of skin Erythrodermic psoriasis and pustular psoriasis will have a large amount of desquamation, the skin loses protection and moistening, and often has the symptom of malignant cold, therefore, the topical drugs should be mainly moistening and protective, and should not be irritating. Clinically, simple petroleum jelly or pig cream can have good moisturizing effect, but the external application should be applied thinly, and the thickness will hinder the opening and closing of the skin’s air gates, which will make the disease difficult to heal. If there is local infection, you can also apply moist burn cream external rubbing, moist burn cream to rhubarb, Huang Lian, Huang Bai, bitter ginseng as the main medicine, the base is fragrant oil, can play the role of heat detoxification and moisten the skin. Third, the treatment of the late stage of the disease When the high fever subsides, the treatment of the disease should focus on restoring the function of the skin. At this time, due to massive desquamation, the skin guarding external function is poor, therefore, the fluctuation of body temperature around 37.5℃ is normal; since there is no normal skin all over the body, patients often have no sweat. The basic reason of psoriasis is that the cells do not die completely in the process of epidermal layer metabolism, and they remain and accumulate in the stratum corneum to form thick layers of scales; therefore, we should start from improving cell metabolism and restoring skin function; once the skin function returns (such as local sweating begins, or dotted islands of normal skin appear), the disease will develop in the direction of healing. Clinical practice has proved that Tu Fu Ling and Scutellaria are two important drugs, the dosage of Tu Fu Ling should be more than 50g effect, the rest of the treatment with the evidence to add or subtract. It should be noted that cold drugs should not be applied too much for too long, this is the evidence of fire, such as cold, cold, the formation of “cold fire”, but the heat does not subside. In clinical practice, patients often have purple color around the orbit and mouth, dark tongue and dark red skin color. In the later stage of the disease, the method of cooling and nourishing is clinically proven to be effective. Commonly used drugs such as Radix et Rhizoma Ginseng, Radix et Rhizoma Macrocephalae, Radix et Rhizoma Ginseng, Rhizoma Dendrobium, Radix Salviae Miltiorrhizae, Fructus Lycii, Radix et Rhizoma Huangjing, and the basic formula of “Dihuang Drink” from “The Golden Guide to Surgery” are effective and can speed up the recovery of the skin. Clinical practice has proved that the disease can be cured in 4-5 months. Daily care In the treatment of severe psoriasis, daily care is particularly important. First of all, the skin has poor external function and is not resistant to external wind and cold, so attention should be paid to keeping warm to prevent upper sensation. Secondly, the skin lesions are heavily desquamated, keratin is lost in large quantities, and patients will show weakness and lower limb edema. Therefore, food therapy should mainly be supplemented with collagen, and collagen can be supplemented with bone broth and pork skin jelly, which have better clinical effects. In summary, although severe psoriasis is one of the difficult diseases, as long as we understand its pathogenesis, understand its disease evolution process and pay attention to the overall diagnosis and treatment of Chinese medicine, we can achieve satisfactory results and even clinical cure.