It usually occurs on the scalp, the extensor sides of the joints of the limbs, and the sacrococcygeal area, and is symmetrical.

Typical manifestations: initially appear as red corn-to-mung bean-sized papules/maculopapular rashes, gradually expanding into well-defined red plaques (drop-shaped, plaque-shaped, coin-shaped, map-shaped, oyster-shell-shaped), covered with a thick layer of silver-white scales ; When the uppermost layer of scales is scraped, it can be observed that the scales are layered, like scraping wax drops (wax drop phenomenon). After scraping off the scales, a red shiny film will be revealed (film phenomenon). If the scales are scraped off again, small dewdrop-like bleeding will appear. Spots (spot-like bleeding phenomenon, the essence is that the tortuous and expanded capillaries on the top of the dermal papilla are scratched), the above three are collectively called Auspitz's sign; patients often feel itchy to varying degrees

Different parts have different performances

Course of disease: long course, sometimes self-healing but easy to relapse; usually severe in winter and mild in summer

Special type - acute guttate psoriasis/ eruptive psoriasis: common in young people, often with a history of streptococcal infection in the throat before the onset; the onset is sudden, and it can spread throughout the body within a few days, with skin Papules/maculopapular lesions of 0.3~0.5mm, flush in color, covered with a small amount of scales, with varying degrees of itching; can subside within a few weeks after appropriate treatment, and a few can become chronic

Arthropathic psoriasis (psoriasis arthropathica): RF-negative but HLA-B27-positive arthritis, which can occur in all joints but is asymmetrical; has a high incidence in severe psoriasis; most arthritis symptoms and skin lesions are severe The degree is parallel, manifesting as joint swelling and pain, and limited movement, which may later recover or cause joint bone destruction and deformity.

Pustular psoriasis (psoriasis pustulosa)

Erythrodermic psoriasis (psoriasis erythrodermica): mostly transformed from the vulgaris/pustular type. It can be induced by the use of strong irritating drugs, long-term use of antimalarial drugs, and irregular use of glucocorticoids; it manifests as systemic skin disease Diffuse flushing, infiltration and swelling, and a large amount of bran-like desquamation, with flakes of normal skin (skin islands) in between; hyperkeratosis of the palms and soles, thickening and peeling of the nail plate; systemic symptoms in the acute phase; the course of the disease can last from months to years

Find and eliminate triggers (such as anti-infection, relieving mental stress, improving immunity); avoid the external use of strong irritating drugs and avoid mechanical irritation to the skin

Retinoic acid: various types of psoriasis

Immunosuppressants: suitable for unusual types; commonly used MTX Antibiotics: suitable for obvious infections and generalized pustular types

Glucocorticoids: generally not recommended for use in the usual type, mainly used in erythrodermic type, acute arthropathy type, and generalized pustular type

Traditional Chinese medicine treatment: clearing heat and cooling blood, cooling blood and activating blood circulation, activating blood circulation and removing blood stasis. Immunomodulator: suitable for those with low cellular immune function.

Biological agents: suitable for moderate to severe psoriasis and psoriatic arthritis; use with caution in tuberculosis

Glucocorticoids (creams/creams); are effective, but attention should be paid to their adverse reactions (especially long-term use of powerful preparations over large areas can induce pustular/erythrodermic psoriasis after discontinuation)

Retinoic acid cream: commonly used concentration is 0.025~0.1%

Vitamin D3 derivatives: such as calcipotriol; but not suitable for use on the face and skin folds. Others: such as keratin promoters

UVB is mostly used (especially narrow-band UVB, 311nm); photochemotherapy, 308nm excimer laser, hydrotherapy, and oxygen therapy can also be used

More common in women aged 15 to 40 years old; more common in spring and autumn; more common in the trunk and proximal limbs

It is initially an isolated rose-colored light red papule/macula, which can merge into an oval/annular shape, and can quickly expand to 2~3cm in diameter (larger than subsequent skin lesions), with clear borders, and the surface is covered with fine scales, which is called It is the precursor spot/mother spot, which usually lasts for 1 week; then the mother spot disappears and the skin lesions gradually spread, with a diameter of 0.2~1cm, often oval, and the edges are covered with thin scales with a collar-like free edge inward. The long axis and Parallel skin lines; often moderate itching

The course of the disease is self-limiting, usually 6 to 8 weeks; some cases may not recover for several years; there is generally no recurrence after recovery.

The skin lesions are limited to one place and merge into annular patches, similar to tinea corporis papule type: more common in children (especially those under 5 years old)

Purpuric type: manifests as petechiae and petechiae distributed along the neck, trunk, and proximal skin striae of the limbs

Oral lesions: uncommon; occur at the same time as skin lesions, manifesting as mucosal erythema, raised edges, and ulcers or ulcers in the center; no subjective symptoms

Ultraviolet (UVB) treatment, topical corticosteroids/calamine lotion

Oral antihistamines; in severe cases, short-term oral/intramuscular corticosteroids

More common in children and young women, with a predilection in spring and autumn; the onset is rapid and may have prodromal symptoms (chill, fever, headache, joint/muscle pain); the course of the disease is self-limiting and relapsing

Skin lesions are polymorphic

Erythema-papule type

Vesicular-bullous type

Severe form (Stevens-Johnson syndrome)