Patient Question: Disease:Psoriasis Description:The patient is now 62 years old and has been suffering from psoriasis for 7 years, a lot of which is seen on the head, calves, limbs, elb and other parts of the body, and has been treated with Chinese medicine and Western medicine, but the effect is not obvious and the condition is getting worse. Previous treatment and effect: Chinese medicine treatment (snake bile powder infusion) in Beijing Chinese Hospital, combined Chinese and Western medicine treatment in Tianjin Changzheng Hospital, but the effect was not obvious, and Western medicine treatment (Dalisi ointment) in Air Force General Hospital, which had certain relief effect, relapsed after stopping the medicine. Now the area of psoriasis has increased, the itching is unbearable, the oozing fluid is serious, and the onset of the disease is symmetrical, and the local crusting is followed by cracking and bleeding. 2. And please recommend suitable remedies for me (including internal and external use) 3. I would like to ask you to guide me to overcome the disease and relieve my pain. Thank you. Department of Dermatology, Beijing Hospital of Traditional Chinese Medicine Department of Dermatology and Venereology, Peking University People’s Hospital Zhou Cheng replied: 1. Hello, your medical history and photos are very clear and very useful. Based on the history and photos, the diagnosis of psoriasis is certain. 2. Psoriasis is generally divided into four types: the common type, the pustular type, the arthritic type and the erythrodermic type. It can be basically determined that you have the common type. If there is also joint swelling and pain, you need to consider the existence of arthritic psoriasis, which needs to be determined by further laboratory tests and examinations. 3. If you only have these rashes in the photo, then your psoriasis is not too severe. For mild psoriasis, it is generally recommended to use topical medications, such as Halomethasone, Darex, Dextran, Tacrolimus, etc., which are safe and effective, and pay attention to moisturizing the skin and avoiding colds. If the rash does not subside or worsens, you can try ultraviolet light therapy and oral medication. Of course, there are many kinds of oral medications, which need to be used under the guidance of your doctor according to your specific situation, and some of them have more side effects. 4. psoriasis currently relatively new drug advances at home and abroad are: 1) topical: benenimod cream topical, very good effect, less side effects, but at present is still in the experimental stage, can not buy. 2) systemic use: a variety of biological agents, such as Yicep, class gram, Xumel and so on TNF-α antagonist, very good effect, also relatively very safe, but extremely expensive, some patients will also experience some side effects, recommended It is recommended for severe psoriasis of the common and arthritic types.