Itin P H, Helbling F
Dermatologische Klinik, Universitätsspital Basel.
Ther Umsch. 1998 Aug;55(8):484-91.
Psoriasis was already mentioned in the Corpus Hippocratium and only 1842 was it possible to separate this entity from lepromatous skin manifestations. Psoriasis is rather common and the prevalence in northern countries ranges between 1-2%. Psoriasis is an inherited disorder but the clinical manifestations depend on several triggers such as infections, drugs and stress. The clinical presentation is characterized by silvery scales on an erythematous ground. The management of psoriatic patients needs a broad experience. The objective degree of disease activity as well as the subjective aspects of the disease need to be taken in account. The therapeutic modalities used in the treatment of psoriasis can be compared with a symbolic ladder. At the beginning of the ladder emollients are to be mentioned. Ascending the ladder, different topical treatments can be used such as steroids or vitamin D and the more severe forms do need systemic treatments such as ultraviolet therapy, eventually combined with a photosensitizer, retinoids or methotrexate and even cyclosporine. In special cases treatment as an outpatient is not possible and then hospitalisation in a dermatologic unit is necessary.
银屑病在《希波克拉底文集》中就已被提及，直到1842年才有可能将该疾病与麻风性皮肤表现区分开来。银屑病相当常见，在北方国家的患病率在1%至2%之间。银屑病是一种遗传性疾病，但其临床表现取决于多种诱因，如感染、药物和压力。临床表现的特征是在红斑基底上有银色鳞屑。银屑病患者的管理需要丰富的经验。需要考虑疾病活动的客观程度以及疾病的主观方面。用于治疗银屑病的治疗方式可以用一个象征性的阶梯来比较。在阶梯的起始阶段要提到润肤剂。沿着阶梯向上，可使用不同的局部治疗方法，如类固醇或维生素D，而更严重的形式确实需要全身治疗，如紫外线疗法，最终可联合使用光敏剂、维甲酸或甲氨蝶呤，甚至环孢素。在特殊情况下，门诊治疗是不可能的，那么就有必要在皮肤科病房住院治疗。
