What is the disease? What causes it?
Patients with psoriasis may hinder their social activities due to embarrassment. The causes of psoriasis are same as Eczema.
What is Autoimmune Disorder/Disease?
Our immune system is responsible for fighting foreign invaders that threaten our body such as bacteria, viruses and fungi,etc. When one has autoimmune disease, the body’s immune system cannot recognise what is good or bad cells. Part of the reaction occurs when a type of white blood cell called a T cell mistakenly attacks healthy skin cells. So it mistakenly attacks its own body cells causing damage and diseases. These overactive T cells then trigger other immune responses that collectively speed up the growth cycle of skin cells, causing them to move to the outermost layer of your skin in a matter of days rather than weeks.
Because the dead skin cannot be removed quickly enough, it builds up into the thick patches characteristic of psoriasis. For up to 60 percent of people with psoriasis, the condition seriously impacts their daily life.
Other autoimmune diseases are rheumatoid arthritis, some thyroid diseases, anaemia, lupus, celiac disease and type 1 diabetes.
Psoriasis is not contagious. However, the condition may run in families. Risk factors for psoriasis include:
- family history of the condition
- having a viral or bacterial infection
- uncontrolled stress
- use of certain medications, such as those used to treat bipolar disorder and high blood pressure
Psoriasis can increase your risk for other illnesses. Some people develop psoriatic arthritis, which can cause severe joint damage. You’ll need to see a rheumatologist for treatment if your dermatologist suspects this type of psoriasis.
You also have a greater risk of developing type 2 diabetes and cardiovascular disease. Other possible complications of psoriasis include an increased risk for:
- high blood pressure
- celiac disease and Crohn’s disease
- Parkinson’s disease
- kidney disease
- eye problem
Because psoriasis can develop anywhere on the body and become a widespread problem, you may also deal with periods of low self-esteem, social isolation, and depression
牛皮癣患者可能会妨碍他们的社交活动，因为尴尬。银屑病的原因和湿疹相同 什么是自身免疫性疾病/疾病？ 我们的免疫系统是负责打击威胁着我们的身体，如细菌，病毒和真菌等外来入侵者。当一个人的自身免疫性疾病，身体的免疫系统无法识别什么是好还是坏细胞。发生反应的一部分，当一种类型的白细胞称为T细胞错误地攻击健康的皮肤细胞。因此，它错误地攻击自身机体细胞造成伤害和疾病。这些过度的T细胞，然后触发其它免疫反应，它们共同加速皮肤细胞的生长周期，导致它们移动到你的皮肤的最外层，在几天而不是几周内。 因为死皮不能被删除的速度不够快，它构建成牛皮癣的厚厚的补丁特性。对于高达60％的人患有银屑病，病情严重影响他们的日常生活中。 其他自身免疫性疾病是类风湿性关节炎，一些甲状腺疾病，贫血，狼疮，乳糜泻和1型糖尿病。 牛皮癣是不会传染的。然而，条件可以在家庭中。风险因素牛皮癣包括：•家庭条件的历史•具有病毒或细菌感染•肥胖•吸烟•不受控制的压力•使用某些药物，例如那些用于治疗双相性精神障碍和高血压的
你发展2型糖尿病和心血管疾病的危险性更大。银屑病其他可能的并发症包括风险增加为：· 高血压· 腹腔疾病，节段性回肠炎· 帕金森氏病· 肾脏疾病· 眼部问题由于牛皮癣可以在身体任何地方，你也许会经历自卑的时期，社会隔离和抑郁。
Up to 7.5 million Americans suffer from the disease, which has a surprisingly significant economic impact as well.
A new study in JAMA Dermatology reported that direct US healthcare costs related to psoriasis may be up to $63 billion a year.1 There were also indirect costs (such as loss of work hours) of up to $35 billion and another $35 billion in costs related to associated health problems, like heart disease and depression.
Taken together, the researchers found the annual US cost of psoriasis amounted to approximately $112 billion in 2013.
Up to 30 percent of sufferers also develop psoriatic arthritis, which can cause debilitating joint damage.
高达750万美国人患有该疾病，其具有令人惊奇的显著经济影响。 在JAMA皮肤科一项新的研究报告说，与牛皮癣美国直接医疗费用可能高达$ 63十亿一年。也有高达$ 35个十亿，另外$ 35个十亿的相关费用间接费用（如工作时间损失）到相关的健康问题，如心脏疾病和抑郁症。 综合来看，研究人员发现，在2013年银屑病的美国每年的成本约为$器112十亿。 高达患者的30％还开发牛皮癣关节炎，这可能会导致衰弱的关节损伤。
What symptom? How to detect it?
Psoriasis is an autoimmune disease, characterised by red, dry patches and thickened skin. The dry flakes and skin scales are thought to result from the rapid buildup of skin cells
This common form of psoriasis causes raised, red patches on the skin. Skin patches can be itchy and painful.
This type of psoriasis can start in childhood or young adulthood.
This type of psoriasis causes red lesions in body folds.
This type causes white blisters and red skin.
This rare inflammatory type of psoriasis can develop over the entire body. Symptoms include widespread redness, pain, and severe itching.
If you’re diagnosed with psoriasis, your doctor may refer you to a dermatologist. A dermatologist is a doctor who specializes in skin diseases.
There’s no cure for psoriasis. But with treatment, you can reduce inflammation and skin irritation. Some treatment options are described below
Treatments are determined by the type and severity of your psoriasis and the area of skin affected. Your doctor will probably start with a mild treatment, such as topical creams (which are applied to the skin), and then move on to stronger treatments if necessary.
A wide range of treatments are available for psoriasis, but identifying which treatment is most effective can be difficult. Talk to your doctor if you feel a treatment isn’t working or you have uncomfortable side effects.
Treatments fall into three categories:
- topical – creams and ointments that are applied to your skin
- phototherapy – your skin is exposed to certain types of ultraviolet light
- systemic – oral and injected medications that work throughout the entire body
Often, different types of treatment are used in combination.
Your treatment for psoriasis may need to be reviewed regularly. You may want to make a care plan (an agreement between you and your health professional) as this can help you manage your day-to-day health.
Topical treatments are usually the first treatments used for mild to moderate psoriasis. These are creams and ointments you apply to affected areas.
Some people find that topical treatments are all they need to control their condition, although it may take up to six weeks before there’s a noticeable effect.
If you have scalp psoriasis, a combination of shampoo and ointment may be recommended.
Emollients are moisturising treatments applied directly to the skin to reduce water loss and cover it with a protective film. If you have mild psoriasis, an emollient is probably the first treatment your GP will suggest.
The main benefit of emollients is to reduce itching and scaling. Some topical treatments are thought to work better on moisturised skin. It’s important to wait at least half an hour before applying a topical treatment after an emollient.
Emollients are available as a wide variety of products and can be bought over the counter from a pharmacy or prescribed by your GP, nurse or health visitor.
Read more about emollients.
Steroid creams or ointments
Steroid creams or ointments (topical corticosteroids) are commonly used to treat mild to moderate psoriasis in most areas of the body. The treatment works by reducing inflammation. This slows the production of skin cells and reduces itching.
Topical corticosteroids range in strength from mild to very strong. Only use topical corticosteroids when recommended by your doctor. Stronger topical corticosteroids can be prescribed by your doctor and should only be used on small areas of skin or on particularly thick patches. Overusing topical corticosteroids can lead to skin thinning.
Vitamin D analogues
Vitamin D analogue creams are commonly used along with or instead of steroid creams for mild to moderate psoriasis affecting areas such as the limbs, trunk or scalp. They work by slowing the production of skin cells. They also have an anti-inflammatory effect.
Examples of vitamin D analogues are calcipotriol, calcitriol and tacalcitol. There are very few side effects, as long as you don’t use more than the recommended amount.
Calcineurin inhibitors, such as tacrolimus and pimecrolimus, are ointments or creams that reduce the activity of the immune system and help to reduce inflammation. They’re sometimes used to treat psoriasis affecting sensitive areas (such as the scalp, the genitals and folds in the skin) if steroid creams aren’t effective.
These medications can cause skin irritation or a burning and itching sensation when they’re started, but this usually improves within a week.
Coal tar is a thick, heavy oil and is probably the oldest treatment for psoriasis. How it works isn’t exactly known, but it can reduce scales, inflammation and itchiness. It may be used to treat psoriasis affecting the limbs, trunk or scalp if other topical treatments aren’t effective.
Coal tar can stain clothes and bedding, and has a strong smell. It can be used in combination with phototherapy (see below).
Dithranol has been used for over 50 years to treat psoriasis. It has been shown to be effective in suppressing the production of skin cells and has few side effects. However, it can burn if too concentrated.
It’s typically used as a short-term treatment for psoriasis affecting the limbs or trunk under hospital supervision, as it stains everything it comes into contact with, including skin, clothes and bathroom fittings. It’s applied to your skin (while wearing gloves) and left for 10 to 60 minutes before being washed off.
Dithranol can be used in combination with phototherapy (see below).
Phototherapy uses natural and artificial light to treat psoriasis. Artificial light therapy can be given in hospitals and some specialist centres, usually under the care of a dermatologist. These treatments aren’t the same as using a sunbed.
Ultraviolet B (UVB) phototherapy uses a wavelength of light that is invisible to human eyes. The light slows down the production of skin cells and is an effective treatment for some types of psoriasis that haven’t responded to topical treatments. Each session only takes a few minutes, but you may need to go to hospital two or three times a week for six to eight weeks.
Psoralen plus ultraviolet A (PUVA)
For this treatment, you’ll first be given a tablet containing compounds called psoralens, or psoralen may be applied directly to the skin. This makes your skin more sensitive to light. Your skin is then exposed to a wavelength of light called ultraviolet A (UVA). This light penetrates your skin more deeply than ultraviolet B light.
This treatment may be used if you have severe psoriasis that hasn’t responded to other treatment. Side effects of the treatment include nausea, headaches, burning and itchiness. You may need to wear special glasses for 24 hours after taking the tablet to prevent the development of cataracts. Long-term use of this treatment isn’t encouraged, as it can increase your risk of developing skin cancer.
Combination light therapy
Combining phototherapy with other treatments often increases its effectiveness. Some doctors use UVB phototherapy in combination with coal tar, as the coal tar makes the skin more receptive to light. Combining UVB phototherapy with dithranol cream may also be effective (this is known as Ingram treatment).
Want to know more?
If your psoriasis is severe or other treatments haven’t worked, you may be prescribed systemic treatments by a specialist. Systemic treatments are treatments that work throughout the entire body.
These medications can be very effective in treating psoriasis, but they all have potentially serious side effects. All the systemic treatments for psoriasis have benefits and risks. Before starting treatment, talk to your doctor about your treatment options and any risks associated with them.
There are two main types of systemic treatment, called non-biological (usually given as tablets or capsules) and biological (usually given as injections). These are described in more detail below.
Methotrexate can help to control psoriasis by slowing down the production of skin cells and suppressing inflammation. It’s usually taken once a week.
Methotrexate can cause nausea and may affect the production of blood cells. Long-term use can cause liver damage. People who have liver disease shouldn’t take methotrexate, and you shouldn’t drink alcohol when taking it.
Methotrexate can be very harmful to a developing baby, so it’s important that women use contraception and don’t become pregnant while they take this drug and for three months after they stop. Methotrexate can also affect the development of sperm cells, so men shouldn’t father a child during treatment and for three weeks afterwards.
Ciclosporin is a medicine that suppresses your immune system (immunosuppressant). It was originally used to prevent transplant rejection, but has proved effective in treating all types of psoriasis. It’s usually taken daily.
Ciclosporin increases your chances of kidney disease and high blood pressure, which will need to be monitored.
Acitretin is an oral retinoid that reduces the production of skin cells. It’s used to treat severe psoriasis that hasn’t responded to other non-biological systemic treatments. It’s usually taken daily.
Acitretin has a wide range of side effects, including dryness and cracking of the lips, dryness of the nasal passages and, in rarer cases, hepatitis.
Acitretin can be very harmful to a developing baby, so it’s important that women use contraception and don’t become pregnant while they take this drug, and for two years after they stop taking it. However, it’s safe for a man taking acitretin to father a baby.
Biological treatments reduce inflammation by targeting overactive cells in the immune system. These treatments are usually used if you have severe psoriasis that hasn’t responded to other treatments, or if you can’t use other treatments.
Etanercept is injected twice a week and you’ll be shown how to do this. If there’s no improvement in your psoriasis after 12 weeks, the treatment will be stopped.
The main side effect of etanercept is a rash where the injection is given. However, as etanercept affects the whole immune system, there’s a risk of serious side effects, including severe infection. If you had tuberculosis in the past, there’s a risk it may return. You’ll be monitored for side effects during your treatment.
Adalimumab is injected once every two weeks and you’ll be shown how to do this. If there’s no improvement in your psoriasis after 16 weeks, the treatment will be stopped.
Adalimumab can be harmful to a developing baby, so it’s important that women use contraception and don’t become pregnant while they take this drug, and for five months after the treatment finishes.
The main side effects of adalimumab include headaches, a rash at the injection site and nausea. However, as adalimumab affects the whole immune system, there’s a risk of serious side effects, including severe infections. You’ll be monitored for side effects during your treatment.
Infliximab is given as a drip (infusion) into your vein at the hospital. You’ll have three infusions in the first six weeks, then one infusion every eight weeks. If there’s no improvement in your psoriasis after 10 weeks, the treatment will be stopped.
The main side effect of infliximab is a headache. However, as infliximab affects the whole immune system, there’s a risk of serious side effects, including severe infections. You’ll be monitored for side effects during your treatment.
Ustekinumab is injected at the beginning of treatment, then again four weeks later. After this, injections are every 12 weeks. If there’s no improvement in your psoriasis after 16 weeks, the treatment will be stopped.
The main side effects of ustekinumab are a throat infection and a rash at the injection site. However, as ustekinumab affects the whole immune system, there’s a risk of serious side effects, including severe infections. You’ll be monitored for side effects during your treatment.
如果你确诊为牛皮癣，医生可能会向您推荐一个皮肤科医生。皮肤科医生是一名医生谁专门从事皮肤疾病。 牛皮癣不能根治。但随着治疗，可以减轻炎症和皮肤刺激性。 治疗由类型和银屑病的严重程度和皮肤的受影响的范围来确定。医生可能会开始用温和的处理，例如外用药膏（其被施加到皮肤），如果必要，需要更强的治疗。 广泛的治疗方法可用于银屑病，但确定哪些治疗是最有效的可能是困难的。如果你觉得治疗不工作，或者你有不舒服的副作用，告诉你的医生。 治疗方法可分为三类：•局部 – 应用到你的皮肤乳膏和软膏•光疗 – 皮肤暴露于某些类型的紫外线•系统 – 口服药物和注射药物整个身体机能 通常，你需要不同类型的治疗组合使用。你的治疗牛皮癣可能需要定期复查。您可能需要做一个关怀计划（你和你的健康专家之间的协议），因为这可以帮助你管理你的一天到一天的健康。
局部治疗通常用于轻到中度银屑病的第一个治疗。这些乳膏和软膏应用到受灾地区。一些人发现，局部治疗就足以控制自己的病情，尽管它可能需要长达六个星期才可能看到显着的影响。如果你有头皮牛皮癣，洗发剂和软膏的组合可能被推荐。 润肤剂润肤剂的保湿直接施用于皮肤以减少水的损失，并用保护膜覆盖它的治疗方法。如果你有轻度银屑病，润肤剂可能是你的医生会建议第一次治疗。润肤剂的主要好处是减少瘙痒和脱屑。一些局部治疗被认为在有被滋润皮肤更有效用。重要的是要等待润肤之后至少半小时才进行局部治疗。润肤剂可作为多种产品，可买了从药店柜台或你的家庭医生，护士或者健康访问规定。 类固醇药膏或软膏类固醇乳膏或软膏（局部皮质类固醇）通常用于治疗轻度至中度银屑病在身体的大部分区域。能减少炎症。这降低了生产的皮肤细胞，并减少瘙痒。外用皮质类固醇范围在强度从轻微到非常强。只使用外用皮质类固醇，当你的医生建议。较强的外用皮质类固醇，可以由医生处方，应该只对皮肤的一小块区域或特别厚的补丁使用。过度使用外用皮质类固醇可导致皮肤变薄
蒽酚已经使用了50多年治疗牛皮癣。它已被证明是有效地抑制生产皮肤细胞的并且具有很少的副作用。但是，如果过于集中它可以燃烧皮肤。 在医院的监督下，它通常用来作为短期治疗牛皮癣影响，四肢或躯干，因为它渍一切它与接触，包括皮肤，衣服和浴室配件。它适用于你的皮肤（戴手套），并放置10〜60分钟，然后被洗掉。蒽酚可以在与光疗组合使用（参见下文）。 光疗采用自然和人工光源来治疗牛皮癣。人造光疗可以在医院和部分专科中心给出，通常在皮肤科医生的照顾。这些处理和使用日光浴床是不一样的。 紫外线光疗紫外线（UVB）光疗法使用的光的波长是看不见的人的眼睛。光减慢生产皮肤细胞，并且是一种有效的治疗某些类型的牛皮癣该尚未答复的局部治疗。每个疗程只需要几分钟的时间，但你可能需要去医院，六到八周，每周两三次的。
补骨脂素加长波紫外线A（PUVA）对于该处理，则首先给予含有称为补骨脂素化合物的片剂，或补骨脂素可直接施用于皮肤。这使你的皮肤对光就越敏感。你的皮肤于是暴露在紫外线A（UVA）的波长。这种光比紫外线B光能穿透皮肤更深入。 如果你有没有回应其他治疗严重的牛皮癣,这种治疗方法可以使用。治疗的副作用包括恶心，头痛，烧和发痒。您可能需要服用药片，防止白内障的发展后，戴上特殊的眼镜24小时。不鼓励长期使用这种治疗方法，因为它可以增加你的皮肤癌的风险。 结合光疗结合光疗与其他治疗往往增加了其有效性。有些医生用紫外线光疗结合煤焦油，如煤焦油使皮肤更容易接受的光。结合紫外线光疗与地蒽酚软膏也可能是有效的（这被称为英格拉姆处理）。 如果你的牛皮癣严重或其他治疗方法都没有奏效，你可以通过一个专门规定的全身治疗。全身治疗是以整个身体机能做工治疗。 这些药物可以非常有效地治疗牛皮癣，但它们都具有潜在的严重的副作用。所有银屑病的系统治疗都有益处和风险。在开始治疗前，请告知你的医生你的治疗方案，并与他们相关联的所有风险。 有两种主要类型的全身治疗的，称为非生物（通常给定为片剂或胶囊剂）和生物（通常给定为注射）。这些将在下面更详细描述。 非生物药物Methotrexate 甲氨蝶呤甲氨蝶呤可帮助通过放慢生产皮肤细胞和抑制炎症以控制牛皮癣。它通常采取每周一次。甲氨蝶呤可引起恶心，并可能影响生产血细胞。长期使用可引起肝损害。谁有肝病的人不宜服用甲氨蝶呤和服用时，你不应该喝酒。甲氨蝶呤可以是一个发育中的胎儿是非常有害的，所以重要的是，妇女使用避孕药具，不怀孕直到治疗结束后三个月。甲氨蝶呤也可影响精子细胞的发育，所以在治疗过程中和三个星期之后，男人应该不要计划生育孩子。
Want to know more?
- The Psoriasis Association: systemic treatments
- The Psoriasis Association: biologic drugs for the treatment of psoriasis
- NICE guidance on etanercept and efalizumab for the treatment of psoriasis (efalizumab has been withdrawn from use because of safety concerns and NICE has suspended its guidance on this drug)
- NICE guidance on adalimumab for psoriasis
- NICE guidance on infliximab for psoriasis
- NICE guidance on ustekinumab for the treatment of adults with moderate to severe psoriasis
(age, gender, weight, height)
(exercise, smoke, dancer, etc)
|Smoke every morning|
|Condition||Whole body with patches of psoariasis|
|Dosage (daily), duration||3 x 3SL for the 1st three week (2 bottles), 2 x 3 SL for a month (2 bottles)|
|Result||Recovered 90% in two months|
(age, gender, weight, height)
|Condition||Psoriasis and diabetes|
|Dosage (daily), duration||1 Iz, one month|
|Condition||Psoriasis for 15 years|
|Dosage (daily), duration||(2Sl, 1 Iz) x 2|
|Result||After 3 days, skin started to peel|
|Dosage (daily), duration||1 Iz, but 2 Iz during detox period|