Diagnosis and Management of Psoriasis-A Narrative Review

Psoriasis is a chronic, non-infectious skin disease. According to clinical manifestations, psoriasis can be classified as psoriasis vulgaris and unusual psoriasis. Psoriasis vulgaris usually occurs on the scalp, extensor side of the limbs, and joints, and its distribution is symmetrical. The lesions are clearly demarcated, red, scaling papules or plaques, often covered with silvery-white scales. Unusual psoriasis shows greater variations, manifesting as pustules, erythroderma, or involvement of the joints, including joint psoriasis, pustular psoriasis, and erythrodermic psoriasis. The disease conditions are divided into the progressive stage, stationary stage, or regressive stage in the course of development. The Koebner phenomenon often occurs in the progressive stage, and non-specific injuries may induce preexisting skin diseases. The course of the disease is long and sometimes self-healing, but easy to relapse. Symptoms usually worsen in winter and lessen in summer. The disease is common during adolescent and menopausal periods. The lesions in female patients generally improve when they are pregnant. Also, psoriasis is associated with cardiovascular disease, depression, and psoriatic arthritis. Oral immune-regulatory drugs, topical creams, and light therapy are used to treat psoriasis. The latest drugs are injectable bioagents. However, though initially effective, these bioagents gradually become less effective after several years of treatment. The newest oral target therapy drugs are available in Taiwan.

關鍵字

plaque psoriasis ； psoriasis vulgaris ； guttate psoriasis ； psoriatic arthritis ； pustulosa psoriasis ； erythrodermic psoriasis

並列摘要

乾癬是一種非傳染性皮膚病，根據臨床表現可分為尋常型乾癬和非尋常型乾癬。尋常型乾癬好發頭皮、四肢關節伸側，分佈對稱且病灶界限明顯、紅色脫屑之丘疹斑塊表面常覆蓋銀白色鱗屑。非尋常型乾癬的表現為膿皰、紅皮症或侵犯關節包括：乾癬性關節炎、膿皰型乾癬和紅皮症型乾癬。依病情可分為進行期、靜止期、消退期。進行期出現Koebner's phenomenon（同形反應），非特異性損傷誘發已存在的皮膚病，有時可以自癒但容易復發，冬季症狀加重而夏季減輕，青春期及更年期發病率較高，乾癬與心血管疾病、憂鬱症也有關；治療包含口服免疫調節劑或是外用藥、照光等，最後是新型的注射式生物製劑，生物製劑雖然效果好但常用了幾年後會逐漸變差，國內目前有最新的口服標靶藥物。

並列關鍵字

乾癬；尋常型乾癬；滴狀乾癬；乾癬性關節炎；膿泡型乾癬；紅皮型乾癬

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