It's not contagious, but it looks disgusting
It is recommended to be optimistic about the disease.
Reference treatment:
Usually according to mild, moderate and severe treatment: mild, lesion area 10%. Mild need only topical drugs, moderate and severe need combined treatment.
(1) Drugs for external use
1. tar preparation
Commonly used are coal tar, pine distillate oil, bran distillate oil and black bean distillate oil. The concentration is generally 5%. The method of use is conventional external coating, encapsulation and combination with other drugs. It has the best effect on chronic stable psoriasis, scalp psoriasis and palmoplantar psoriasis. Pregnant women are forbidden, especially in the first three months, and patients with severe acne and folliculitis are forbidden.
2. Diphenol
Also known as anthracyclines, it is the most effective drug to treat psoriasis vulgaris. Anthracene ointment and wax stick are commonly used, and the methods include routine application, short-term contact treatment and comprehensive treatment.
3. Corticosteroids
The most commonly used external medicine, psoriasis vulgaris can choose moderate or strong glucocorticoid, ointment has the best effect, and lotion is poor. The usage is routine external use, intermittent impulse therapy, rotational therapy, package therapy and comprehensive therapy.
4. Retinoic acid drugs
Suitable for psoriasis vulgaris. It can cause local irritation and photosensitivity. If combined with glucocorticoid or UVB, it can improve the curative effect and reduce adverse reactions. Pregnant women, lactating women and women who have a desire to give birth recently are prohibited, and children should avoid using them. Avoid contact with mucous membranes and avoid sun exposure.
5. vitamin D3 analogues
It is very effective in the treatment of stable or patchy psoriasis, and it is more effective in the treatment of onychomycosis psoriasis. There are two kinds of carbotriol and tacalcitol, among which tacalcitol can be used on the face.
6. Immunosuppressants
Tacrolimus and pimecrolimus are the first choice for the treatment of facial psoriasis.
(2) Drugs for oral administration
1. Antitumor drugs
Methotrexate is the standard drug for systemic treatment of psoriasis, but the therapeutic dose is close to the toxic dose, so the initial dose should be small. It can be taken orally, intramuscularly, subcutaneously or intravenously.
2. Retinoic acid drugs
Used alone or in combination with other therapies, the curative effect is satisfactory. There are avermectin A ester, avermectin A, aromatic ethyl formate and so on. The main side effect is teratogenesis. Women of childbearing age should take contraceptive measures within 2 years after stopping taking drugs.
3. Immunotherapy
Cyclosporin A (1) is used for generalized plaque psoriasis which is ineffective in conventional treatment. Adverse reactions include nephrotoxicity, hypertension, nausea, vomiting, fatigue, muscle tremor and urinary tract irritation.
(2) Tacrolimus is effective in the treatment of severe stubborn plaque psoriasis. The adverse reaction is similar to cyclosporine A, but it has no serious influence on nephrotoxicity, hypertension and bone marrow suppression.
(3) Mycophenolate mofetil has a good effect on severe psoriasis. Adverse reactions include gastrointestinal symptoms, anemia and leukopenia, which increase the risk of infection and induce tumors, so attention should be paid to detection.
4. Biological agents
(1) Cytokine blockers: etanercept, infliximab, Addali.
(2) Inhibit the co-stimulation of T cells and presenting cells, such as alfacet and efazumab.
5. Antibiotics
Acute psoriasis guttata is often accompanied by acute tonsillitis or upper respiratory tract infection. Penicillin, cephalosporin, chloramphenicol, erythromycin, metronidazole and thiamphenicol can be used.
(3) Physical therapy
1. Ultraviolet rays are suitable for winter-type cases at rest, and are prohibited for summer-type patients.
2. Photochemical therapy (PUVA).
3. broad-spectrum UVB therapy.
4. Narrow band UVB therapy.
5.308nm single frequency excimer laser therapy.
6. Photodynamic therapy.
7. Bath therapy (hydrotherapy).