Lebwohl Mark
Department of Dermatology, Mount Sinai School of Medicine, New York, New York 10029, USA.
J Am Acad Dermatol. 2005 Jul;53(1 Suppl 1):S59-69. doi: 10.1016/j.jaad.2005.04.031.
Psoriasis is a chronically recurring inflammatory disease that affects the skin, scalp, and joints. It ranges in severity from mild to severe, and patients with moderate to severe disease experience significant deterioration in quality of life. The goals of psoriasis treatment are to gain initial and rapid control of the disease process, decrease the percentage of body surface area involved, decrease plaque lesions, achieve and maintain long-term remission, minimize adverse events, and improve patient quality of life. Therapy varies depending on disease severity and spread and will shift from control of acute flares to long-term maintenance. Topical treatment for mild psoriasis includes the use of topical corticosteroids, calcipotriene, tazarotene, topical tars, anthralin, and keratolytics. Treatment of moderate to severe psoriasis includes systemic therapies, such as methotrexate, acitretin, cyclosporine, and biologic agents. Treatment can be effected using combination, rotational, or sequential regimens. Treatment algorithms developed by a 2002 consensus conference are described. Because some degree of therapy will always be necessary, ranging from maintenance of long-term remission to control of acute psoriasis flares, each patient requires an individualized plan.
银屑病是一种慢性复发性炎症性疾病，可累及皮肤、头皮和关节。其严重程度从轻到重不等，中重度患者的生活质量会显著下降。银屑病治疗的目标是初步并迅速控制疾病进程，减少受累体表面积百分比，减少斑块病变，实现并维持长期缓解，将不良事件降至最低，并提高患者生活质量。治疗方法因疾病严重程度和扩散情况而异，会从控制急性发作转向长期维持治疗。轻度银屑病的局部治疗包括使用外用皮质类固醇、卡泊三醇、他扎罗汀、外用焦油、蒽林和角质剥脱剂。中重度银屑病的治疗包括全身治疗，如甲氨蝶呤、阿维A、环孢素和生物制剂。可采用联合、轮换或序贯治疗方案。描述了2002年共识会议制定的治疗算法。由于无论从维持长期缓解到控制急性银屑病发作，某种程度的治疗总是必要的，因此每位患者都需要个性化的治疗方案。
