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Abstract: A 30-year-old Ms. Zhou had a red rash and scales on her trunk, accompanied by itching and pustules, and the area was relatively large, which belonged to the clinical manifestation of pustular psoriasis. She had a history of related diseases, and recently her symptoms worsened after taking folk remedies.
Basic information】Female, 30 years old
Disease Type】Pustular psoriasis
Hospital】Wuhan University Central South Hospital
Date of consultation】September 2020
Treatment plan】Medication (Olopatadine hydrochloride tablets, mometasone furoate cream, secukizumab injection)
Treatment Period】3 weeks of hospitalization and regular review
Effectiveness】The skin pustules have subsided, the color of the rash has become lighter, and gradually returned to normal.
I. Initial consultation
When she first saw Ms. Zhou, she had red rash and psoriasis with itching and pustules in many parts of her body, and said that she had developed the corresponding symptoms 10 years ago. A month ago, he came to our hospital for consultation and treatment because he blindly believed in prescriptions, which led to the aggravation of skin damage symptoms, pustules and fever of 39℃, etc. The preliminary diagnosis was pustular psoriasis, which was mainly induced by improper medication.
II. Treatment process
First of all, Ms. Zhou’s skin was examined, and it was found that there were densely distributed psoriasis and red rashes on the trunk and limbs of her body, and there were also scattered pustules, and because the symptoms were relatively serious, the patient was recommended to be hospitalized. After admission, the patient was required to undergo relevant examinations, including physical examination, blood routine, liver and kidney function, ultrasensitive C-reactive protein, and imaging examination, etc. No significant abnormalities were found. The treatment was mainly based on medication, including topical medication and internal medication, i.e. mometasone furoate cream and olopatadine hydrochloride tablets, and at the same time, the pustular symptoms were treated with secukinumab injection, and the pustular symptoms were relieved after medication, and the lesions were significantly reduced in extent and lightened in color, so the patient could be discharged at that time and was asked to review regularly.
III. Treatment effect
After the drug treatment, Ms. Zhou’s skin lesion symptoms were significantly relieved. The herpes in the skin pustules dried up when she was hospitalized for 2 weeks, and the skin lesions were significantly reduced in extent and lightened in color after 3 weeks of treatment, and there was no recurrence during this period. After the relevant basic examination, the physical condition was normal and the treatment effect was good, so the discharge could be permitted, but it was necessary to continue the regular application of secukinumab injection and to follow up at the hospital at any time if the uncomfortable symptoms appeared.
IV. Notes
Seeing that the patient’s symptoms improved, my heart was also very happy, and I instructed the patient to pay attention to the following aspects in daily life.
1, the patient in the diet as far as possible to avoid drinking alcohol, tea, coffee and other stimulating drinks, but also should avoid eating chili, garlic and other spicy stimulating food, can be appropriate to eat more fresh fruits, vegetables, while pay attention to drink more water to promote metabolism, help the recovery of skin damage.
2, patients are recommended to wear loose cotton clothing in life, to avoid repeated friction on the skin lesions caused by irritation, while paying attention to diligent change of bed sheets, open the windows, and keep the room clean and hygienic. Attention should also be paid to avoid repeated scratching of the affected area, so as not to cause infection.
3, patients can also appropriate exercise, such as running, yoga, mountaineering, etc., to help relieve stress, promote physical and mental health, and enhance the body’s ability to resist disease.
V. Personal insight
For the case of 30-year-old Ms. Zhou, due to years of poor treatment results, and blindly believe in prescriptions, resulting in the aggravation of the original condition, we need to be cautioned, in the body after the symptoms of discomfort should be timely to the regular hospital, so as not to delay the disease. The female patient’s skin damage symptoms had been significantly reduced at the time of the review after medication and lifestyle improvement, and I was very happy to see the smile on the patient’s face. Usually, if the symptoms of psoriasis persist or even appear to be expanding in scope, patients should go to the hospital in time for treatment and should not use drugs on their own.