Stein Gold Linda F
Director of Dermatology Research Henry Ford Health System Detroit, Michigan.
Semin Cutan Med Surg. 2016 Mar;35(2 Suppl 2):S36-44; quiz S45. doi: 10.12788/j.sder.2016.006.
Psoriasis is a chronic disease that has a substantial effect on quality of life of patients and often needs long-term treatment. Topical treatments for psoriasis include corticosteroids, vitamin D derivatives, tazarotene, anthralin, tacrolimus, pimecrolimus, and newer formulations of tar. Although many of these treatments are effective, they must be prescribed appropriately and used consistently for a period of weeks to months before clinical evidence of improvement can be seen and patients perceive that the treatment is working. As such, medication dosage/schedule, choice of vehicle, and especially patient adherence to medication are key factors for a treatment to be effective. Addressing patient preferences about treatments and concerns about treatment-related toxicities and managing their expectations represent additional aspects of patient care. Therapies such as calcipotriene and betamethasone dipropionate (Cal/BD) fixed combination foam and new drugs and vehicles continuously enhance the treatment landscape for psoriasis. Because adherence to topical treatment can be a major difficulty, keeping the treatment regimen simple and using new and sophisticated treatment vehicles that are acceptable to patients can likely improve treatment outcomes.
银屑病是一种慢性疾病，对患者的生活质量有重大影响，且常常需要长期治疗。银屑病的局部治疗方法包括皮质类固醇、维生素D衍生物、他扎罗汀、蒽林、他克莫司、吡美莫司以及新型焦油制剂。尽管这些治疗方法中有许多是有效的，但必须合理处方并持续使用数周乃至数月，才能看到临床改善的证据，患者也才能感觉到治疗正在起作用。因此，药物剂量/用药时间表、剂型选择，尤其是患者对药物的依从性，是治疗取得成效的关键因素。关注患者对治疗方法的偏好、对治疗相关毒性的担忧以及管理他们的期望，是患者护理的其他方面。诸如卡泊三醇和二丙酸倍他米松（钙泊三醇/倍他米松）固定复方泡沫制剂以及新药和新剂型等疗法不断改善着银屑病的治疗局面。由于坚持局部治疗可能是一个主要难题，保持治疗方案简单并使用患者可接受的新型复杂治疗剂型可能会改善治疗效果。
