Dubertret L
Service de dermatologie, hôpital Saint-Louis, Paris.
Rev Prat. 1991 Oct 15;41(22):2188-91.
The strategy of psoriasis treatment consists first in informing the patients about the too quick renewal of their skin with, as a consequence, the necessity of two phases in the treatment; the clearing phase aimed at suppressing the skin lesions, and a maintenance phase where it is necessary to continue the treatment on an apparently normal skin in order to avoid relapse. For local treatments (tar, anthralin, topical local steroids, mechlorethamine, vitamin D3 derivatives and ointment) and for systemic treatment (UVB, PUVA therapy, retinoids, cyclosporine or methotrexate) it is necessary that the inconvenience of the treatments (due to modifications in everyday life and due to side effects) be less important than the decrease of life quality due to psoriasis. The aim is not to clear psoriasis but to increase the quality of life of the patients. A peculiar strategy of treatment is necessary for some forms of psoriasis like flexural psoriasis, psoriasis arthritis, ungueal psoriasis, palmoplantar psoriasis, pustular psoriasis, psoriatic erythroderma and psoriasis of the child. With the various treatments that we have now, used alone or in association, it is possible to improve the quality of life of nearly all psoriatic patients.
银屑病的治疗策略首先在于告知患者其皮肤更新过快，因此治疗需要分两个阶段进行；清除阶段旨在抑制皮肤病变，维持阶段则需要在皮肤表面看似正常时继续治疗，以避免复发。对于局部治疗（焦油、蒽林、局部外用类固醇、氮芥、维生素D3衍生物和软膏）和全身治疗（UVB、PUVA疗法、维甲酸、环孢素或甲氨蝶呤），治疗带来的不便（由于日常生活的改变和副作用）必须小于银屑病导致的生活质量下降。目标不是清除银屑病，而是提高患者的生活质量。对于某些类型的银屑病，如屈侧银屑病、银屑病关节炎、甲银屑病、掌跖银屑病、脓疱型银屑病、红皮病型银屑病和儿童银屑病，需要采取特殊的治疗策略。使用我们现有的各种单独或联合使用的治疗方法，可以改善几乎所有银屑病患者的生活质量。
