The treatment of psoriasis includes the following aspects. (1) In addition to the etiology and general treatment ① Psoriasis caused by streptococcal upper respiratory tract infection such as tonsillitis or pharyngitis should be controlled by antibacterial therapy. ② If the mental factors of suspected patients are related to psoriasis, psychotherapy, sedative or vein blocking therapy should be added to the treatment. ③ Patients with psoriasis vulgaris usually bathe in Qin Ying, but erythrodermic psoriasis lesions should not be scrubbed. 4 Diet should pay attention to eating less beef and mutton and eating more fish. ⑤ In the course of treatment, we should pay attention to the comprehensive treatment of removing the cause and combining internal and external factors, but we should avoid adding treatment indiscriminately. (2) Topical medicine ① Salicylic acid: 3%~5% ointment or ethanol (alcohol) solution is commonly used, and the initial concentration should be low. Attention should be paid to the side effects of local stimulation and systemic absorption poisoning. ② Coal tar: It can inhibit cell mitosis and DNA synthesis, and has antipruritic and anti-inflammatory effects in clinic. Commonly used 2%~ 10% ointment or solution or lotion. If ultraviolet rays are combined with bathing, the curative effect can be significantly increased. ③ Anthracene: generally use 0. 1%~ 1% ointment. If salicylic acid or corticosteroids are added to the ointment, its curative effect can be increased. Anthracene ointment can also be used externally. Combined application of ultraviolet rays can improve its curative effect. ④ mustard gas ointment or nitrogen mustard tincture was used externally. ⑤ Camptothecin for external use. ⑥ external use of vitamin d. ⑦ Corticosteroid hormones, etc. (3) Oral medication ① Antibiotic or antibacterial therapy. ② Tretinoin treatment. ③ Cyclosporine treatment. ④ Blocking therapy. ⑤ Other vitamin therapy. ⑥ Corticosteroid hormone should not be used as a routine treatment for psoriasis, but it can be considered for systemic pustular psoriasis and arthropathy psoriasis. ⑦ Other immunotherapy. 8 Chinese medicine, etc. (4) Physical therapy includes ultraviolet rays and bath therapy. The relationship between streptococcus upper respiratory tract infection such as pharyngitis, tonsillitis or other site infection and streptococcus superantigen on psoriasis has been confirmed. At present, some people have proposed the relationship between psoriasis and Staphylococcus aureus and its superantigen. These provide theoretical basis for effective antibacterial treatment of psoriasis. Antibacterial therapy is generally used for patients with new punctate or patchy psoriasis vulgaris, especially those with obvious sore throat or a history of "cold" before eruption. Of course, it can also be used for people who are chronic, have a disease course of more than several years, and often have a history of "cold" or sore throat before the recurrence of skin lesions or sudden aggravation of symptoms. Antibacterial treatment can generally be intramuscular injection of penicillin 14 days, or oral administration of penicillin 500 mg, 4 times a day, *** 10~ 14 days; Or oral erythromycin 10~ 14 days. It is recommended to take rifampicin 5 days after penicillin or erythromycin treatment. However, some people think that the curative effect of rifampicin is not increased; Oral penicillin 10 day, followed by clindamycin 150 mg, four times a day, 10 day, and so on for more than four courses; Some people use cefradine 10~ 14 days. According to the existing literature, we extend the antibacterial treatment of psoriasis to introduce it, including other microorganisms except bacteria, which can also be called antibacterial treatment. Some people think that the skin lesions of psoriasis limbs are infected by group A β hemolytic streptococcus, and introduce the above penicillin and erythromycin therapy; The skin lesions at the folds of psoriasis are infected by group B β hemolytic streptococcus. This paper introduces the treatment of amoxicillin, but we think that amoxicillin is easy to cause serious drug eruption and should be used with caution. Some people suggest that psoriasis is related to helicobacter pylori infection, and it is suggested to use corresponding drugs for treatment; Some people think that psoriasis with costal chondritis, diabetes, or skin lesions including erythema and severe itching of palms and soles are related to the migration or infection of Candida albicans (a fungus), and ketoconazole or fluconazole is used to treat it. Some people think that the extensive aggravation of psoriasis symptoms may be related to endotoxin produced by pityrosporum ovale, intestinal yeast or gram-negative bacteria. This theory can explain why psoriasis lesions occur in sebum overflow sites (such as scalp, armpit, chest and back center, related to pityrosporum ovale) and diaper areas (vulva and buttocks, related to candida), and psoriasis is aggravated after drinking (due to liver injury). In addition, some people have treated psoriasis with oral ketoconazole (antifungal drugs) and achieved good results. However, it is worth noting that after oral ketoconazole 15 days, most patients will have liver function damage. Therefore, the application time should generally not exceed 10~ 12 days; Some people use metronidazole (Letiling), which can resist Gram-negative bacilli and trichomoniasis and is effective in treating acute plaque psoriasis. Tretinoin is an analogue of vitamin A, and people have noticed that vitamin A has a certain effect on psoriasis. Among tretinoin, the first generation products are all-trans tretinoin and 13- cis tretinoin. All-trans tretinoin (retinoic acid) can be used for external treatment of psoriasis, and 13- cis tretinoin can be used for oral treatment of psoriasis vulgaris, but both of them have unsatisfactory curative effects. The second generation products of tretinoin include avermectin ester (also known as Itrac or Ticazon) and tretinoin (also known as Itrac or Neoticazon), both of which are mainly used to treat psoriasis, and the curative effect is positive. The third generation products include aromatic retinoic acid, adapalene and tazarotene. Aromatic tretinoin is mainly used to treat psoriasis, adapalene is used to treat acne, and tazarotene is used to treat psoriasis and acne. At present, the second generation retinoic acid psoriasis is mainly used. Both avia ester and avia acid can regulate the normal differentiation and immune function of keratinocytes in patients with psoriasis, and can effectively treat all kinds of severe psoriasis, especially pustular psoriasis, which is more effective than chronic plaque psoriasis and erythrodermic psoriasis, but it needs maintenance treatment after symptom control and is expensive. Avermectin A ester has more adverse reactions, and avian A acid has less adverse reactions, which can be used for women of childbearing age, and their curative effects are similar, so avian A acid has tended to replace avermectin A ester in the market at present.
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