1, the lesions are initially pinpoint to lentil large inflammatory red papules, often in a dotted distribution, rapidly increasing, the surface covered with silvery white multilayered scales, like mica. After the scales are peeled off, the film phenomenon and sieve hemorrhage can be seen, the base is infiltrated, and there can be isomorphic reaction. The old rash can be coin-shaped, disc-shaped, map-shaped, etc.
2. The rash is usually found on the scalp, extensor side of the limbs, more often on the elbow joint surface, and often generalized to the whole body.
3, some patients can see nail lesions, the lighter the dotted depression, the heavier the nail plate thickening, luster disappeared. It may be seen in the oral cavity and mucous membrane of the pubic area. If it occurs on the scalp, bundles of hair can be seen.
4. Slow onset, easy to recur. There are obvious seasonality, generally heavy in winter and light in summer.
5. There may be a family history.
6. Histopathological examination shows hyperkeratosis and underkeratosis of the epidermis. There is accumulation of neutrophilic polymorphonuclear leukocytes in the stratum corneum and thickening of the spinous layer. The epidermal protrusions extend downward in a regular manner, the dermal papillae are edematous and rod-shaped, the blood vessels within the papillae are dilated, and there is inflammatory cell infiltration around the blood vessels.
Treatment of psoriasis – general treatment
Remove ideological concerns, eliminate mental trauma, avoid various triggering factors, and do not abuse drugs, especially stimulating drugs.
Treatment of psoriasis-external drug treatment
1.Keratinizing agents: mustard gas ointment, anthralin ointment, etc.
2.Corticosteroids: dexamethasone cream, enbrel cream, clofloxacin cream, etc.
3.Vincristine ointment
4.Calcipotriol
Treatment of psoriasis – systemic treatment
1.Immunosuppressants: strictly controlled for the common type (refractory), arthritic type, pustular type
2.Hormone: only for erythrodermic type, generalized pustular type, severe arthritic type
3.Vitaminic acid: 0,5-1,0mg/kg/day, teratogenic side effects
4.Cyclosporin A: 1-5mg/kg/day, increase to 6mg/kg/day after 4 weeks
Treatment of psoriasis-Physical therapy
Ultraviolet ray therapy is an important method for treating skin diseases. Traditional ultraviolet irradiation treatment methods include psoralen plus long-wave ultraviolet therapy and broad-spectrum medium-wave ultraviolet therapy. Narrow-spectrum medium-wave ultraviolet wavelength is more penetrating than broad-spectrum medium-wave ultraviolet, and can reach the papillary layer of the dermis. Narrow-spectrum medium-wave UV irradiation therapy is a kind of light therapy gradually developed in recent years, and its efficacy on some skin diseases such as psoriasis is better than that of broad-spectrum medium-wave UV, and the phototoxic reaction and systemic adverse reaction are less than that of long-wave UV therapy.
Treatment of psoriasis-Chinese medicine treatment
1. Blood-heat and wind-rich type (common progressive stage): The treatment is to clear heat and cool the blood to dispel wind, and the formula is to add and reduce the amount of Cool Blood and Four Objects Tang and Dissipate Wind.
2.Blood stasis in the skin (unusual stationary phase): the treatment is to invigorate the Blood and remove blood stasis.
3.Blood deficiency and wind dryness (unusual waning period): the treatment is to nourish blood and remove wind, with formulae including and reducing Angelica Drinking and Siwu Tang.
4.Dampness and heat (limited or palmoplantar pustular): the treatment is to clear heat and dampness.
5.Fire-poison incandescence type (generalized pustularity): the treatment is to remove the fire and detoxify the toxin, with Huang Lian Detoxification Tang and Wu Wei Disinfection Drink.
6, wind and dampness blocking the ligament type (arthropathy): the treatment is to remove wind and dampness, invigorate the blood and open the ligament, the formula with Douwuxiaosheng Tang and Santo Tang with addition and subtraction.
7.Psoriatic psoriasis (heat poisoning and yin injury type): The treatment is to clear heat and detoxify the toxins, nourish yin and cool the blood, with the formula of Qing Ying Tang and Sheng Wei Yin Drink plus or minus. Lei Gong Tang and Kunming Shan Hai Tang have reliable efficacy on common, palmoplantar pustular and arthritic psoriasis. Compound Qing Dai capsule (pill), Yu Jin Yin Qi tablets, Yin Qi Ling and Yin Qi Punch are mainly used to clear heat and detoxify toxins, and are suitable for the treatment of common psoriasis and other types of adjuvant therapy. Danshen is a traditional Chinese medicine for activating blood circulation and removing blood stasis; Qingkailin, Glycyrrhiza sweetener and Yansuuning injection are mainly herbal medicines for clearing heat and detoxifying toxins, and Huangqi injection is mainly used for regulating immunity.