Psoriasis is a chronic inflammatory, non-infectious skin disease. The pathogenesis may be related to genetic susceptibility and abnormal immune function of T cells. It can develop in different ethnic groups, genders and ages. There are no good large-scale findings on the incidence of psoriasis in China in recent years. A study back in 1984 showed that the incidence of psoriasis in China was 0.12%. Although the incidence rate is not high and is not life-threatening per se, clinical treatment is still tricky. The clinical presentation of psoriasis varies, from localized psoriatic plaques on the elbows and knees to generalized plaques of varying degrees, with most patients being evaluated as having mild disease and a few as having moderate to severe disease. Although it is difficult to determine the severity of psoriasis, most dermatologists agree that the patient’s perception of disease activity and the efficacy of previously used treatments also need to be considered when determining the severity of psoriasis. Topical medications, phototherapy and systemic therapies offer many treatment options for the disease. However, the treatments that are currently available do not seem to be sufficient to fully control psoriasis. The following are a few of the more common and effective treatments currently in use. Topical treatment Most patients can be treated topically, with vitamin D analogs and topical corticosteroids being the first-line drugs. Tazarotene can be used as an alternative to vitamin D when it is not effective. In some patients, dithranol and coal tar may also be used as treatment options. UVB phototherapy or photochemotherapy (PUVA) may be used in patients who have had poor results with local therapy. Systemic treatments such as methotrexate, cyclosporine, and avobenzoic acid are only used in patients who are not controlled by local therapy or phototherapy (due to treatment tolerance or toxicity). Corticosteroids: A single intradermal steroid injection can cure small plaques that continue to fade for several months. Topical steroids are fast-acting to control inflammation and pruritus, with temporary relief, and are most suitable for inter-rub areas and the face; continued use of steroids decreases efficacy, and long-term use of steroids can lead to skin atrophy and capillaries. Calcipotriol (Hercules): well tolerated, long-term relief But some patients have local burning sensation and skin irritation symptoms. Most suitable for moderate plaque type psoriasis. It is one of the best topical medications for efficacy. Tazarotene (Tazorac): Good efficacy, combined with steroid hormone can control skin irritation and improve the efficacy. Anthralin: For chronic plaque psoriasis, dithranol can be combined with other drugs or therapies, such as dithranol in combination with UVB or with tar baths and UVB. Short-course contact therapy in combination with UVB significantly delays relapse and can reduce the symptoms of erythema irritation. Combining with tar is less irritating than using anthraquinol alone and does not affect its antipsoriatic activity. For thicker lesions, a keratolytic agent may be used first, followed by the application of compounded dithranol. When the lesions have subsided, maintenance therapy is administered as appropriate. It is mainly an irritant to the skin, causing redness, burning and itching. Nail hair may be dyed reddish-brown. Tar : Newer preparations are easier to apply than before, but are only effective in certain patients. Combined with medium-wave UVB is the most effective. Medium-wave ultraviolet (UVB) light: The most effective topical treatment option is UVB therapy combined with tar or tazarotene. Combining tazarotene with medium-wave UVB therapy results in more rapid and effective clearance of lesions. Several studies have shown that Uv therapy combined with topical glucocorticoids has a shorter duration of induced regression. When calcipotriol is used in combination with UvB, its efficacy is better than that of UvB phototherapy alone. 2. Systemic treatment Local treatment has its limitations. Many patients with moderate to severe psoriasis do not respond to the most potent topical treatment options, or the lesions are so extensive that topical treatment is not feasible. Moderate to severe psoriasis, defined as lesions ≥ 20% of the body surface or unresponsive to topical therapy, can be treated with a variety of therapies, including phototherapy, PUVA, avobenzoic acid, methotrexate, cyclosporine A, or biologic agents. There are many systemic drugs available, some of which have potentially serious toxic effects. Methotrexate is very effective and is relatively safe and well tolerated. However, the need for regular blood tests and liver biopsies with methotrexate has forced many patients and physicians to abandon the use of this drug. PUVA is effective and relatively safe, and aveloxic acid enhances the efficacy of PUVA and can be used alone to treat plaque, pustular, and erythrodermic psoriasis. aveloxic acid has many similar side effects. Hydroxyurea is not hepatotoxic and is not a commonly used drug because it is effective in only a small percentage of patients. Cyclosporine has a rapid onset of action, but long-term use may impair renal function. In view of these problems, appropriate combination or alternate treatment regimens are recommended for patients with moderate to severe psoriasis. Combination therapy usually leads to better results. Favorable combinations include: topical vitamin D3 and topical corticosteroids; topical vitamin D3 plus systemic therapy; topical retinoic acid and phototherapy; and topical vitamin D3 and phototherapy. The following treatment combinations can increase toxicity and should be avoided: retinoic acid and cyclosporine A (cytochrome P45O); cyclosporine A and phototherapy; methotrexate and avidin (hepatotoxicity). The main purpose of alternating treatments is to minimize cumulative toxicity, switching from one treatment to another before the initial treatment reaches toxicity levels, or an increase in side effects due to a gradual decrease in the effect of the initial treatment. Alternating therapy after a relatively long period of application (months or years) reduces the cumulative toxicity of the drug. The first alternating treatments used were UvB plus tar, PUVA, methotrexate, and etretinate, which were alternated every 1 to 2 years. Topical agents, systemic agents, and phototherapy can be used alternatively. Biologic agents may also play a role in alternating therapy. In severe patients with poor efficacy of topical, phototherapy and systemic therapy or with contraindications to treatment, specific antibodies produced by bioengineering techniques can also be used to neutralize, seal and modulate the individual immune abnormalities of psoriasis, resulting in a much improved clinical outcome. For example, the use of infliximant for ten weeks resulted in an average 75% reduction in PASI scores in approximately 80% of patients with plaque psoriasis. Twice weekly subcutaneous injections of etanercept/Enbre1 resulted in an 8 87% improvement rate in patients with arthritic psoriasis after 12 weeks. The introduction of these new drugs undoubtedly brings new hope for the treatment and overcoming of psoriasis. New drugs and therapies have to undergo extensive clinical practice to determine their role in the treatment of psoriasis. In summary, there are many drugs and methods for the treatment of psoriasis. Each treatment drug and method has its own advantages and disadvantages. It cannot be said which drug or method is the best. How to complement and combine the advantages of these drugs or methods to achieve improved efficacy, reduced adverse effects, prolonged remission, reduced costs and improved compliance is an issue that every dermatologist should focus on. When formulating a treatment plan, besides considering efficacy, safety, clinical type and severity of the disease, type and location of lesions, gender and age of the patient, and response to previous treatment, attention should also be paid to the long-term adverse effects, efficacy/price ratio, pros and cons of the therapeutic drugs and methods, and sometimes to the psychological treatment of the patient. Therefore, the treatment of psoriasis should be individualized and evolve with the times. Psoriasis itself does not cause death, but can seriously affect the quality of life of the patient. Therefore, quality of life is an issue that should be given special attention during the treatment of psoriasis. Unlike heart disease and respiratory disease, the impact of psoriasis on patients’ quality of life is mainly in the areas of emotional, psychological and social functioning. The skin is the exposed organ of the human body, and if the impact of skin lesions on patients’ self-image and psychological state is not taken seriously, sometimes patients may still feel dissatisfied with the treatment results even if good clinical treatment results are obtained. One study found that there are psychological characteristics that correlate with changes in the disease as the condition worsens, such as the need to always ask permission to do things, fear of negative evaluation, difficulty expressing anger, and the development of depression. Therefore, some scholars have proposed that the patient’s self-evaluation as a criterion for the severity of psoriasis disease also has some merit. Therefore, in clinical diagnosis and treatment practice, it is important to educate patients to correctly understand psoriasis for disease control; and to deepen the public’s understanding of psoriasis by means of relevant public education with the power of the government will also help improve the overall quality of life of patients. Current treatments cannot completely eradicate psoriasis, but can only suppress the disease flare-ups to a certain extent. In many cases, this suppression does not reach a satisfactory level. The current state of medicine can only do so much, but many patients do not understand this and often demand the complete elimination of the damage caused by psoriasis (eradication of the root cause). In addition, many treatments are expensive, not easy to apply long-term or have significant toxicity, so patient compliance with treatment is poor. One study showed that 40% of adults seen in psoriasis clinics sometimes or never comply with medications prescribed by their doctors. This requires that a reasonable treatment goal and plan be developed for the patient prior to treatment, a process that requires both the physician and the patient to work together. The characteristics of the course of psoriasis should be explained to the patient at the initial consultation, and based on this, realistic treatment goals should be developed with the patient. Rapid relief is usually needed to encourage compliance with medications and to maintain prolonged remission in a safe manner. In addition, based on our long-term experience in treating psoriasis, we have summarized a set of treatment methods with Chinese medicine characteristics combining Chinese and Western medicine, such as oral administration of Chinese herbal medicine, herbal medicine bath, narrow-spectrum ultraviolet irradiation, packet sealing and acupuncture point injection, which have greatly improved efficiency. After the rash has mostly or completely disappeared, we give Chinese medicine long-term conditioning to prevent recurrence, which has won the approval of the majority of patients.