The use of psoriasis herbal topical drugs should follow the different stages of progressive, quiescent and receding phases, and the efficacy should be moderated to increased and then moderated again; the concentration should be reduced from low to high and then reduced in a cyclic pattern to avoid stimulating new rashes due to isomorphic reactions. The progressive and receding phases of psoriasis and the migration between the various types of psoriasis may all belong to the pre-stable or unstable phase of psoriasis. In the choice of topical drug form, a single ointment or aromatic wax cream without irritation should be chosen as far as possible (fragrant oil fried group medicine, proportionally blended into yellow wax), and some even use only some powder, lotion or no rubbing of topical drugs. Dermatology Department of Tangshan Workers’ Hospital Liu Guohai Acute progressive psoriasis internal medicine is based on heat-clearing and detoxifying traditional Chinese medicine or proprietary Chinese medicine, and ultraviolet radiation or strong topical drugs are prohibited. The concentration of topical medication treatment increases gradually from low to high. When the skin lesions are red in color and in sensitivity, it is appropriate to use soothing and non-irritating topical drugs such as Qingliang cream, Lingbai cream, Huanglian cream and Xiangwax cream, etc. Bathing should be moderate, the water temperature should not be too high, hot water scalding is prohibited, and not too much rubbing and scaling should be removed. Those with limited skin lesions can be treated with topical drugs alone, while those with extensive skin lesions should be given regular systemic treatment at the same time. The use of western topical drugs for psoriasis Western topical drugs for psoriasis also need to follow the principle of applying different concentrations and strengths for different conditions of the rash, “too much is too little”, and appropriate topical drugs are the key to psoriasis treatment. For areas with more skin, tendons, bones, less gas and less blood (such as the back of the hands, scalp, shin front of calves); inter-rubbing areas (such as axilla, femur, waist, cleavage); and ring-shaped lesions with obvious itching; those whose lesions are stubborn and do not recede despite treatment; all should consider whether the treatment is resisted due to the involvement of bacterial exo-endotoxin, Candida albicans and Malassezia furfur in the isomorphic reaction of psoriasis, and give the corresponding anti-toxic ( bacterial, fungal, viral, protozoal, etc.) topical treatment. Although the topical application of glucocorticosteroids can provide temporary relief, it is very likely to lead to drug resistance or rebound and breeding of microorganisms at the lesions, which will instead prolong the course of treatment, so long-term or individual use is not recommended. The principle of this treatment is to dissolve keratin and exfoliate epithelium, so tar and other keratin reducers, salicylic acid keratolytics and retinoids can be used alternately. The commonly used drugs are 5%-25% black bean distillate ointment, 5%-10% salicylic acid ointment, 10%-20% urea ointment, 0.025%-0.1% vincristine ointment, etc. The low concentration is suitable for thin infiltration and less scaling, and the high concentration is suitable for the limited hypertrophic lesions. The lesions at the scalp can be washed with compound coal tar shampoo, and topical application with 5% salicylic acid ethanol or skin spirit.