Diagnosis is made on the basis of the clinical manifestations of the disease, characteristics of the lesions, predilection for sites, and seasonality. Laboratory tests: show non-specific anemia, accelerated sedimentation, increased serum complement levels and C-reactive protein levels. Rheumatoid factor and ANA antibodies are generally negative, and blood uric acid is normal. Other ancillary tests: Histopathology: 1. Psoriasis vulgaris. Hyperkeratosis of the epidermis with hyperkeratosis, with neutrophil aggregation visible within the stratum corneum or in the upper spiny layer, called Munro microabscess and Kogoji spongy pustules, respectively; chronic inflammatory cell infiltration within the dermal papillae. Guan Xin, Department of Dermatology, Peking University Third Hospital, Beijing, China 2. Erythrodermic psoriasis. With features of psoriasis and chronic dermatitis, capillary dilation, dermal edema, inflammatory infiltration and sponge formation are more obvious. 3.Pustular psoriasis. kogoji spongy pustules are larger and dermal inflammatory infiltration is obvious. 4. X-ray examination of peripheral arthritis is characterized by: (1) asymmetric joint lesions. (2) The presence of joint ankylosis, periosteal new bone formation, erosion and osteolysis. (3) Distal phalangeal arthropathy, usually characterized by erosion, narrowing of the joint space, and intra- and peri-articular fluid accumulation. Complications Patients with psoriasis may have kidney damage, and may also have liver, eye, gastrointestinal, cardiovascular and other organ lesions. The prognosis of the disease is long, lasting from several years to several decades, during which it can recur. There are patients who heal spontaneously without medication and those who are aggravated by medication, and there are also patients who develop erythrodermic-like damage all over the body due to medication. There is no specific treatment for this disease, but it is not an incurable disease. Appropriate symptomatic treatment can control the symptoms. Because the disease is a chronic recurrent disease, many patients need long-term medical treatment, and various therapies have certain adverse effects. The main therapies are combination therapy, alternate therapy, sequential and intermittent therapy, etc. 1, topical drugs New lesions of small size, as far as possible, the use of topical drugs. The concentration of the drug should be low to high. The choice of which drug to use depends on the nature of the drug itself and the specific condition of the patient. (1) Vitamin D3 analogs. This class of drugs includes carbotriol and tacalcitol, which are more effective for plaque psoriasis. Carbotriol creams, ointments and lotions (for the head) applied topically twice daily are usually effective within 8 weeks and do not cause dependence with long-term use. The combination of this drug with glucocorticoids or UVB may improve the efficacy. It should be used with caution in patients with bone disease, calcium metabolism disorders and renal insufficiency to avoid causing hypercalcemia. (2) Glucocorticoids. Topical glucocorticoids are still the common treatment for psoriasis. Strong hormones are suitable for the head and palmoplantar area, and weak hormones are suitable for the face and inter-rubbing area. Ointments and creams are commonly used for general areas. For the head, solutions (propylene glycol) and gels must be used. Topical encapsulation therapy can significantly increase the intensity of action. The effect of glucocorticoids on the lesions is temporary. The initial effect is significant, and sudden discontinuation of the drug often results in a “rebound” phenomenon. For long-term use, intermittent therapy is recommended, i.e., one application every 2-3 days. The use of other drugs (such as vitamin D3 analogues, retinoic acid, etc.) can help consolidate the efficacy and reduce adverse reactions. (3) Anthralin. Commonly used in chronic plaque type psoriasis. It can be formulated as ointment, paste and paraffin agent. The commonly used concentration is 0.05%~1.0%, starting from low concentration and gradually increasing according to the patient’s tolerance. Do not use on the face and inter-rub areas and take care to protect normal skin. The lesions usually begin to fade after 2-3 weeks. (4) Vitamin A acid. Gels and creams (0.05%-0.1%) applied topically 1 or 2 times daily are effective for psoriasis. Because of the slow onset of action, it is generally not used as a first-line drug alone. It can be used in combination with glucocorticoids such as clobetasol propionate, and tazarotene is continued after the lesions are controlled, and glucocorticoids are gradually discontinued. Pregnant women, lactating women and women with recent childbirth requirements are prohibited. (5) Tar. Commonly used tar, including coal tar, pine distillate, bran distillate and black bean distillate, etc., formulated into a 5% concentration of ointment for external use. Coal tar is more effective for chronic stable psoriasis, scalp psoriasis and palmoplantar psoriasis. It is contraindicated in pregnant women and in pustular and erythrodermic psoriasis. A number of colorless, odorless coal tar preparations are available that are close to the effectiveness of crude products. Soluble coal tar can be used for bathing and coal tar shampoo for shampooing hair. Coal tar spiritus is used for application, which is effective for the treatment of head psoriasis. (6) Other topical drugs such as immunosuppressants. Such as tacrolimus, pimecrolimus topical treatment, sealing package for the treatment of intractable limited psoriasis. 0.03% camptothecin ointment, 5% salicylic acid ointment, etc. MTX can inhibit the proliferation of activated lymphocytes in vivo, weaken the function of CD8 cells and inhibit the chemotaxis of neutrophils, MTX is the standard drug for the systemic treatment of psoriasis, but long-term use of the drug can cause extensive liver MTX is indicated for erythrodermic, arthritic, pustular, and pancytopenic psoriasis. pustular, generalized psoriasis, and those who have poor results with other conventional treatments. Avoid use in the presence of abnormal liver and kidney function, pregnancy or lactation, reduced white blood cell count, active infectious diseases, alcoholism, immunodeficiency and other serious diseases. (2) Retinoic acid. Retinoic acid drugs can regulate epidermal proliferation and differentiation as well as immune function, etc. They are used for generalized pustular psoriasis, erythrodermic psoriasis and severe plaque psoriasis, and have satisfactory efficacy when taken alone or in combination with other therapies. The main side effect of the drugs is teratogenicity, and the study proves that 2 years after stopping taking Avastin, Avastin is still measured in urine, and part of Avastin can be converted into Avastin, therefore, women of childbearing age should take contraceptive measures within 2 years after stopping the drug: dryness of lips, eyes and nasal mucosa, diffuse skin flaking and hair loss occur during the drug. Elevated blood lipids may occur with long-term use. Liver damage, etc., but can recover after stopping the drug. (3) Glucocorticoids. This kind of medicine should not be used routinely and systematically for psoriasis, because the effect is not great, and the symptoms are even more serious than before after stopping the medicine, and may even induce acute pustular psoriasis or erythrodermic psoriasis. However, because of the “anti-inflammatory” effect of glucocorticoids, they can be used with caution for erythrodermic, arthritic and generalized pustular psoriasis when other therapies (such as MTX) are not effective or are contraindicated. (4) Immunotherapy and biologic agent therapy. Immunosuppressants such as cyclosporine A, tacrolimus and mycophenolate are currently used in severe psoriasis with good efficacy. The application of some new biological agents, such as cytokine blocker etanercept (Yicep), is a new development in the treatment of psoriasis, but it is expensive and has adverse reactions, so its clinical application needs further observation. (5) Antibiotics. The occurrence and recurrence of some psoriasis are related to micro-object infections such as bacteria, fungi and viruses, especially acute punctate psoriasis is often accompanied by acute tonsillitis or upper respiratory tract infection, and these cases can be treated with penicillin and cephalosporins with good efficacy. Certain antibiotics also have immunomodulatory effects, such as erythromycin. Some patients with seborrheic areas have a large number of Malassezia, can be treated with ketoconazole lotion. 3.Physical therapy Ultraviolet light, photochemotherapy (PUMA), broad-spectrum medium-wave ultraviolet (BB-UVB) therapy, narrow-spectrum medium-wave ultraviolet (NB-UVB) therapy, spa therapy with topical drug therapy can be applied. 4.Chinese herbal medicine treatment Chinese herbal medicine and Chinese patent medicines such as compound Qing Dai pill, Lei Gong Tang, compound Dan Shen tablet can be applied.