I. What are the traditional therapeutic drugs for psoriasis? Among the therapeutic drugs for psoriasis, the so-called traditional drugs are relative to the new targeted therapeutic drugs – biological agents. In the traditional drugs of psoriasis treatment guidelines both at home and abroad, Aveline, methotrexate and cyclosporine are listed as the first-line treatment drugs, in addition to leflunomide and lorazepam, etc. Second, what are the biological agents? Since the first biologic agent for psoriasis treatment, tumor necrosis factor alpha antagonist (etanercept, domestic Ixep), was marketed in the United States in 2004, new biologic agents have been introduced continuously, such as its similar products infliximab (class gram) and adalimumab (Xumile) have been applied in China for many years and have played a very good effect in the clinic. In 2019, there are even new targeted therapeutics, such as interleukin 12/23 antagonist (Usnu), interleukin 17a antagonist secukizumab (Cosentin) and echizumab (Topaz), as well as guselkizumab (Tenoia), which have entered the Chinese market, bringing miraculous results for the treatment of moderate to severe psoriasis. People define 2019 as the first year of biologics treatment for psoriasis. Third, psoriasis has been treated with oral methotrexate for more than 10 years, and it has been taken for four years so far. 2 months ago, thrombocytopenia appeared, can I still continue to take it? Methotrexate is the first-line treatment for psoriasis at home and abroad, but it must be used in accordance with scientific and reasonable principles, not exceeding 35mg per week and 1.5g in total in a course of treatment. Regular monitoring of liver and kidney function and blood count is required during the course of taking the drug. The following conditions should be discontinued immediately If the following conditions occur: 1. platelets <100x109/L or white blood cells <3.5x109/L; 2. liver function ALT is more than 2 times higher than the upper limit of normal value. You have been taking methotrexate for four years and the total amount of methotrexate is estimated to be much more than 1.5 g. Now you are experiencing thrombocytopenia and the bone marrow hematopoiesis is considered to be suppressed, so you are advised to stop methotrexate immediately and seek medical attention promptly. D. Can I continue to use Aviagen capsules if I have severe dry skin and peeling of the lips after taking them? Avia is commonly used in the treatment of moderate to severe psoriasis and has no significant hepatic or renal toxicity. It has a slow onset of action, usually 3 to 4 weeks. Avelia is the best drug for combination therapy and can be combined with phototherapy, methotrexate and topical medications to improve the effectiveness of treatment. The most common side effects are dryness of the skin mucosa and even peeling and cracking of the mouth and lips. Patients are expected to accept and tolerate such side effects by applying moisturizers to the skin and olive oil and lip balm to the mouth and lips to reduce discomfort. The drug should not be taken by women with severe hepatic or renal insufficiency, hyperlipidemia, pregnant or lactating women, and women who have the desire to have children within 2 years. Men are also required to use contraception during the drug and stop taking it for 3 months before conception. V. When using biological agents, do I have to continue to complete the induction period if I feel that the effect is not obvious before the induction period is completed? Most of the biological agents used for psoriasis treatment require induction doses and courses of treatment. Since it takes time for the drug to exert its therapeutic effect, the timing of assessing the therapeutic effect varies slightly for each biologic agent for psoriasis treatment, so do not be too anxious and insist on completing the induction phase of treatment. VI. Can biologics be used for patients with latent tuberculosis? Active tuberculosis is a contraindication to biologics. However, for patients with latent TB, i.e. no history of TB and contact, normal chest X-ray but T-Spot positive, the European guidelines for the use of biologics recommend prophylactic anti-TB treatment followed by biologics treatment. VII. Can biologics be used in patients with hepatitis B? Specific assessment is needed. ① Biologics cannot be used if liver function is abnormal. ②If liver function is normal, hepatitis B viral load measurement is required. ③Biotics are not recommended if the liver function is normal but the viral load is above normal. ④If the liver function is normal but the viral load is less than the minimum measurement value, antiviral therapy can be administered for 3 weeks before using biological agents and applied until 6~9 months after the biological agents are discontinued. Eight, can tonsillectomy really prevent psoriasis recurrence? The onset of psoriasis is clinically related to infection in some patients, and whenever the tonsils become inflamed, it will lead to recurrence or aggravation of the disease. For this part of patients, tonsils can be removed to reduce recurrence. Nine, can psoriasis take a bath? Psoriasis can be bathed diligently, and the scales on the lesions should be gently wiped off during each bath, which will help the topical drugs to be absorbed and thus play a better therapeutic effect. However, excessive scratching or rubbing should be avoided when bathing to prevent isomorphic reaction. It is recommended to apply moisturizing skin care products externally after each bath, which not only promotes skin barrier repair, but also reduces itching and discomfort due to dryness. X. Do I need to avoid eating in psoriasis? The question about whether psoriasis needs to be avoided is one that almost every patient asks in front of their doctor. In the real world, there are too many psoriasis patients who excessively abstain from eating meat, beef, lamb, eggs and seafood, and only eat potatoes and cabbage all year round, thus causing serious malnutrition and reduced resistance, which will on the contrary aggravate the disease and affect the recovery of the disease. There is no scientific evidence to prove that the onset of psoriasis is related to diet, patients need a reasonable diet and nutrition, and they can eat beef and mutton and seafood normally. It is worth emphasizing that alcohol should not be consumed during treatment.