1. Is psoriasis really ringworm?
A: Psoriasis is actually not ringworm. Ringworm is a medical condition caused by fungal infections, such as ringworm of the head, ringworm of the body, ringworm of the hands and feet, ringworm of the fingernails, etc. The local dander of these ringworm can often be found under a microscope as fungal hyphae or fungal spores, and treatment with antifungal medications often has good results. Psoriasis, on the other hand, is not caused by a fungal infection and is medically referred to as psoriasis. It has a complex pathogenesis and treatment with antifungal drugs is often ineffective. Therefore, do not look to the text and take antifungal drugs or use ringworm topicals indiscriminately on your own to avoid wasting money and aggravating the condition of psoriasis.
2.What causes psoriasis?
A: The exact pathogenesis of psoriasis has not been fully understood, but the more consistent understanding is that the disease is a multi-factorial (or multi-genetic) complex disease related to the environment, genetics, and immunity. In addition, factors such as infection, humidity, cold, menstruation, pregnancy, childbirth, trauma, surgery, alcohol consumption, spicy food, drugs, emotional stress, overexertion and mental trauma
3.What is the incidence of psoriasis?
A: The incidence of psoriasis in the population is 1~3%. According to the epidemiological survey of psoriasis in 1984, the prevalence rate of men was 0.193%, which was higher than that of women at 0.139%. The standardized prevalence rate is 0.20% in 12 cities in the north and 0.14% in 14 cities in the south, and the standardized prevalence rate is 0.18% in 6 rural areas in the north and 0.065% in 14 rural areas in the south, the prevalence rate in the north is obviously higher than that in the south, and the prevalence rate in cities is higher than that in rural areas.
4.Is psoriasis related to geographical environment?
A: According to the survey in 1984, the incidence of psoriasis is higher in the north than in the south, and higher in the city than in the countryside, which is related to the temperature, sunlight exposure, production work and living habits. In contrast to rural areas, urban life is characterized by industrial pollution, fast-paced life, strong competition and excessive psychological burden.
4.The relationship between psoriasis and climate and temperature?
A: Most of the patients are heavy in winter and light in summer, a few of them develop in other seasons, some of them have obvious seasons in the early stage, but there is no seasonality after repeated attacks. The average annual temperature, air pressure, relative humidity and total annual precipitation are obviously negatively correlated with the incidence of psoriasis.
5.Is psoriasis contagious?
A: People suffering from psoriasis, especially the elderly or young couples, are very worried about infecting their family members and beloved children, and some people worry that psoriasis patients at home will infect each other, which is actually completely redundant. Psoriasis is not a contagious disease, there is no contagious, no matter how close contact will not be infectious to others.
6.Can people with psoriasis get pregnant?
A: At present, there is no prenatal diagnosis of psoriasis on the fetus carried by pregnant women, that is to say, it is not yet possible to accurately predict the onset of psoriasis patients’ children, so psoriasis patients who want to get pregnant should fully understand the knowledge about psoriasis heredity, weigh the pros and cons from the perspective of eugenics, and finally make their own choice. Generally speaking, if a single parent has psoriasis, the chance of their children having the disease is about 16%, while if both parents have psoriasis, the chance of their children having the disease is about 50%, and there are no legal provisions about psoriasis patients not being able to get pregnant.
7.At what age are people prone to psoriasis?
A: The age of onset ranges from 6 days old infants to 91 years old. The age of first onset of the disease: 20-24 years old for men and 15-19 years old for women, 5 years earlier for women than men. The age of onset is mostly <34 years old, accounting for 75% of the total number of people investigated.
8.How many types of psoriasis are there in Western medicine?
A: Western medicine generally divides psoriasis into four types: the most common is the common type, which accounts for the majority of psoriasis, and the incidence rate accounts for more than 95% of psoriasis; other types include arthritic type, pustular type, and erythrodermic type. Among them, pustular psoriasis and erythrodermic psoriasis are mostly transformed from common psoriasis due to irregular treatment or even indiscriminate treatment, which should be highly valued by sufferers.
9.How many types of psoriasis are there in Chinese medicine?
A: There is no definite theory on the typing of psoriasis in ancient and modern Chinese medicine, and there are at least two types of dialectical typing and at most nine types, among which blood stasis, blood heat and blood deficiency are the most common. 1) Blood stasis type: the skin lesions are thick and infiltrated, dark red in color, and do not subside after a long time. (2) Blood-heat type: lesions are bright red, rash keeps appearing, erythema increases, shiny film is visible when scales are scraped away, punctate bleeding, with isomorphic reaction. It is accompanied by irritable thirst, dry stool, yellow urine, red tongue, yellow or greasy tongue coating, smooth or counted pulse. 3) Blood deficiency type: the lesions are pale, partially faded, with more scales, accompanied by dry mouth and dry stool. The tongue is light red, the coating is thin, and the pulse is slow and thin.
10.Does having psoriasis affect life expectancy?
A: There are four common types of psoriasis, namely common, pustular, arthritic and erythrodermic. Since psoriasis is a chronic inflammatory skin disease, generally speaking, it does not affect the life expectancy of patients, especially the life expectancy of patients with common psoriasis is almost no different from that of normal people. Although pustular and arthritic psoriasis may be accompanied by joint or liver and kidney function damage, secondary infection and electrolyte disorders, they are rarely life-threatening. It is worth paying attention to erythrodermic psoriasis, which is often caused by the indiscriminate use of hormones and anti-cancer drugs, and there are many reports of leukemia induced by anti-cancer drugs. Since erythrodermic type patients have capillary dilation throughout the body, flushed skin, large amount of skin flakes, impaired regulation of body temperature, etc., fever, edema, enlarged liver, increased heart burden, disorders of water and electrolyte balance and protein metabolism, etc., mortality rate can be as high as 10% or more, which must be brought to the attention of psoriasis patients, who must use drugs under the guidance of doctors, and must not take the initiative to Do not use drugs indiscriminately, so as not to cause serious consequences.
11.What kind of performance does common psoriasis have?
A: Psoriasis vulgaris is the most common type clinically, the initial lesions start as red pinhead or chestnut-sized papules, or slightly larger macules, which can gradually expand or fuse into patches, the surface covered with multiple layers of silvery white scales, gently scrape off the surface scales, gradually revealing a layer of light red shiny translucent film, if the film is scraped off again, a small amount of blood spots will appear, known as the film punctate bleeding phenomenon. The lesions can occur in all parts of the body, with the scalp, limbs and trunk being the most common, accompanied by itching of varying degrees.
12.What kind of performance does arthritic psoriasis have?
A: Simply put, in addition to the rash of psoriasis, there are also joint lesions. The incidence of arthritis in psoriasis patients is 6.8%. Patients are predominantly male. It is an asymmetric peripheral small arthritis, with small joints of the hands, wrists and feet, especially the end joints of the fingers (toes) being the most common. Joint symptoms often decrease or worsen with skin damage, and the joints can be swollen and painful, with limited movement and deformity. On X-ray, the edges of the affected joints may be eroded, and in severe cases, there may be osteolysis or hypertrophic arthritic changes. Patients with severe arthritic psoriasis are often accompanied by high fever and increased blood sedimentation.
13.What kind of performance does pustular psoriasis have?
A: This type of psoriasis is less common and is usually clinically divided into two types, namely, generalized pustular psoriasis and palmoplantar pustular psoriasis. Patients with generalized pustular psoriasis can have inflammatory erythema all over the body, and a large number of dense pinhead to chestnut-sized sterile pustules appear on the spots, which occur repeatedly and can appear in batches or one after another. The pustules often fuse and become lamellar pus lakes and keep expanding. They may be accompanied by systemic symptoms such as fever and lethargy. The lesions of palmoplantar pustular psoriasis are limited to the hands and feet, and mostly occur in the palms of both hands and the plantar areas.
14.What kind of performance does erythrodermic psoriasis have?
A: This type of psoriasis is characterized by generalized redness, swelling and desquamation, and erythrodermic changes, mostly due to improper treatment or other reasons, so that common psoriasis or pustular psoriasis is transformed into erythrodermic disease. It is common that the disease is triggered by the application of highly irritating topical drugs during the progressive stage or by the sudden discontinuation of a large number of long-term oral hormones or certain immunosuppressive drugs, and the patient’s whole body is diffusely flushed and has a large amount of flaking. It is often accompanied by fever, chills and other general discomfort. Superficial lymph nodes are enlarged. During the course of the disease, a large number of scales are shed every day, and the loss of a large amount of protein will lead to hypoproteinemia, coupled with the patient’s skin expansion and congestion, heat dissipation quickly, so it is easy to occur colds, pneumonia and other comorbidities, causing adverse consequences.
15.What are the characteristics of psoriasis in children?
A: The initial onset of psoriasis in children is mostly associated with infections, the onset of the disease is urgent and the rash lesions are characterized by droplet-like. Patients with acute punctate psoriasis often have a history of acute tonsillitis attacks before the onset of the disease. For recurrent tonsillitis, psoriasis can be improved or cured after removing the tonsils or giving antibiotic treatment.
16.What is the homomorphic reaction of psoriasis?
A: In the progressing stage of psoriasis, the skin is in a highly sensitive state to external stimuli. If the skin is rubbed, injected, needled or touched by trauma, or stimulated by other skin diseases, new psoriasis rashes can occur in the lesions or stimulated places, which is called the phenomenon of homomorphic reaction. Generally speaking, the more serious and active the disease is, the greater the possibility of isomorphic reactions. Therefore, progressive psoriasis sufferers should avoid scratching and trauma to prevent the occurrence of isomorphic reaction.
17.How is the process of development and regression of psoriasis vulgaris divided?
A: Western medicine divides the whole process of psoriasis vulgaris into three phases – the progressive phase, the stable phase and the receding phase. In terms of the course of the disease, the general order of lesion remission is from the progressive phase to the stationary phase, which can be long or short and varies from person to person, and then to the receding phase to achieve clinical healing. In the progressive phase, new rashes appear continuously, old rashes continue to expand, adjacent lesions often fuse with each other, inflammation increases, scales thicken, itching, and isomorphic reactions; in the stable phase, the development of the disease basically stops, no new rashes appear, old rashes develop slowly, and inflammation is reduced. In the receding phase: the rash gradually shrinks and flattens. There is a tendency to fade on its own, but most patients have their lesions gradually reduced or faded only after treatment.
18.What is reverse psoriasis?
A: We know that the preferred sites of psoriasis are on the scalp, trunk and extremities. In a few patients, the lesions mainly or only involve the vulva, under the breast, groin, umbilicus, armpit and other folds, and the lesions are exactly on the opposite side of the generally preferred sites, so it is called reverse psoriasis. This disease should be distinguished from friction erythema, seborrheic dermatitis in the folds and candidiasis.
19.Why is there so much scaling in psoriasis?
A: This is because the epidermal cells proliferate too fast. The normal epidermal turnover time is about 28 days, while the epidermal turnover time of psoriasis lesions is 3 to 7 days, and the growth cycle of normal epidermal cells is 457 hours, while it is only 37.5 hours in psoriasis, so that the epidermal cell turnover time is significantly shortened, and a large number of skin scales are produced as a result of accumulation and shedding on the skin surface.
20.What are the things that female psoriasis patients of childbearing age need to pay attention to?
A: Avoid taking oral retinoids, immunosuppressants and other drugs that have an impact on fertility.
21.Which drugs can induce or aggravate psoriasis?
A: It has been shown that ① β-blockers: propranolol, apranolol, etc.; ② non-steroidal anti-inflammatory drugs: including anandamide, pautazone, ibuprofen, diclofenac, etc.; ③ calcium antagonists (nifedipine, nimodipine, nicardipine), metformin, interferon-α; ④ hydroxychloroquine and lithium metal-containing drugs may induce and aggravate psoriasis.
22.What treatment methods are available for psoriasis?
A: Psoriasis is a chronic inflammatory and recurring disease. There is no treatment that can prevent the disease from occurring in advance or eradicate it without recurrence. However, there are many safe and effective therapies available for doctors to choose according to different types and severity of the disease, so as to bring relief, ensure the physical and mental health of patients and improve the quality of life of psoriasis patients.
(1) Systemic systemic therapy: It refers to the administration of drugs by oral, intramuscular or intravenous injection. It is generally used for patients whose rash involves a large body area or whose condition is more serious. Oral administration is convenient and safe, and there are many kinds of oral drugs for the treatment of psoriasis, and new drugs are still being researched and developed. Injectable administration is fast and highly effective. However, it is more troublesome, requires certain medical conditions, and is not suitable for long-term use.
(2) Topical topical drugs for rashes: skin diseases are mostly grown on the surface of the human body, and psoriasis is a disease that mainly damages the skin, which is very suitable for topical drug treatment. Topical drug treatment is characterized by convenient use, fast efficacy, small side effects, and easy to observe the efficacy and side effects. However, for patients with severe disease and large rash areas, topical topical medication alone is not effective enough and should be used in conjunction with systemic systemic therapy. The disadvantage of topical topical medication is that it sometimes affects the aesthetics and can easily soil clothing. The skin is a more sensitive and allergenic organ, so some drugs should be used topically in a gradual manner, starting with a small area and a small number of times to give the skin a stage of adaptation. Some drugs for systemic treatment can be made into topical dosage forms. At present, there are many kinds of topical drugs for the treatment of psoriasis, and they are still being developed and innovated. However, there are many old drugs that are still retained after years of clinical use, and experience has proved that these old drugs have the characteristics of exact efficacy, high safety and small side effects. Therefore, do not believe in new drugs. Under the guidance of experienced professional dermatologists, appropriate treatments and drugs should be selected scientifically and reasonably.
(3) Physical therapy: there are light therapy, photochemotherapy, bath therapy, mineral bath therapy, etc., are relatively safe and effective methods. As long as the proper use of the rash can make a large area as soon as possible to subside, and is not easy to recur. With the improvement of equipment and economic level, more and more patients can receive physical therapy nearby.
(4) Chinese herbal medicine therapy. Chinese herbal medicine has a unique style of treatment for chronic skin diseases, and although the treatment is slow, except for individual anti-tumor herbs, the side effects are generally small, which is conducive to long-term treatment. However, the efficacy of some herbal medicines needs to be further studied to determine.
23.What are the treatment principles of internal medicine for psoriasis?
A: Psoriasis is a disease that mainly affects the skin, especially the common type which rarely involves internal organs. The internal drugs need to be absorbed by the body first, and distributed, metabolized, transformed and excreted in the body, and this series of processes will affect various organs. As the saying goes, “medicine is toxic in three parts”, any medicine not only has the side of treating diseases, but also has the side of possible toxic side effects. The so-called “poison” refers to these toxic side effects. Although the possibility of toxic side effects is very small, before using drugs, we must weigh the pros and cons and think twice before doing so, and only when the benefits significantly outweigh the disadvantages, then use internal drug treatment. For psoriasis there is no drug to stop the disease from recurring, any drug or therapy is only to relieve the disease, it is difficult to fundamentally cure the disease. Therefore, the first thing to consider is the safety of any drug. You should not be eager to seek medical help and use drugs with large side effects at will, which will damage your body and make you regret it. Experienced regular physicians should decide the treatment plan and choose the treatment drugs according to the following information, such as the gender of each patient, age, the trigger of this attack, the area of rash involvement, the degree of erythema hypertrophy, the amount of flaking, the location of the rash, the previous treatment, the general health condition, the recent and long-term efficacy of the drugs, the side effects and toxicity of the drugs, the economic burden of the drugs, etc.
24.Which therapy is effective in treating psoriasis? How long does it take?
A: No one therapy is a special treatment for psoriasis. Individualized treatment is the guideline for doctors to choose a treatment plan, and doctors must take into account the patient’s condition, economic situation, distance and proximity, treatment time and other factors when formulating a treatment plan. When there are only a few rashes, it is often enough to use only topical drugs; if the lesions are large, it is necessary to use internal and external medicine + physical therapy or Chinese medicine; when using phototherapy, those with average economic status can choose NBUVB or PUVA, and those with good economic status can choose to add 304nm or 308nm phototherapy appropriately. Those who have ample time can choose inpatient treatment, and those who have tight time can choose outpatient treatment. If a single treatment does not work, you can choose a combination of therapies. How to choose the combination of treatment methods requires the doctor’s experience and combined with the patient’s condition. The treatment time varies from one area of the disease to another. If the psoriasis on the head and face is usually cured in 1 to 2 weeks, while the psoriasis on the trunk or extremities may take a month or more to heal. The current treatment technology cannot achieve the efficacy of “cure” or “never relapse”. Although it is not possible to “eradicate” the disease, many people can achieve several years or more without recurrence through reasonable prevention and scientific treatment by the patient. After healing, the skin around the body is the same as normal people, and no traces of lesions can be seen in appearance.
23.How to screen the false advertisements of psoriasis treatment?
A: 1) Promote reasonable use of medicine and green medical treatment. Sufferers should read more popular science books or articles on psoriasis prevention and treatment written by dermatologists in regular hospitals to increase their clear understanding of the disease; 2) Some false advertisements often seize the eagerness to seek treatment and promote their own treatment to achieve “quick effect”, “root cause” and “never relapse”. “Some even claim to use “gene therapy” to treat the disease. (3) Some patients waiting for consultation in regular hospitals are often “brainwashed” by medical trustees dressed as “warm-hearted people” and go to those irregular medical institutions, and in the end, they are not well and spend a lot of money. Therefore, psoriasis sufferers should beware of medical trusts to avoid being duped.
24.Who is the best doctor to treat psoriasis?
A: The prevention and treatment of psoriasis has always been “three parts treatment and seven parts prevention”, and the patient’s understanding and personal feelings about his or her condition cannot be replaced by any doctor. Patients should attach great importance to the prevention of psoriasis, proper prevention will be able to reduce recurrence or not recurrence, improper prevention will be continuous rash difficult to subside. Many triggering factors need to be carefully avoided or protected by patients. With scientific treatment and reasonable prevention, many patients can stop developing psoriasis for several years or even a dozen years, so in a sense, the most “cattle” doctor is precisely the psoriasis patient himself.
25.What are the problems that psoriasis patients should pay attention to in daily life?
A: Psoriasis patients should avoid the stimulation of smoking and alcohol, staying up late and fatigue, mood swings, mental stress, irregular life, unscientific diet, drug abuse and other problems that contribute to the aggravation of psoriasis.
26.Why should psoriasis patients pay attention to psychological self-regulation?
A: Research now confirms that psoriasis is also one of the psychosomatic skin diseases. A large number of psychological research shows that 30% to 46% of patients with psoriasis, the development process is often related to mental and neurological factors, short-term high mental stress, the burden of thought can induce or aggravate psoriasis, long-term worry and depression can cause psoriasis delayed. Therefore, adjusting the mentality, facing the existence of the disease, cooperating with the doctor’s treatment and actively preventing it are the magic weapons for psoriasis patients to overcome the disease.
27.Why should psoriasis patients pay attention to the prevention of infection?
A: According to the literature, 6% of patients have a history of upper respiratory tract infection, especially drippy psoriasis, erythrodermic and arthritic psoriasis are often accompanied by upper respiratory tract infection or tonsillitis and other diseases, and their anti-O values are increased. The proportion of pediatric psoriasis with upper respiratory tract infection or acute tonsillitis is 10%-20%, and it is generally believed that the occurrence of psoriasis is caused by the metamorphic reaction to bacterial toxins or viruses. Therefore, psoriasis patients should pay attention to their daily lives and avoid upper respiratory tract infections or infections of other systems.
28.Do psoriasis patients need to avoid eating?
A: Some so-called “hair products” have the possibility of causing psoriasis to relapse or aggravate, which requires patients to pay attention to the food that may cause their disease to relapse or aggravate in daily life, and avoid eating the same food if it causes the disease to aggravate or relapse more than twice. It is not advisable to avoid all “hairy foods” without analysis, because a long-term partial diet can lead to malnutrition, mental stress, lower immunity, and can also lead to aggravation or prolongation of the disease. Each patient’s “hair products” are often not exactly the same.
29.Can psoriasis be treated with hormones?
A: The hormone treatment of psoriasis mentioned by the patients usually refers to the medical glucocorticoids. Topical glucocorticoid treatment of psoriasis is one of the recognized treatment options at home and abroad, with good efficacy, and patients do not need to avoid using it. The site, course and method of its use need to be carried out under the guidance of a dermatologist in a regular hospital, so that the therapeutic effects of the drug can be brought into play to a great extent while reducing its side effects. Patients are not recommended to apply it freely on their own. The systematic use of glucocorticosteroids (oral or intramuscular injection) is absolutely contraindicated for the most common common type of psoriasis, and patients do not require quick effect and use it to avoid aggravation or transformation of the disease.
30.Is there a therapeutic drug or treatment method without side effects for psoriasis treatment?
A: So far, there is no drug or treatment for psoriasis that has no side effects. As long as the patient adopts the drug or treatment in the dermatology department of a regular hospital, the doctor will generally control its therapeutic effects and side effects well.