Luba Kelly M, Stulberg Daniel L
Am Fam Physician. 2006 Feb 15;73(4):636-44.
Chronic plaque psoriasis, the most common form of psoriasis, is a papulosquamous disease defined by erythematous plaques with a silvery scale. The diagnosis usually is clinical, but occasionally a biopsy is necessary. Psoriasis affects 0.6 to 4.8 percent of the U.S. population, and about 30 percent of affected patients have a first-degree relative with the disease. Psoriasis is a T-cell-mediated autoimmune disease, but certain medications and infections are well-known risk factors. Management of psoriasis includes education about chronicity, realistic expectations, and use of medication. Steroids and vitamin D derivatives (e.g., calcipotriene) are the mainstays of topical therapy. Topical steroids and calcipotriene together may work better than either agent alone. Patients with psoriasis involving more than 20 percent of their skin or those not responding to topical therapy are candidates for light therapy; traditional systemic therapy; or systemic treatment with immunomodulatory drugs such as alefacept, efalizumab, and etanercept.
慢性斑块状银屑病是银屑病最常见的形式，是一种以带有银色鳞屑的红斑鳞屑为特征的丘疹鳞屑性疾病。诊断通常依靠临床症状，但偶尔需要进行活检。银屑病在美国人群中的发病率为0.6%至4.8%，约30%的患者有一级亲属患此病。银屑病是一种T细胞介导的自身免疫性疾病，但某些药物和感染是众所周知的危险因素。银屑病的治疗包括对慢性病的教育、现实的预期以及药物的使用。类固醇和维生素D衍生物（如卡泊三醇）是局部治疗的主要药物。局部类固醇和卡泊三醇联合使用可能比单独使用任何一种药物效果更好。银屑病累及皮肤超过20%的患者或对局部治疗无反应的患者可选择光疗、传统的全身治疗或使用免疫调节药物（如阿法赛特、依法利珠单抗和依那西普）进行全身治疗。
