Psoriasis

Psoriasis-What is psoriasis?

Psoriasis is a common and recurrent inflammatory skin disease.Psoriasis commonly known as psoriasis. Lesions for symmetry Pan overlying silvery white scaly rash, plaques. Difficult to cure, easy to recur.

Psoriasis - OverviewPsoriasis is a common and recurrent inflammatory skin disease. Commonly known as psoriasis. Lesions for symmetry Pan overlying silvery white scaly rash, plaques. Difficult to cure, easy to recur. Course of the disease can be divided into the following period:
① carried Phase. May be associated with acute tonsillitis, acute onset, a bit like a red rash, skin debris, scratching the same skin lesions occur.
The ② resting. There are large patches, skin debris, and stationary.
③ catagen. Skin lesions subsided reduced. Also abscess and systemic generalized manifestations of fever, general malaise, it is easy to become erythrodermic. Joint type is associated with rheumatoid arthritis. The erythroderma systemic invasion that turns red skin, skin debris and permanently. Period should be focused on systemic therapy, do not use of irritating drugs, so as not to become erythroderma; still, the catagen focus on the topical; effective ultraviolet radiation; oral retinoid in recent years, UV irradiation, or combined with topical Anthralin or tar preparations ; oral medicine. Local available non-irritating the ointment Waicha, such as the Mourinho Split, 10% boric acid ointment, 10% urea cream, 5% white down mercury, salicylic acid ointment and so on. Paint on the drug before the scales will be washed away with hot soap. Systemic treatment available procaine intravenous seal or intramuscular vitamin B12, oral administration of vitamin C, folic acid and other. Also can use traditional Chinese medicine treatment
Psoriasis - etiologyThe etiology of this disease is not entirely clear in recent years, most scholars believe that heredity, infection, metabolism disorders, immune dysfunction, endocrine disorders.
1, geneticAccording to the clinical findings, this disease is often a family history and genetic predisposition. Abroad had reported a family history of 30% to 50%, and even individuals are stressed up to 100%. To reports, have a family history for about 10% to 20% on the mode of inheritance, it was felt that the Department of autosomal dominant inheritance with incomplete penetrance, and others argue that the Department of autosomal recessive or sex-linked inheritance. One of the parents suffering from psoriasis, their descendants incidence than the healthy children is three times higher if the parents are suffering from psoriasis, their descendants higher incidence.
In recent years, the histocompatibility antigen (HLA) and psoriasis significantly correlated. Abroad reported that patients with psoriasis, HLA-B13, HLA-B17 antigen frequency was significantly increased, but were also reported in patients with psoriasis HLA-B3, and HLA-the CT7, HLA-W6 increased. Chinese patients with psoriasis in addition to HLA-B13, HLA-B17 antigen than the normal group was significantly higher, the HLA-DR7, and HLA-A19, gene frequencies were also increased. HLA-BW35, HLA-DR9, HLA-C7, HLA-DQ gene frequencies decreased. That psoriasis by multi-gene control, but also by environmental factors.
2, infection
Clinical practice has proved that the pathogenesis of psoriasis and upper respiratory tract infection and tonsillitis. 6% of patients with psoriasis has a throat infection. We found that many children with psoriasis and tonsillitis closely related. For example, a mother and her three children suffering from acute tonsillitis, disease control, there are three people in the psoriasis. Patients with antibiotic treatment. After removal of the tonsils, the rash can be significantly improved or subsided, the infection is an important factor in psoriasis.
Some scholars believe that the incidence of the disease and viral infections. It was confirmed that eosinophilic inclusion bodies in the prickle cells, but others deny its existence. Someone who by mouse inoculation, similar to the disease, skin lesions appear, and inclusion body found in the tissue slices. But its incidence is only 7.5% in the chicken embryo inoculation experiments, the success rate of 86.7%, the disease is strong nuclear division. Deoxyribonucleic acid (DNA) increased, the virus theory seems to have some basis, but so far not been able to cultivate the virus.
Recently the relationship between domestic Liu Zhengyu, who studies human cytomegalovirus (HCMV) infection and the pathogenesis of psoriasis, detected 86 cases of psoriasis in patients with HCMV-specific IgM, IgA and urine of HCMV-DNA positive rate. The results showed that patients with psoriasis active HCMV infection rate was significantly higher and urine of patients with HCMV-DNA positive rate was also significantly higher, indicating that patients with psoriasis in vivo active HCMV infection, the incidence and HCMV activation of a certain relationship.
3, and metabolic disorders
Psoriasis blood chemistry, chemical and skin diseases of the skin tissue pathophysiology research, failed to get interested in the results. Some people think that the pathogenesis of psoriasis and lipid metabolism disorder. On the etiology of this disease is not caused by class of lipid metabolism disorders. More from the change of metabolic enzymes. Four enzymes in the normal epidermis, the skin lesions of psoriasis patients, the lack of two kinds of them, and after healing of the lesions, two of the enzyme appeared again. Known psoriasis lesions, lack of cyclophosphamide adenosine (cAMP) is an epidermal chalone (Epidermal chalone) inhibit epidermal cell division, maintaining cell growth and disappearance of the balance between The other hand, cAMP activation of phosphorylase, and thus affect the metabolism of glycogen. Such as increased epidermal glycogen, which can cause epidermal cell mitosis increases, the conversion rate increased. But psoriasis metabolic abnormalities are manifold, not only cAMP lack of increase in lesions of the surface of the inner ring phosphorus (cGMP), guanosine, free peanuts, arachidonic acid, multi-amines, the proliferation of epidermal cells also play an important role.
Psoriasis but is worth mentioning that some scholars believe that the decision epidermal cell proliferation and differentiation, the proportion of cAMP and cGMP is very important, the proliferation of epidermal cells of psoriasis patients, incomplete differentiation and glycogen savings is due to the low cAMP and a high of cGMP, but not fully substantiated.
In addition, the adenylate cyclase activity in psoriasis, abnormal, adrenaline stimulation of this enzyme is very low, but higher response to prostaglandin E2, psoriasis skin cell membrane beta-adrenergic receptor activity is reduced. Prostaglandins also play an important role in the regulation of cyclic nucleotides. Cyclic nucleotides on cell proliferative response is a direct regulatory role in the synthesis of cellular polymer substances. That is, cAMP directly regulates the synthesis of DNA, so a direct role of cAMP on cell division and the formation of the enzyme.
4, immune dysfunction
The relationship between psoriasis and immunity has been subject to wide attention. The clinical use of immunosuppressive agents commonly used in the disease effects of methotrexate (MTX), cyclosporin A treatment of the imine significantly. Psoriasis patients with a variety of local or systemic immune dysfunction, the disease HLAB13, the B17 antigen expression highly correlated and so suggesting that the disease is an autoimmune disease. Immune pathogenesis of the disease is not yet fully understood. The more popular view is that psoriasis is caused by activated T cells, epidermal cell proliferative disease. Psoriatic lesions, dermal infiltration of activated T cells, these cells release gamma-interferon induced epidermal cell synthesis of tumor necrosis factor and interleukin 8, interleukin-6 cytokines such as to attract neutrophils in infiltration of the epidermis, resulting in dermal blood vessels to dilate, causing skin inflammation. In addition, mononuclear cells and epidermal cells release interleukin 6 and interleukin 8, or promote the proliferation of epidermal cells. Thereby making the psoriasis lesions to form a coexistence of pathological features of epidermal dysplasia and skin inflammation. The initiating factor on skin lesions of psoriasis T cell activation remains to be studied further. May be associated with infection, trauma, neuropsychiatric factors.
5, endocrine disorders
The relationship between psoriasis and the hormone, has long been the people's attention. This disease and pregnancy, childbirth, lactation, menstrual period. We observed in clinical practice, some patients with psoriasis during pregnancy rash mitigate or dissipated. Chuzch has been observed in 43 cases, 38% of patients with skin lesions subsided during pregnancy; domestic Liucheng Huang et al reported 169 cases of patients with psoriasis 6.2% in patients with endocrine related five cases of skin lesions healed during pregnancy or mitigate, but exacerbate postpartum. Xu Yan Chun et al reported 19 cases of 12 to 45-year-old female patients with psoriasis plasma estradiol levels determination, significantly higher than the normal control group, while plasma progesterone levels are significantly lower than normal control group. Therefore, they believe that the increase of plasma estradiol levels and lower progesterone levels may precipitate or aggravate the skin lesions of patients 12 to 45-year-old female crumbs. But some women in pregnancy lesions aggravate or deterioration, so some use long-acting contraceptive for treatment of the disease reports of a certain effect. In summary, we can see the disease and endocrine changes.
6, such as mental trauma, trauma or surgery, wet, Blood rheology, and physical and chemical factors and drugs to stimulate the onset of psoriasis patients also have a certain relationship.

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Psoriasis - pathological changesThe pathological changes of psoriasis psoriasis is epidermal hyperkeratosis and parakeratosis. Keratosis is not region-wide visible neutrophils constitute a small abscess, known as Munro's abscess. Granular layer is significantly reduced or disappear. Thickening of the stratum spinosum. The sudden extension of the epidermis, its the bottom widened, consistent with the adjacent epidermis sudden extension of the dermal papilla was clubbed, thinning of the upper stratum spinosum. Nipple capillary dilatation and congestion of the clinical Auspitz's sign. Seen around the shower horse cells, addicted to the infiltration of neutrophils and other.
Pathological changes of arthritis, psoriasis, psoriasis vulgaris above, and not repeat them here.
Erythrodermic psoriasis, pathological changes are more obvious for the inflammatory response and significant edema of the upper dermis, similar to psoriasis vulgaris.
The pathological changes of pustular psoriasis continuity acrodermatitis is characterized by the formation of large pustules, to Kogoj pustules, mainly in the epidermis upper part of the blister as neutrophil in the epidermis, and other changes and unusual silver The crumbs disease is roughly the same, but parakeratosis and epidermal sudden extension of the lighter.
Pathological changes of palmoplantar pustulosis for intraepidermal unilocular pustule, a large number of neutrophils in the blister, a small number of mononuclear cells, superficial dermal lymphocytes, histiocytes and neutrophils infiltration.
Psoriasis - Psoriasis of dietary considerationsFruits and vegetables? Plum, grapefruit: heat, cooling blood, thirst-quenching fluid's role is not only rich in vitamins and trace elements, can also lower blood lipids, blood viscosity.
Grapefruit and grapefruit: has been confirmed with inhibition of cell division, effective prevention and treatment of psoriasis in the summer fruits. The Huaihua have Qingreliangxue, Qufeng itching of the function.
Cabbage: Contains carotene, vitamin C and other ingredients. Their sexual sweet, warm, antipyretic, sedative effects.
Carrots: contain large amounts of carotene, can be added in patients with vitamin A deficiency.
Turnip: contains carbohydrates, calcium, phosphorus, carotene, vitamin C and other ingredients. Their sexual sweet, acrid, cool, with the role of clearing heat and detoxification, digestion, etc.
Eggplant: contains protein, carbohydrates, calcium, phosphorus, carotene, vitamin C and other. Their sexual sweet, cool, non-toxic, promoting blood circulation and cooling blood to the wind swelling and so on.
Taro: Contains protein, calcium, phosphorus, iron and vitamins. Their sexual sweet, acrid, flat, a small drug, clearing and detoxifying, blood stasis and swelling, tonic, analgesic, anti-inflammatory role.
Spinach: Contains protein, calcium, phosphorus, carotene, vitamin C and B1, B2, and so on. Their sexual tasteless, cold, non-toxic, with clearing and detoxifying, circulation and swelling and so on.
Potatoes: contains large amounts of starch, the other protein, fat, calcium, phosphorus, carotene, vitamin C and so on. Of sweet, acrid, cold, clearing and detoxifying, anti-inflammatory and lipid-lowering equivalent. Germination or potato skin is blue, with the toxicity of solanine and can not eat.
Rape: contains protein, fat, carbohydrates, calcium, phosphorus, iron and vitamins. Their sex spicy, warm, non-toxic, with the role of detoxification, blood swelling, clearing the lungs eyesight. However, pregnant women, mothers, peptic ulcer, and allergy system in patients unfit for human consumption.
Bitter: contains protein, carbohydrates, calcium, phosphorus, carotene, vitamin C, higher vitamin C content. Its nature is bitter, cold, detoxification role.
Cucumber: contains sugars, amino acids and B2, C and A, and other vitamins. Their sexual sweet, cool, has Qingrejiedu diuresis role.
Loofah: contains protein, carbohydrates, calcium, phosphorus, iron and vitamins. Their sexual sweet, cool, clearing and detoxifying effect.
Asparagus, a prevention and treatment of psoriasis of the dishes, of course, there are a lot of fruits, vegetables and cereals such as bean sprouts, mung bean sprouts, tofu, spinach, celery, tomatoes, beans, etc., all contain protein, calcium, phosphorus, iron, carrots hormone, vitamin C and other ingredients, nourishing and soothing heat and cooling blood, blood swelling of medical effects, can be beneficial in patients with psoriasis often edible fruits and vegetables? .

Psoriasis - Clinical manifestationsAccording to the clinical and pathological features of psoriasis, can generally be divided into an unusual type of arthritis type, pustular, palmoplantar pustulosis, erythrodermic, and continuity of acrodermatitis six inflammation type.
An unusual type psoriasis (Psoriasis Vulgaris) clinically the most common, most of the acute onset, the rapid extension of the body. The early damage is often red or reddish brown papules, or rash. Then gradually expanded to become a reddish brown plaque. Lesions covered by dry scales. Clear boundary, adjacent to the damage, can be compatible.
The scales of this disease was a silver-white, gradually thickened, scrape off the scales translucent film, it was known as a film phenomenon. The stripped film spotting, known as Auspitz's sign. Film phenomenon and Auspitz sign of psoriasis diagnosis specificity. Some patients the scales are thick and hard, was oyster shells, can affect the skin stretching. Pain in the articular surface of the thick hard scales are very easy to break the skin to chapped.
Psoriasis damage is much more varied, and some called guttate psoriasis rash was scaly teardrop-shaped; small scaly lesions located in the follicular openings, known as follicular psoriasis; scales showed an oyster shell known as the oyster shell-like psoriasis-like; some damage was irregular map-like, is called like psoriasis; the most common clinical damage is discoid or coin-shaped, called discoid or nummular psoriasis .
Psoriasis vulgaris can be generalized throughout the body, but the most common extensor limbs, especially the elbow, the knee, can be symmetrical, and sacrococcygeal. Scalp damage are also common and can occur in isolation, you can also coexist and systemic damage. Head damage clear boundaries, the hair was wispy, but not hair loss. (Toe) A can also be affected, a surface of a thimble or depression uneven. A surface lose their luster, and can also be thickened and pale yellow color, the deck and the nail bed separation, its free edge can be broken or tilt, a small number of patients with damage can occur in the lips, penis, penis, etc.
Psoriasis vulgaris according to the lesions were classified into three:
(1) The conduct of the old lesions but not subside and new lesions continue to appear. Lesions infiltration obvious, obvious inflammation, damage to surrounding flush, thick scales. This issue such as acupuncture, stab wounds, burns, surgery and other mechanical irritation to the skin, usually in 7 to 14 days later, to stimulate the skin around the typical psoriasis damage, known as artificial psoriasis (Psoriasis factitia), also known as the same type of reaction (isomorphism),, or Köebne phenomenon.
(2) long-term quiescent lesions have not changed much, almost no new rash appears, reduce the inflammation in stable condition.
(3) the catagen damage inflammation basic subsided, the rash to reduce or flatten. The pigment left over to reduce white spots or pigmentation spots. The disease often recurrent. Some patients began to have significant seasonal winter skin lesions summer remission or regression. After long-term healing. Small number of patients clinically cured after a long time not to relapse.
Themselves as having varying degrees of itching in this disease, recent foreign reports, pathological changes in internal organs of some patients with psoriasis, patients with psoriasis may be associated with occlusive vasculitis, pulmonary abnormalities, hepatic steatosis and focal necrosis, keratoconjunctivitis, male patients, there may be changes in semen quality and quantity. Psoriasis patients with organ damage in the treatment of psoriasis should be attention.
2, arthritis, psoriasis (Psoriasis arthropathica), also known as psoriatic arthritis. This type of psoriasis in addition to rash, the relevant section of the lesions, joint symptoms often associated with skin damage while mitigating or aggravating. But the patient is generally the first rash, then the joint symptoms. Any joint can be affected, including Zhouxi large joints can also refer to the small joints (toe). The spinal joints and sacroiliac joints, the same can be violated. Can be relevant section of the swelling and pain, limited mobility, can also occur deformity, rheumatoid arthritis-like performance. Bone can have a devastating change from mutilation deformity, known as the disfigurement arthritis psoriasis, heavy arthritis, psoriasis often have persistent fever and ESR, rheumatoid factor is often negative. The rash may also have changes in concentrated blister-type psoriasis. X-ray showed that some patients joint changes and the same rheumatoid arthritis, bone can be partial decalcification, joint space narrowing, with varying degrees of joint erosion and soft tissue swelling. The course of the disease is chronic, often throughout the year after year unhealed.
Pustular psoriasis (Psoriasis pustulose)
This type of psoriasis rare, often no obvious incentive to acute disease, since the beginning of large areas of inflammatory erythema quickly in the dense needles to miliary size, pale yellow or yellow and white light color in sexual sterile pustules on the basis of erythema, surface often thin scaly erythema adjacent to each other fusion ring or back to shape. The edges tend to have more pustules. The small number of patients in the short term, the body quickly redness, swelling, there are numerous sterile pustules. Patients often accompanied by general malaise, the first chills after the fever was remittent fever type, skin burning sensation. Joint swelling and pain. A few days later, the pustules dry scab. The condition can be a natural ease, psoriasis skin rash, several days later, the sudden onset of illness repeatedly mitigating and aggravating the patient is often complicated by secondary infection, systemic failure, or liver, kidney damage and life-threatening.
Pustular psoriasis throughout the body can be rash. The most common flexor side, after the rapid increase, and they branch and body. Sometimes the oral mucosa (toe) may also be involved. Often often grooved tongue, referring to hypertrophy (toe) A cloudy or cracked under the deck can be deposits or pustules.
4, palmoplantar pustulosis (Pasfulosis palmaris et plantaris) palmoplantar pustulosis including palmoplantar pustular psoriasis (Pustular psoriasis of the palma and soles) and pustular bacteria rash (Pustular bacterid).
(1) of palmoplantar pustular psoriasis was considered to be limited to Board of pustular psoriasis, palmoplantar common damage is common in the palm of your hand size of the thenar and plantar arch parts. Can also be developed to (toe) dorsal, beginning when the symmetry of erythema, and soon a number of sterile pustules, the surface does not uplift, and pustules in the epidermis, the gradual expansion of convergence, a week or two The Dryout formed crust, scab off small scales. But the emergence of new pustules, and so forth endless. (Toe) A involvement discoloration or deformation. A cloudy hypertrophy, ridges, perceived pain, other parts of the body can not typical of psoriasis vulgaris lesions, or successful piece pustular psoriasis damage. Some patients have a grooved tongue.
(2) The pustular bacterial rash damage often occurs first in the center of the palm of your hand or foot, and gradually spread to the palms and soles can also be spread to the hand, foot on the side, beginning when the blisters, and quickly become non-bacterial pustules, a few days later pustules dry scab into brown scales, the scales fall off, and new pustules, and so forth endless, continue for some years, often plantar skin redness, thickening, surface scaly. Some patients with local itching and pain, the pustules of bacterial culture negative.
(3) the catagen damage inflammation basic subsided, the rash to reduce or flatten. The pigment left over to reduce white spots or pigmentation spots. The disease often recurrent. Some patients began to have significant seasonal winter skin lesions summer remission or regression. After long-term healing. Small number of patients clinically cured after a long time not to relapse.
Themselves as having varying degrees of itching in this disease, recent foreign reports, pathological changes in internal organs of some patients with psoriasis, patients with psoriasis may be associated with occlusive vascular inflammation, lung abnormalities, hepatic steatosis and focal necrosis, keratoconjunctivitis, male patients, there may be changes in semen quality and quantity. Psoriasis patients with organ damage in the treatment of psoriasis should be attention.
2, arthritis, psoriasis (Psoriasis arthropathica), also known as psoriatic arthritis. This type of psoriasis in addition to rash, the relevant section of the lesions, joint symptoms often associated with skin damage while mitigating or aggravating. But the patient is generally the first rash, then the joint symptoms. Any joint can be affected, including Zhouxi large joints can also refer to the small joints (toe). The spinal joints and sacroiliac joints, the same can be violated. Can be relevant section of the swelling and pain, limited mobility, can also occur deformity, rheumatoid arthritis-like performance. Bone can have a devastating change from mutilation deformity, known as the disfigurement arthritis psoriasis, heavy arthritis, psoriasis often have persistent fever and ESR, rheumatoid factor is often negative. The rash may also have changes in concentrated blister-type psoriasis. X-ray showed that some patients joint changes and the same rheumatoid arthritis, bone can be partial decalcification, joint space narrowing, with varying degrees of joint erosion and soft tissue swelling. The course of the disease is chronic, often throughout the year after year unhealed.

Pustular psoriasis (Psoriasis pustulose)
This type of psoriasis rare, often no obvious incentive to acute disease, since the beginning of large areas of inflammatory erythema quickly in the dense needles to miliary size, pale yellow or yellow and white light color in sexual sterile pustules on the basis of erythema, surface often thin scaly erythema adjacent to each other fusion ring or back to shape. The edges tend to have more pustules. The small number of patients in the short term, the body quickly redness, swelling, there are numerous sterile pustules. Patients often accompanied by general malaise, the first chills after the fever was remittent fever type, skin burning sensation. Joint swelling and pain. A few days later, the pustules dry scab. The condition can be a natural ease, psoriasis vulgaris rash several days later, the sudden onset of illness repeatedly mitigating and aggravating the patient is often complicated by secondary infection, systemic failure, or liver, kidney damage and life-threatening.
Pustular psoriasis throughout the body can be rash. The most common flexor side, after the rapid increase, and they branch and body. Sometimes the oral mucosa (toe) may also be involved. Often often grooved tongue, referring to hypertrophy (toe) A cloudy or cracked under the deck can be deposits or pustules.
4, palmoplantar pustulosis (Pasfulosis palmaris et plantaris) palmoplantar pustulosis including palmoplantar pustular psoriasis (Pustular psoriasis of the palma and soles) and pustular bacteria rash (Pustular bacterid).
(1) of palmoplantar pustular psoriasis was considered to be limited to Board of pustular psoriasis, palmoplantar common damage is common in the palm of your hand size of the thenar and plantar arch parts. Can also be developed to (toe) dorsal, beginning when the symmetry of erythema, and soon a number of sterile pustules, the surface does not uplift, and pustules in the epidermis, the gradual expansion of convergence, a week or two The Dryout formed crust, scab off small scales. But the emergence of new pustules, and so forth endless. (Toe) A involvement discoloration or deformation. A cloudy hypertrophy, ridges, perceived pain, other parts of the body can not typical of psoriasis vulgaris lesions, or successful piece pustular psoriasis damage. Some patients have a grooved tongue.
(2) The pustular bacterial rash damage often occurs first in the center of the palm of your hand or foot, and gradually spread to the palms and soles can also be spread to the hand, foot on the side, beginning when the blisters, and quickly become non-bacterial pustules, a few days later pustules dry scab into brown scales, the scales fall off, and new pustules, so repeated endless, continuing for several years, palmoplantar skin redness, thickening, surface scaly. Some patients with local itching and pain, the pustules of bacterial culture negative.
5, erythrodermic psoriasis (Erythrodermic psoriasis), also known as psoriatic erythroderma (Erythrodema psoriaticum) The disease mostly due to improper treatment or other reasons why the original psoriasis vulgaris or pustular psoriasis shift erythroderma. The common reason is that in psoriatic Application irritating severe external use, or suddenly disabled and dramatic spread of the disease due to oral administration of some immunosuppressive drugs. Common drugs such as oral corticosteroids, reduction process occurred.
Beginning when the original psoriatic lesional skin flushing, rapid expansion into a large, diffuse flushing infiltration more than 2/3 of the last body skin, swelling, accompanied by a large number of bran-like scales. During this period flake normal "skin island" appears, the scalp can be a large number of thick scales of plot filthy scab. Hand, foot and was a "glove" type "socks" like skin exfoliation. (Toe) A change in opacity, thickening or deformation. The disease can have a fever, general malaise, superficial lymph nodes, white blood cell count increased. The erythroderma cure after the damage of psoriasis. The disease course is longer, easy to relapse after cure.
Continuous acrodermatitis (Acrodermatitis continua) of the disease, also known as serpiginous dermatitis (Dermatitis repens) continuous acrodermatitis to aseptic pustules its features, so some people think that with pustular psoriasis the same disease. Some people think that is a subtype of pustular psoriasis, but there are different views. Is an independent disease, the book of the disease as psoriasis a type described.
The disease occurs in middle-aged, mostly caused by post-traumatic onset of aseptic pustules on both sides of a finger or toe, a few days later pustules dry scab, the scab fell off light red, left by erosion surface, but soon a new pustules appear, damage continues to expand, can be violated throughout the fingers, toes, back of the hand and dorsum. The patients rarely become systemic or extended to a distance. The disease mainly affects the hands and feet of the extremities, and occasionally violations of the oral mucosa, the more common (toe) A involvement. A cloudy lose their luster, deformation, and in severe A fall off the nail bed can be repeated aseptic pustules. Course of the disease is chronic, recurrent.

 

Psoriasis - diagnosis and differentialAccording to the clinical manifestations of this disease, especially rash characteristics and pathological features, and generally difficult to diagnose. But it should be with the following diseases.
1, the edge of seborrheic dermatitis damage is not obvious, basal infiltration lighter, rash on the scales were chaff-like, no Ausspitz's sign and seborrheic dermatitis of the scalp is often accompanied by hair loss, hair was bundle.
Pityriasis rosea damage occurs mainly in the trunk and proximal extremities, consistent with the long axis of the rash and striae. Scales small and thin. Short-term course of the disease more difficult after the recurrence.
3, lichen planus damage occurred in the limbs, flat purple polygonal papules, the surface of a wax-like luster. Visible Wickham pattern. The oral cavity often damage, often varying degrees of itching, pathological specificity.
4, pityriasis rubra pilaris damage occurred in the extensor limbs, early follicular keratosis papules, follicular keratosis papules can still be seen around the lesions of advanced plaques. Especially the characteristics of follicular keratotic papules of the first phalanx of the disease. The damage is covered with tiny scales, is not easy exfoliation. Often accompanied by palmoplantar hyperkeratosis.
, Vice psoriasis damage is covered with tiny scales, multilayer scales film phenomenon and Auspitz's sign, no more symptoms.
Psoriasis - TreatmentThis disease is currently no satisfactory treatment, most can only achieve short-term effect, but can not stop recurrence.
1, general therapy
First establish the confidence of the patient's emotional stability. Eliminate the factors that induce the disease attack. Actively control the infection. Taboo spicy diet and alcohol consumption of patients to disable the irritating strong external use.
2, systemic treatment
Any type of generalized psoriasis systemic treatment-based, systemic treatment principles to choose the side effects, recurrence of a long cycle of drugs. Liver, kidney functions and blood changes in medication during the regular observation.
(1) The immunosuppressant
1) methotrexate (MTX) for the anti-folic acid antitumor earlier cytotoxic drugs used to treat psoriasis. Various types of psoriasis. For arthritis type, erythrodermic, pustular psoriasis and generalized psoriasis vulgaris, methotrexate can be used with other therapy ineffective. Major role in DNA synthesis, and prevent DNA generated and inhibition of cell nuclear mitosis. Practice of medicine, different views are generally 15mg / weeks, the maximum dose is 50 mg / week. Can be oral, intramuscular or intravenous administration. Severe liver toxicity of this drug. Can cause extensive liver fibrosis and cirrhosis. Have inhibitory effects on the hematopoietic system, mainly leukopenia, there are implications on platelet whole blood decreased in severe cases. Therefore, periodic liver function and blood during the treatment, in addition to strictly selected indications. Liver and kidney dysfunction, anemia, leukopenia, and pregnant women to disable this drug.
Imine 2) B, also known as the imine 154, or ketone hydrochloride. Inhibit the synthesis of DNA in cells, resulting in the inhibition of cell growth. The general usage of adult daily 300 ~ 400mg 2 ~ 3 times a day orally, generally 3 to 4 weeks after the medication cured, markedly effective rate of 58% to 88%. Its main side effect is bone marrow suppression, resulting in leukopenia and thrombocytopenia. In recent years, has been reported to use the drug report of leukemia, so the use of the drug on a regular basis review the blood. To reduce the side effects of leukopenia secondary to drug the Batilol leucogen l white blood cells. The shortcomings of the drug is easy to relapse after drug withdrawal, in order to avoid relapse, can be rash subsided after the small dose of a longer period of time to maintain daily ketone hydrochloride could be reduced to 100mg, or even every other day 100mg recurrence inflammation reduce. As a result of double-ketone hydrochloride withdrawal, relapse, and then double-ketone hydrochloride is often compared with the initial application of poor results, the dose required larger than the initial.
3) hydroxyurea for refractory psoriasis and pustular psoriasis have a positive effect can reduce generalized pustular psoriasis, pustular, fever and symptoms of poisoning, its major role in inhibiting DNA synthesis, the amount of each adult 0.5g, day 2 or 3 times, 4 to 8 weeks for a course. The main toxicity is the reduction of white blood cells and platelets, less toxic to the liver.
4) cyclosporin A (cyclosporin was A. of CyA) as a new generation of immunosuppressants, since 1979, Mueller first reported the treatment of severe psoriasis have a significant effect of CyA more and more widely used to treat various types of psoriasis . The mechanism of the drug treatment of psoriasis is not fully understood. Currently there are many reports of the seriousness of the application of CyA treatment psoriasis usage CyA starting dose of 5mg / (kg · d) The two oral markedly after tapering, often adverse gastrointestinal reactions, fatigue, urinary tract irritation and blood pressure. CyA immune function is reversible, it is easy to relapse after stopping. CyA treatment of psoriasis, currently abroad to study gastrointestinal lesions Plaque injection and packet. CyA is expensive, not widely used. New Neoral (Sandimmun Neoral) is a novel cyclosporin A micro-emulsifiers, erythrodermic, pustular, arthritis, type psoriasis has an excellent treatment and mitigation.
(2) corticosteroids
Although corticosteroid therapy has a good effect in various types of psoriasis, now generally do not advocate the use of this drug. Because the application of larger doses, a longer time, enough to cause severe hormonal side effects. Reduction or withdrawal, resulting in recurrence of severe psoriasis becomes pustular psoriasis. Erythrodermic psoriasis protracted and can not control the disease; pustular psoriasis caused by a high fever caused by the symptoms of patients suffering with other drugs to lift; When acute joint psoriasis severe damage to joints, Consider the application of corticosteroid preparations. General application of 60mg prednisone daily or equivalent doses of other hormone preparations. Observe the side effects of the hormone.
(3) vitamins
1) Vitamin C daily intravenous injection or intravenous vitamin C, 3g, for one month. Some people think that vitamin C can increase the level of cAMP within the lesions, inhibit the proliferation of epidermal cells may play a therapeutic role.
2) of retinoic acid is a series of derivatives of vitamin A, commonly used aromatic retinoic acid, such as according to the song for the ester of pustular psoriasis have a good effect, the usual dose of 0.5 ~ 1mg/kg, the main side effects caused abnormal and liver damage, disabled women of childbearing age and liver dysfunction.
(4) Antibiotics

Many psoriasis patients for treatment with antibiotics in the clinical receive a satisfactory outcome. Such as the dual effect of penicillin 800 000 U intramuscularly, 1 day, 15 days for a course; the erythromycin adult each 0.75 0.9g intravenous 5% glucose solution, 1 day, 15 days to 30 days for treatment. , Changzheng Hospital, Tianjin, erythromycin, lincomycin, fosfomycin, Pioneer will prime and other intravenous treatment of psoriasis vulgaris received satisfactory results; thiamphenicol treatment of pustular psoriasis trial, oral administration of each times 0.25 to 0.5g, 3 times a day or intramuscular injection 0.4g, 2 times a day.
(5) The immunomodulator

Immunocompromised patients with psoriasis trial of immunomodulatory agents such as thymic factor D injection daily 10mg intramuscular injection every other day its side effects are mild. Can also be used levamisole, 150mg / d, taking three days a week, 4 days withdrawal, general medication 1 to 3; can also be used to transfer factor. There is a certain therapeutic effect.
(6) Chinese medicine treatment

Motherland medicine, said the disease "white facial skin disease. Chinese medicine believes that the poison of the pathogenesis of psoriasis of blood heat Sheng; blood imaginary wind-dryness caused by many methods and effective prescription of traditional Chinese medicine treatment of this disease, Changzheng Hospital, Tianjin, dermatology, were used to heat the pathogenesis of the disease method, blood stasis, and nourishing method for diagnosis and treatment.
Thermal heat treatment of blood psoriasis, equivalent to of main Qingreliangxue, prescription: habitat, $ parameter, Hang Shao, Chine, Buff, Anemarrhena, Nepeta, wind, cohosh, licorice, etc. . Of the party is the treatment of psoriasis of 98 cases, the total efficiency of 84.7%. Recently concentrated extract water decoction of the party carried out the experimental study of the epidermal cells and interleukin-6, the results show that the drug can directly inhibit the proliferation of keratinocytes and inhibition of IL-6 production, which proves the Treatment of Psoriasis effective mechanism.
Promoting blood circulation and blood stasis type of treatment of psoriasis, which is equivalent to the resting stage, mainly blood stasis. Prescription: Smilax glabra, triangular, Curcuma, red flowers, red peony root, the final end, licorice.
The nourishing law treatment of blood deficiency and wind-dryness psoriasis, equivalent to the quiescent persistent disease course of time. Prescription: Moreover, The Hives, Angelica, Radix, white peony root, Asparagus, Ophiopogon, Polygonatum, licorice.
In addition you can also use the traditional Chinese medicine preparation tetramethylpyrazine injection or Mailuoning treatment. Such as tetramethylpyrazine 200mg intravenous 5% glucose liquid, 1 day, 30 days for treatment. Or 5% glucose liquid intravenous use Mailuoning 20mL, 1 day, 30 days for a course, proved to be effective.
3, for external use
On the limitations of the rash can choose to use outside of drug treatment, the main principles of exfoliation agents and cytostatics. During the period should not use strong irritant topical, so as not to cause erythroderma.
(1) Anthralin (anthralin) inhibit epidermal cell proliferation, topical treatment of psoriasis have a certain effect, used in the clinic 0.1% to 1% Anthralin ointment, paste or emulsion. The main side effect is skin irritation, should not be applied to the genital area rash Anthralin preparations can make the skin black, contaminated clothing.
(2) corticosteroid-resistant cell mitosis role. Commonly used in clinical Fuqing Song, the chlorofluorocarbons triamcinolone ointment or cream psoriasis have good curative effect. The main side effects such as can cause long-term topical application of skin atrophy, hirsutism, telangiectasia.
(3) calcipotriol (calcipotriol) vitamin D2 active metabolites, analogs of calcitriol, is the world's first listed in 1991 the treatment of psoriasis drug, the drug of keratinocyte differentiation and proliferation and strong regulatory role. Calcipotriol ointment 50μg / g, the treatment of mild or moderate psoriasis is effective and safe.
(4) chloroformate neopterin cream methotrexate methotrexate methotrexate (MTX) treatment of psoriasis is effective, but toxic side effects. Foreign Zhang Guoyi and other topical treatment of refractory psoriasis 54 cases of 0.1 percent methotrexate cream, while for the serum MTX concentration monitoring, the methotrexate treatment group was 83.3%, not measured in the serum of MTX, no significant systemic side effects. The results show that topical 0.1 percent methotrexate cream treatment of psoriasis.
4, medicated bath treatmentMedicated bath is one of the disease outside of governance in the Chinese medicine, medicated bath therapy can drugs act directly on the skin, hole orifices, shu points, fast and direct access to disease and achieved good effect, medicated bath therapy can be avoided drugs directly enter the body circulation, which can reduce the toxicity of the liver, kidneys and other organs.The principle of medicated bath by water temperature, mechanical stimulation of water and the role of drug treatment efficacy of the body play. When the use of hot liquid Washing of the skin or affected area, causing the skin throughout the blood vessels to dilate, due to thermal stimulation, can promote the local and whole body, blood and lymphatic circulation, metabolism, and improve the local tissue nutrition and body function, and to clear the meridians to promote the regulatory activities of the meridian. Liquid but also to stimulate the nerve endings of the skin receptors, nervous system, the formation of new reflex, thereby undermining the original pathological reflex contact to cure the disease.5, other therapies
Appropriate choice of the spa, according to the disease tar bath UV triple therapy, photochemical therapy can be selected

 

Psoriasis - diagnosis and differentialAccording to the clinical manifestations of this disease, especially rash characteristics and pathological features, and generally difficult to diagnose. But it should be with the following diseases.
1, the edge of seborrheic dermatitis damage is not obvious, basal infiltration lighter, rash on the scales were chaff-like, no Ausspitz's sign and seborrheic dermatitis of the scalp is often accompanied by hair loss, hair was bundle.
Pityriasis rosea damage occurs mainly in the trunk and proximal extremities, consistent with the long axis of the rash and striae. Scales small and thin. Short-term course of the disease more difficult after the recurrence.
3, lichen planus damage occurred in the limbs, flat purple polygonal papules, the surface of a wax-like luster. Visible Wickham pattern. The oral cavity often damage, often varying degrees of itching, pathological specificity.
4, pityriasis rubra pilaris damage occurred in the extensor limbs, early follicular keratosis papules, follicular keratosis papules can still be seen around the lesions of advanced plaques. Especially the characteristics of follicular keratotic papules of the first phalanx of the disease. The damage is covered with tiny scales, is not easy exfoliation. Often accompanied by palmoplantar hyperkeratosis.
, Vice psoriasis damage is covered with tiny scales, multilayer scales film phenomenon and Auspitz's sign, no more symptoms.
Psoriasis - TreatmentThis disease is currently no satisfactory treatment, most can only achieve short-term effect, but can not stop recurrence.
1, general therapy
First establish the confidence of the patient's emotional stability. Eliminate the factors that induce the disease attack. Actively control the infection. Taboo spicy diet and alcohol consumption of patients to disable the irritating strong external use.
2, systemic treatment
Any type of generalized psoriasis systemic treatment-based, systemic treatment principles to choose the side effects, recurrence of a long cycle of drugs. Liver, kidney functions and blood changes in medication during the regular observation.
(1) The immunosuppressant
1) methotrexate (MTX) for the anti-folic acid antitumor earlier cytotoxic drugs used to treat psoriasis. Various types of psoriasis. For arthritis type, erythrodermic, pustular psoriasis and generalized psoriasis vulgaris, methotrexate can be used with other therapy ineffective. Major role in DNA synthesis, and prevent DNA generated and inhibition of cell nuclear mitosis. Practice of medicine, different views are generally 15mg / weeks, the maximum dose is 50 mg / week. Can be oral, intramuscular or intravenous administration. Severe liver toxicity of this drug. Can cause extensive liver fibrosis and cirrhosis. Have inhibitory effects on the hematopoietic system, mainly leukopenia, there are implications on platelet whole blood decreased in severe cases. Therefore, periodic liver function and blood during the treatment, in addition to strictly selected indications. Liver and kidney dysfunction, anemia, leukopenia, and pregnant women to disable this drug.
Imine 2) B, also known as the imine 154, or ketone hydrochloride. Inhibit the synthesis of DNA in cells, resulting in the inhibition of cell growth. The general usage of adult daily 300 ~ 400mg 2 ~ 3 times a day orally, generally 3 to 4 weeks after the medication cured, markedly effective rate of 58% to 88%. Its main side effect is bone marrow suppression, resulting in leukopenia and thrombocytopenia. In recent years, has been reported to use the drug report of leukemia, so the use of the drug on a regular basis review the blood. To reduce the side effects of leukopenia secondary to drug the Batilol leucogen l white blood cells. The shortcomings of the drug is easy to relapse after drug withdrawal, in order to avoid relapse, can be rash subsided after the small dose of a longer period of time to maintain daily ketone hydrochloride could be reduced to 100mg, or even every other day 100mg recurrence inflammation reduce. As a result of double-ketone hydrochloride withdrawal, relapse, and then double-ketone hydrochloride is often compared with the initial application of poor results, the dose required larger than the initial.
3) hydroxyurea for refractory psoriasis and pustular psoriasis have a positive effect can reduce generalized pustular psoriasis, pustular, fever and symptoms of poisoning, its major role in inhibiting DNA synthesis, the amount of each adult 0.5g, day 2 or 3 times, 4 to 8 weeks for a course. The main toxicity is the reduction of white blood cells and platelets, less toxic to the liver.
4) cyclosporin A (cyclosporin was A. of CyA) as a new generation of immunosuppressants, since 1979, Mueller first reported the treatment of severe psoriasis have a significant effect of CyA more and more widely used to treat various types of psoriasis . The mechanism of the drug treatment of psoriasis is not fully understood. Currently there are many reports of the seriousness of the application of CyA treatment psoriasis usage CyA starting dose of 5mg / (kg · d) The two oral markedly after tapering, often adverse gastrointestinal reactions, fatigue, urinary tract irritation and blood pressure. CyA immune function is reversible, it is easy to relapse after stopping. CyA treatment of psoriasis, currently abroad to study gastrointestinal lesions Plaque injection and packet. CyA is expensive, not widely used. New Neoral (Sandimmun Neoral) is a novel cyclosporin A micro-emulsifiers, erythrodermic, pustular, arthritis, type psoriasis has an excellent treatment and mitigation.
(2) corticosteroids
Although corticosteroid therapy has a good effect in various types of psoriasis, now generally do not advocate the use of this drug. Because the application of larger doses, a longer time, enough to cause severe hormonal side effects. Reduction or withdrawal, resulting in recurrence of severe psoriasis becomes pustular psoriasis. Erythrodermic psoriasis protracted and can not control the disease; pustular psoriasis caused by a high fever caused by the symptoms of patients suffering with other drugs to lift; When acute joint psoriasis severe damage to joints, Consider the application of corticosteroid preparations. General application of 60mg prednisone daily or equivalent doses of other hormone preparations. Observe the side effects of the hormone.
(3) vitamins
1) Vitamin C daily intravenous injection or intravenous vitamin C, 3g, for one month. Some people think that vitamin C can increase the level of cAMP within the lesions, inhibit the proliferation of epidermal cells may play a therapeutic role.
2) of retinoic acid is a series of derivatives of vitamin A, commonly used aromatic retinoic acid, such as according to the song for the ester of pustular psoriasis have a good effect, the usual dose of 0.5 ~ 1mg/kg, the main side effects caused abnormal and liver damage, disabled women of childbearing age and liver dysfunction.
(4) Antibiotics

Many psoriasis patients for treatment with antibiotics in the clinical receive a satisfactory outcome. Such as the dual effect of penicillin 800 000 U intramuscularly, 1 day, 15 days for a course; the erythromycin adult each 0.75 0.9g intravenous 5% glucose solution, 1 day, 15 days to 30 days for treatment. , Changzheng Hospital, Tianjin, erythromycin, lincomycin, fosfomycin, Pioneer will prime and other intravenous treatment of psoriasis vulgaris received satisfactory results; thiamphenicol treatment of pustular psoriasis trial, oral administration of each times 0.25 to 0.5g, 3 times a day or intramuscular injection 0.4g, 2 times a day.
(5) The immunomodulator

Immunocompromised patients with psoriasis trial of immunomodulatory agents such as thymic factor D injection daily 10mg intramuscular injection every other day its side effects are mild. Can also be used levamisole, 150mg / d, taking three days a week, 4 days withdrawal, general medication 1 to 3; can also be used to transfer factor. There is a certain therapeutic effect.
(6) Chinese medicine treatment

Motherland medicine, said the disease "white facial skin disease. Chinese medicine believes that the poison of the pathogenesis of psoriasis of blood heat Sheng; blood imaginary wind-dryness caused by many methods and effective prescription of traditional Chinese medicine treatment of this disease, Changzheng Hospital, Tianjin, dermatology, were used to heat the pathogenesis of the disease method, blood stasis, and nourishing method for diagnosis and treatment.
Thermal heat treatment of blood psoriasis, equivalent to of main Qingreliangxue, prescription: habitat, $ parameter, Hang Shao, Chine, Buff, Anemarrhena, Nepeta, wind, cohosh, licorice, etc. . Of the party is the treatment of psoriasis of 98 cases, the total efficiency of 84.7%. Recently concentrated extract water decoction of the party carried out the experimental study of the epidermal cells and interleukin-6, the results show that the drug can directly inhibit the proliferation of keratinocytes and inhibition of IL-6 production, which proves the Treatment of Psoriasis effective mechanism.
Promoting blood circulation and blood stasis type of treatment of psoriasis, which is equivalent to the resting stage, mainly blood stasis. Prescription: Smilax glabra, triangular, Curcuma, red flowers, red peony root, the final end, licorice.
The nourishing law treatment of blood deficiency and wind-dryness psoriasis, equivalent to the quiescent persistent disease course of time. Prescription: Moreover, The Hives, Angelica, Radix, white peony root, Asparagus, Ophiopogon, Polygonatum, licorice.
In addition you can also use the traditional Chinese medicine preparation tetramethylpyrazine injection or Mailuoning treatment. Such as tetramethylpyrazine 200mg intravenous 5% glucose liquid, 1 day, 30 days for treatment. Or 5% glucose liquid intravenous use Mailuoning 20mL, 1 day, 30 days for a course, proved to be effective.
3, for external use
On the limitations of the rash can choose to use outside of drug treatment, the main principles of exfoliation agents and cytostatics. During the period should not use strong irritant topical, so as not to cause erythroderma.
(1) Anthralin (anthralin) inhibit epidermal cell proliferation, topical treatment of psoriasis have a certain effect, used in the clinic 0.1% to 1% Anthralin ointment, paste or emulsion. The main side effect is skin irritation, should not be applied to the genital area rash Anthralin preparations can make the skin black, contaminated clothing.
(2) corticosteroid-resistant cell mitosis role. Commonly used in clinical Fuqing Song, the chlorofluorocarbons triamcinolone ointment or cream psoriasis have good curative effect. The main side effects such as can cause long-term topical application of skin atrophy, hirsutism, telangiectasia.
(3) calcipotriol (calcipotriol) vitamin D2 active metabolites, analogs of calcitriol, is the world's first listed in 1991 the treatment of psoriasis drug, the drug of keratinocyte differentiation and proliferation and strong regulatory role. Calcipotriol ointment 50μg / g, the treatment of mild or moderate psoriasis is effective and safe.
(4) chloroformate neopterin cream methotrexate methotrexate methotrexate (MTX) treatment of psoriasis is effective, but toxic side effects. Foreign Zhang Guoyi and other topical treatment of refractory psoriasis 54 cases of 0.1 percent methotrexate cream, while for the serum MTX concentration monitoring, the methotrexate treatment group was 83.3%, not measured in the serum of MTX, no significant systemic side effects. The results show that topical 0.1 percent methotrexate cream treatment of psoriasis.
4, medicated bath treatmentMedicated bath is one of the disease outside of governance in the Chinese medicine, medicated bath therapy can drugs act directly on the skin, hole orifices, shu points, fast and direct access to disease and achieved good effect, medicated bath therapy can be avoided drugs directly enter the body circulation, which can reduce the toxicity of the liver, kidneys and other organs.The principle of medicated bath by water temperature, mechanical stimulation of water and the role of drug treatment efficacy of the body play. When the use of hot liquid Washing of the skin or affected area, causing the skin throughout the blood vessels to dilate, due to thermal stimulation, can promote the local and whole body, blood and lymphatic circulation, metabolism, and improve the local tissue nutrition and body function, and to clear the meridians to promote the regulatory activities of the meridian. Liquid but also to stimulate the nerve endings of the skin receptors, nervous system, the formation of new reflex, thereby undermining the original pathological reflex contact to cure the disease.5, other therapies
Appropriate choice of the spa, according to the disease tar bath UV triple therapy, photochemical therapy can be selected

 

Psoriasis - Acupuncture treatment1, body acupuncture
Acupoints wind pool, outside off, Neiguan, Zusanli, A is the point, the liver by distribution of door, blood stasis with a sea of ​​blood, reducing method of real persons, virtual who spilled the waiting 20-30 minutes, leaving the town daily or every other day.

2, plum-blossom needle therapy
Local routine disinfection, percussion plum blossom needle the leukoplakia District, slowly from the outside inward, to leukoplakia flushing or slight bleeding is appropriate, Tapping, coated with 0.2% tincture of iodine daily or every other day.

3, ear cut Governing Law
Broken piece of fine china (Jiangxi porcelain is the best), with a sharp edge (disinfection) uniform helix scraps, small mouth, forced moderateUniform depth, mild bleeding can cut about 2-3 mm, and then disinfect the dressing once a week.Psoriasis drug therapy: taking the combination treatment of psoriasis psoriasis | Granules skin effect is very good

4, auricular therapy
The acupoints lung, pillow, endocrine, adrenal, A is the point, every 3-4 hole, single ear buried the needle, alternating ears, on the 3rd rotation of a.



Psoriasis - psychological therapyPsoriasis is closely related to psychological factors, psychological treatment is very important. In the general treatment of a doctor, such as drug use, attitudes, talk, encourage, such as your doctor confessed, the integration of psychotherapy. Of course, can also be used in patients with stress and other drugs, biofeedback and other methods of psychotherapy. But we are more respected experts in psychology psychological education of patients with psoriasis. Below psoriasis club activities in Shanghai on April 24, 1999, Shanghai Medical University, Department of Medical Psychology, Professor Xu Junmian psoriasis psycho-educational lectures outline quote to introduce to you: "psoriasis rehabilitation, psychological head . " Psoriasis is a psychological and physiological disease (otherwise known as "physical and mental illnesses). Psychological and physiological disorders refers to a set of physical illness, their occurrence, development, prognosis, and prevention are closely related and psychological factors. (In layman's terms, the work of the incidence of psychological and physiological disorders depends on the susceptibility to quality and psychosocial stress, living, learning, interpersonal aspects of pressure) the interaction.

Susceptible to quality refers to the tendency of the susceptibility to certain diseases, with two aspects of the physical and psychological characteristics. The physiological role of genetic factors can be seen. Psoriasis there is a tendency to family illness, now believed to be polygenic inheritance. Like hypertension, diabetes, like, the hereditary tendency to the disease, not necessarily disease. However, thanks to the susceptible tendency, the possibility of incidence increases. Understanding of the role of genetic factors, you do not feel ashamed, embarrassed. Not have a fatalism that recognize the role of genetic factors seems to be no cure hope. In fact: (1) genetic illness tendency, not a hereditary disease. Sick tendencies attention to the prevention, may not incidence. Therefore, people are not in the same family disease. ② understanding of the role of genetic factors, can help people as soon as possible to prevention, control this potentially dangerous. Is actually more conducive to the prevention and treatment.

Susceptible to psychological aspects of the quality of the features is a bad character. Type A behavior is an important indicator of susceptibility to cardiovascular disease, the psychological scale detection, early intervention to preventive measures. Patients with psoriasis may also have a similar situation, I mean about there are some bad character traits, such as easy irritability, easy to anger, but studies have not been made clear and consistent results. Alone susceptible tendencies, not necessarily on the incidence. At this point they are gene carriers, and they I is not the disease, but the genes are still passed to the next generation. In addition, the psycho-social stress in precipitating the disease also plays an important role, which we call predisposing factors. Common incentive to work frustration, interpersonal tensions, family conflict, anxiety, worry, and depressed mood. From the above, susceptible to quality and psychosocial stress in each other is the main part of the incidence. Psychology in which the role of an important, quite a lot.Suffering from psoriasis, in addition to skin lesions, infections and other psychological changes occur, and sometimes psychological barriers may also occur, common in the following areas:(1) psoriasis damage a person's appearance and the surface, weakening people's self-esteem, leading to interpersonal ashamed of holding back, worry, anger, anxiety, restlessness, irritability.
(2) Psoriasis course of the disease, but patients are anxious to immediate improvement, emotional anxiety, feel more itching, the condition worsened, thus creating a vicious cycle.
(3) in patients with psoriasis often one hundred square treatment, hoping to eradicate the intractable conflict with psoriasis.
(4) due to improper treatment, many patients with depression disappointment, aggravation or extension of the difficulties of treatment.


Psychological treatment programs
A friendly doctor-patient relationship. The doctors want to sympathize with the patients, to establish friendly relations with patients, focusing on communication, encourage patients to speak freely and fully express their feelings, and actively ask questions.

Second, individual psychotherapy. Explain psoriasis to patients with detailed knowledge, such as the epidemiological status quo, risk factors, pathogenesis, disease effects on the body, the purpose and status of the treatment, the treatment and attention to such matters, so that patients can correctly understand diseases. Establish the confidence to overcome the disease, changing the point of view of error, to give up the requirements of the ideology of radical, chaos to seek medical attention. Patients and their families clear the disease is contagious, without isolation with relatives.

Third, the group therapy. As far as possible to enable patients to exchange, communication, thereby eliminating the sense of loneliness. Encourage patients to actively participate in sports and social activities, and to shorten the distance between the others, to improve the psychological tolerance to disease and other difficulties.Psoriasis - pay attention to lifestyle modification1, in patients with psoriasis attention to clothing, deletions and regulation of room temperature to avoid cold overheating or sudden climate change hurt the body; enhance the body's ability to adapt to climate change, as appropriate outdoor activities, exercise, swimming, sunbathing, cold water bath, etc., can enhance the regulatory function of the body skin surface of patients with psoriasis;2, patients with psoriasis to be timely medication, in harmony with nature. Patients with psoriasis treatment, attention should be paid to comply with the seasonal climate changes. Physician of the Ming Dynasty: Wu Kun-year-old gas side, people cause of medication will next almost-year-old gas ". The so-called "Year of the air", referring to the annual climate and seasonal changes. Psoriatic lesions, erythema scales mainly manifested on the outside, there are blood heat, blood deficiency syndrome type TCM drugs must be considered as a whole, and strive to Heaven corresponding internal and external integration, so that drug treatment to achieve the best effect.3, heat and cooling blood, relieving bulk evil against psoriasis. Summer psoriasis is more than the performance of the hot air dry blood, mainly when the bitter cold of heat, and a sense of evil light and heavy, be relieving sweating, open Cou Li, scattered tables evil. This law also applies in winter psoriasis Table evil or part of thermal imaging actors, namely the so-called pioneer evil Lane.Patients with psoriasis Wenshen Qi, solid form, anti-evil. Winter psoriasis is the most common clinical type, incidence and ferrite less than yang, poor blood, health and foreign Without a solid foundation the evil off the skin. However, Wei gas under the focus of its development in the coke. Coke gas Wang is on the focus to develop powerful. This law applies to the obvious psoriasis winter chill the performance of the disease, can also be used to prevent the recurrence of the disease, the dialectical consider [2].

Note on the daily lifePatients with psoriasis in addition to actively cooperate with medical treatment in their daily lives to pay attention to:1.3 diet: avoid alcohol, avoid seafood, spicy bogey. Diet, there are different versions, was also suggested that the diet should be individual differences, blindly diet, the body will lose large amounts of nutrients, unfavorable condition improved.
Two. Hemolytic streptococcus infection is a predisposing factor for this disease, as far as possible to avoid colds, tonsillitis, pharyngitis occurred. The event should be actively symptomatic treatment, so as not to aggravate psoriasis. Frequently tonsils, purulent rather induced the disease or aggravate the disease of the proposed line of tonsil enucleation. This entry tonsillectomy should be careful.
3. Eliminate stress factors, to avoid too tired to pay attention to rest.
4. The living conditions are dry, ventilated, easy bathing.
5 Required to wear clean, soft clothes, regular replacement of underwear and bed sheets, to prevent skin infections.
6. Avoid trauma, to prevent scratching and strong stimulation in order to avoid new lesions.
7. Shelter from winds and cold, to prevent upper respiratory tract infection.
8. Use warm water bath, to disable strong alkaline soap, shampoo, bath.
9. The diet is generally given normal diet, light-based, less drinking, Wu Shi Yi cause food allergic reactions, such as lamb, seafood.
10. Note the occurrence of food hygiene, prevention of enteritis and other diseases.
11. The pustular patients not rub the skin lesions, to prevent erosion and to prevent secondary infection.
12. Daily medication, anti-malarial drugs, beta-blockers can induce or aggravate the condition.
13. Endocrine changes of pregnancy can induce the disease and make it worse.
14, eat foods rich in vitamin foods such as fresh fruits and vegetables.
15. Wash the affected area, the action should be gently, not forcibly stripped dander, so as not to cause local infection, such as red, swollen, hot, pain, affect the treatment, so that the extension of the course.
16. Psoriasis temporarily recovered their immune function, microcirculation, and metabolism are still not fully back to normal, it normally takes 2-3 months to recover. After clinical recovery after the appearance of skin lesions completely subsided, should no longer continue taking 2-3 courses of drugs to the consolidation of the virus clean up more thoroughly in order to avoid recurrence.
17. Summer, to allow more surface of the skin by sunlight, but not too strong, easy to burn the skin. (Reference to UV treatment is good, because sunlight contains a small amount of UV pathologies)

 

Psoriasis - Prevention
1) to maintain an optimistic mood, statistics, more than 75% of patients with psoriasis accompanied by impatience, agitation, irritability, bad mood. Many patients with mental stimulation and the incidence of or worsen, some patients due to the cheerful mood and self-healing.

(2) proper rest and exercise, exercise their own body.

(3) to develop good eating habits.

(4) removal of lesions: active treatment of infected wounds and inflammation

(5) recurrent oral administration of folic acid, vitamin A, vitamin C, vitamin B12 and other drugs.

(6) prior to a good season, taking appropriate Liangxue Xiaoban soothing traditional Chinese medicine, can effectively prevent or alleviate psoriasis recurrence.

(7) of patients the incidence of cold season, regular sunbathing.