In the daily clinic treatment, I met a lot of psoriasis patients, see a lot of patients due to misunderstanding and irregular treatment led to aggravation of the disease, doubly saddened, so I will see these problems in the clinic and patients often ask the questions summarized below, with a view to psoriasis patients can increase some psoriasis prevention and treatment of scientific knowledge, to reduce the doctor treatment in the twists and turns and trouble.
1, “psoriasis” and “psoriasis” is the same thing?
The name “psoriasis” has two meanings, that is, the Chinese medicine called “psoriasis” is equivalent to the Western medicine dermatology “neurodermatitis”, while the common people called The “psoriasis” is the “psoriasis” in Western medicine, and the “psoriasis” in Western medicine is called “white H” in Chinese medicine. . Since the majority of patients are accustomed to call psoriasis “psoriasis”, and this name has unknowingly gained the “approval” of doctors, the current name for this disease – “psoriasis “The doctor and the patient basically consider it to be two names for the same disease. That is, commonly known as “psoriasis” = Western medicine “psoriasis.
2.What causes psoriasis?
The exact pathogenesis of psoriasis has not yet been fully understood, but it is relatively unanimous 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?
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 of 12 cities in the north is 0.20%, while that of 14 cities in the south is 0.14%. The standardized prevalence rate of 6 rural areas in the north is 0.18%, while that of 14 rural areas in the south is 0.065%.
4.What season is psoriasis good?
Most of the patients have a good incidence in winter, and a few have the incidence in other seasons. Some patients have an obvious incidence season in the early stage, but there is no seasonality after repeated attacks.
5.Is psoriasis contagious?
Although the common people call this disease psoriasis, but this “psoriasis” is different from the infectious ringworm, ringworm, ringworm, etc., psoriasis is not a fungal infection or infectious microorganisms caused, so there is no contagious.
6. Will psoriasis be passed on to the next generation?
Psoriasis is hereditary, and the literature reports that 4.4%-90% of people have a family history of psoriasis, and 11%-20% are reported in China. Some scholars have reported that if both parents are normal, 11.9% of the children suffer from the disease; if one of the two parents is sick, the incidence rate of their children is 18.4%; if both parents suffer from the disease, the incidence rate of their children increases to 50-70%. Compared to many diseases such as hypertension and diabetes, the heritability of psoriasis is not high, so there is no need to worry about psoriasis all day long because it has a certain degree of heritability.
7.What age are people prone to psoriasis?
According to the available data, the earliest onset of psoriasis is 6 days after birth, and the latest onset is 91 years old. Therefore, psoriasis can occur at any age, but it is thought to be mainly in young adults, with an average age of 28 years for men and 24.6 years for women.
8.What are the types of psoriasis in Western medicine?
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?
The ancient and modern Chinese medicine theory is still inconclusive on the typing of psoriasis, 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 lesions are thick and infiltrated, dark red in color, and do not subside after a long time. The tongue is purple and dark, or petechiae and petechiae are seen.
(2) Blood-heat type: Bright red lesions, rash keeps appearing, erythema increases, shiny film is visible when scales are scraped away, punctate bleeding, with isomorphic reaction. It is accompanied by irritability and thirst, dry stool, yellow urine, red tongue, yellow or greasy tongue coating, and smooth or counted pulse.
(3) Blood deficiency type: light-colored lesions, partially fading, more scales, with dry mouth and dry stool. The tongue is light red, the coating is thin, and the pulse is slow and thin.
10.What kind of manifestations 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, covered with multiple layers of silvery-white scales, gently scraping away the surface scales to reveal a layer of light red shiny translucent film. 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.
11.What kind of performance does arthritic psoriasis have?
Simply put, in addition to the rash of psoriasis, there are also joint lesions. The incidence of arthritis in patients with psoriasis is 6.8%. It is more common in men. It is an asymmetric peripheral arthritis of the small joints of the hands, wrists and feet, especially the terminal joints of the fingers (toes). 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.
12. What are the manifestations of pustular psoriasis?
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 may 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, mostly occurring on the palms of both hands and the plantar areas.
13.What kind of performance does erythrodermic psoriasis have?
This type of psoriasis is characterized by generalized redness, swelling and desquamation, and erythrodermic changes, mostly due to inappropriate 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.
14.What are the characteristics of psoriasis in children?
According to a large number of clinical data at home and abroad, the initial onset of psoriasis in children is mostly associated with infection, the onset of the disease is urgent, and the characteristics of the rash lesions are mostly drip-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.
15.What is the isomorphic reaction of psoriasis?
If the skin is rubbed, injected, pricked or touched by trauma, or stimulated by other skin diseases, new psoriasis rashes can occur in the lesions or stimulated places, and this phenomenon is called isomorphic reaction. According to statistics, the incidence of isomorphic reaction phenomenon among psoriasis patients is 11%~75%. Generally speaking, the more serious and active the disease is, the greater the possibility of isomorphic reaction. Therefore, patients with progressive psoriasis should avoid scratching and trauma to prevent the occurrence of isomorphic reactions.
16.How is the process of development and regression of psoriasis vulgaris divided?
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 sequence of lesion regression 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.
17.What is reverse psoriasis?
The lesions of a few patients mainly involve or only involve the vulva, under the breast, groin, umbilicus, armpit and other folds, and the lesions seem to be on the opposite side of the general prevalent parts, so it is called reverse psoriasis. This disease should be distinguished from friction erythema, seborrheic dermatitis in the folds and candidiasis.
18.Why is there so much scaling in psoriasis?
This is because the epidermal cells proliferate too fast. The normal epidermal turnover time is about 26-28 days, while the epidermal turnover time of psoriatic lesions is 3-4 days. The epidermal cell turnover time is significantly shortened. Therefore, a lot of skin scales will be produced.
19.What are the things that female psoriasis patients of childbearing age need to pay attention to?
Avoid taking oral retinoids, immunosuppressants and other drugs that have an effect on fertility.
20.What drugs can induce or aggravate psoriasis?
It has been shown that β-blockers: propranolol, apranolol, etc.; non-steroidal anti-inflammatory drugs: including anandamide, pautazone, ibuprofen, diclofenac, etc.; calcium antagonists (nifedipine, nimodipine, nicardipine), metformin, interferon-alpha; hydroxychloroquine and lithium metal-containing drugs may induce and aggravate psoriasis.
21.What treatments are available for psoriasis?
There are many treatment methods for psoriasis, which can be broadly divided into topical drug therapy, systemic drug therapy, phototherapy, surgery, Chinese medicine, biofeedback therapy, etc. Topical drugs include local hormone creams, immunomodulators, retinoids, emollients, etc.; systemic drugs include antibiotics, retinoids, immunosuppressants, biological agents, etc.; phototherapy includes narrow-spectrum medium-wave ultraviolet light (NBUVB), PUVA, 304nm high-energy ultraviolet light, 308nm excimer light, 308nm excimer laser, etc.; Chinese medical methods include drug fumigation therapy, Chinese medicine bath therapy, Chinese medicine immunotherapy, Chinese medicine immunotherapy, etc. Chinese medicine includes drug fumigation therapy, Chinese medicine bath therapy, Chinese medicine immune balancing therapy, etc.; biofeedback therapy is one of the psychological adjustment therapies.
22.Which therapy has good effect in treating psoriasis? How long does it take?
Individualized treatment is the guideline for doctors to choose the treatment plan. In formulating the treatment plan, doctors must take into account the patient’s condition, economic situation, distance, treatment time and other factors, for example, if there are only a few rashes, it is often possible to use topical drugs only. The distance is generally based on external oral therapy; when using phototherapy, the distance can choose home type phototherapy instrument, the distance can choose medical type phototherapy instrument, the economic situation in general can choose NBUVB or PUVA, the economic situation is good can choose to add 304nm or 308nm light therapy. 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 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 of them can be relapse-free for several years or more than ten years through reasonable prevention and scientific treatment by the patient. When there is no relapse, 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) Sufferers should read more popular 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?
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. The importance of psoriasis prevention is even more important than that of treatment, and proper prevention can reduce recurrence or no recurrence. If prevention is not done properly, the rash will continue to persist and be 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. Therefore, in a sense, the most “bullish” doctor for treating psoriasis is not a medical expert with a family of apricot trees and a wealth of knowledge, but precisely the psoriasis patients themselves.
25.What issues should psoriasis patients pay attention to in their daily life?
Patients with psoriasis should avoid stimulation by tobacco and alcohol, staying up late and fatigue, mood swings, mental stress, irregular life, unscientific diet, drug abuse and other problems that may aggravate psoriasis.
26.Why should psoriasis sufferers pay attention to psychological self-regulation?
Nowadays, research confirms that psoriasis is also one of the psychosomatic skin diseases. A large number of psychological studies show that the occurrence and development process of psoriasis in 30% to 46% of patients is often related to mental and neurological factors, short-term high mental stress and burden of thought can trigger or aggravate psoriasis, and long-term worry and depression can cause psoriasis to persist. Therefore, adjusting the mentality, facing up to the existence of the disease, cooperating with doctors for treatment and actively preventing it are the magic weapons for psoriasis sufferers to overcome the disease.
27.Why should psoriasis patients pay attention to the prevention of infection?
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 their anti-“O” value is 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 sufferers need to avoid eating?
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 recommended to avoid all “hairy foods” without analysis, because a long-term partial diet can lead to malnutrition, reduce immunity, and also induce aggravation or delay of the disease. If you have the conditions, you can also go to the dermatology department to do the relevant food tests to help identify the “hairy substances”.
29.Can psoriasis be treated with hormones?
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 glucocorticoids (oral or intramuscular) is absolutely contraindicated for the most common form of psoriasis. Patients do not require quick results and use them to avoid aggravation or transformation.
30.Is there a treatment drug or treatment method for psoriasis without side effects?
So far, there is no drug or treatment for psoriasis that has no side effects. Patients do not need to deliberately ask for it, as long as the drugs or treatments are adopted in the dermatology department of regular hospitals, doctors will generally control their therapeutic effects and side effects very well.