Male, hand psoriasis for 2 years
马某，男，46岁，2013年2月13日就诊。
Ma *, male, 46 years old. On February 13, 2013, this patient visited our hospital.
现病史：马某患银屑病有两年了，起初的时候，手肘部发现有点状丘疹，并且有瘙痒感，自行到药店拿了止痒的药膏擦拭，一个礼拜后，未见好转，反而症状加重，鳞屑越来越厚，瘙痒状况严重，无奈之下去了市区的医院诊治，诊断为银屑病，开了外用药膏，马某遵照医嘱按时用药，病情缓解。但春节刚过，马某的银屑病突然加重，原先手肘部位加重复发，经亲戚介绍，来我院接受治疗。
Present Illness: This patient had a psoriasis for two years. At the beginning, a punctuate papule with an itching appeared on the hand/elbow, and then he bought the anti-itching medicinal ointments at a drugstore. After the smearing for one week, above symptoms were not improved but exacerbated, the squama became thicker and thicker, and the itching became serious. Then, he visited an urban hospital, was diagnosed as psoriasis, and prescribed with external ointments. After the smearing strictly at the doctor’s advice, the illness was relieved. However, just at the end of Spring Festival, the psoriasis was exacerbated suddenly, and the papule at the hand/elbow exacerbated and recurred. At the introduction of his relatives, he visited our hospital.
检查：通过申淑华主任的望闻问切，患者的病情是由于自身免疫异常引起，发病时，长期使用药物，进一步刺激了皮损部位，导致皮损面积不断扩大
Examination: Through the diagnosis via inspection, listening/smelling, inquiry and palpation/pulse-taking, Director Shen Shuhua thought that the immune dysfunction caused the psoriasis and the long-term pharmacotherapy further irritated the injured skin to continuously expand the skin injury area
诊断：银屑病
Diagnosis: Psoriasis
治疗：
Treatment:
由于患者皮损处长期受到药物的刺激，导致皮损处出现了严重的血虚、血瘀现象，所以在进行治疗时，首先采用针灸疗法，促进局部毛细血管的功能，加速皮肤对药物的吸收。
Due to the long-term medicinal irritation, a serious blood deficiency and blood stasis appeared at the injured skin. Therefore, an acu-moxibustion therapy was first given to promote the function of local blood capillary and accelerate the skin absorption of medicines.
为更好的从根源清除患者体内的致病机制，采用中药药浴疗法，提高药物吸收率，结合人体的自身调节功能，把毒素排出体外，抑制细菌感染。对综合治疗起到了一定的促进和巩固作用。
In order to better essentially eliminate the internal pathogenesis, a TCM medicinal bathing therapy was given to improve the absorption rate of medicines, expel the toxins by combining the auto-regulation function of human body and inhibit the bacterial infection. It could promote and reinforce the comprehensive treatment to a certain extent.
中医治疗讲究标本兼治，通过外部药物的渗透、血瘀的清除，又采用了中药内服疗法。针对不同的银屑病类型，治疗银屑病的中药方剂也是有所不同的。患者属于热入血分，外发斑疹型患者，采用犀角地黄汤合白虎汤加减的药方。主要帮助患者凉血，清热，解毒，利湿。在经过内外兼治一段时间后，患者皮损处得到了有效的改善。
In the TCM therapy, both the manifestations and root cause were treated through the infiltration of external medicines, the removal of blood stasis and the oral administration of TCM medicines. TCM prescriptions varied with the type of psoriasis. Due to the heat invasion into blood and the external manifestation of macula, the prescription was made by adding or deleting the medicines in the Xijiao Dihuang Tang + Baihu Tang. This prescription mainly had the following effects: blood cooling, heat clearing, toxin removal and diuresis promoting. After the treatment through both internal and external methods for some time, the injured skin was effectively improved.
专家点评：
Expert comment:
采用药膏进行涂抹是很多银屑病患者在初期常做的事情，缺乏对银屑病的认识是导致患者皮损面积不断扩散的主要原因。对大家的提醒时，一旦发现身上皮肤有异样时，一定要及时选择专业正规的医院进行科学有效的治疗，不要轻易去相信随便涂涂抹抹可以治好病。
At the beginning, many psoriasis patients often smear the medicinal ointments, but the skin injury continuously expands due to the incorrect understanding of psoriasis. Whenever any abnormality is found on the skin, you should visit the professional formal hospital in time for scientific effectively cured, and must not take it for granted that the psoriasis can be cured by smearing some uncertain medicines.
