Being a hepatitis B carrier is already a misfortune, and suffering from rheumatic immune diseases (e.g. rheumatoid, ankylosing spondylitis, etc.) or special chronic skin diseases (e.g. psoriasis, lupus erythematosus, pemphigus, etc.), you will have a feeling of having a house full of rain. And what happens when a rheumatologist or dermatologist, confined to his own specialty, does not know that you are a hepatitis B carrier or, even if he does, does not pay enough attention to it before giving you glucocorticoids (prednisone, etc.) or cytotoxic drugs (tretinoin, etc.)? I’ll tell you that it’s often the case that the gourd is pressed, and the immune tolerance to hepatitis B is often broken and causes hepatitis, liver failure and even death. I once met a patient who suffered from pemphigus (a rare skin disease) last September and was hospitalized in a dermatology hospital after taking prednisone tablets for a long time. The patient’s disease was controlled with aggressive treatment. However, two major illnesses in less than a year are undoubtedly a disaster for an ordinary family. After treatment with glucocorticoids or cytotoxic drugs, about 20% to 50% of hepatitis B surface antigen-positive patients can have varying degrees of elevated HBV-DNA load, some patients can experience elevated transaminases and jaundice, and severe cases can experience fulminant liver failure or even death. Regardless of the HBV-DNA load in hepatitis B carriers, prophylaxis with nucleoside analogs (lamivudine, entecavir, etc.) should be administered 2-4 weeks prior to the use of glucocorticoids or cytotoxic drugs. Just like elderly people who have to take prednisone for a long time due to a certain disease, they should add calcium tablets (prednisone can accelerate calcium loss), both belong to prevention before disease and prevention after disease. The above example also reminds every doctor that we should never be limited to the knowledge of our profession, the human body is an organic whole, not a simple combination of organs. In order to become a good doctor, we must have a holistic view, moreover, we must be knowledgeable and proficient, that is, extensive medical knowledge and profound professional knowledge. I think I should continue to work hard.