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标题: 大家讨论 P病如果正确处理会自然发展到什么地步呢？ [打印本页]

作者: xibaolyq 时间: 2007-3-8 17:07
标题: 大家讨论 P病如果正确处理会自然发展到什么地步呢？
所谓正确处理指得是没有错误用过内服药物，这样得话，将来会发展到什么程度？？
大多数基本可以控制？越来越厉害？还是说不清楚，因人而异？？
学院派得观点是  特别严重得不多  中等程度得有  轻度得居多
先说说我得情况  15年左右也许还要长，小的时候很小一片经常脱皮，没觉的是毛病，自然也就没有吃药。
研究生时候有零星发作外用蒽林吃了点中药汤剂下去了  估计有4-5年基本就是小腿有1-2小片，今年冬季
小腿有点滴发作，不多  蒽林处理基本好转了。但是不知道以后会怎么样

认识一个P友年轻是突然四肢头皮泛发，没怎么治疗，自愈  20年保持现状期间生了2个孩子，怀孕期间无变化，
孩子健康。前几年突然泛发全身，还是没有敢吃药，痛苦坚持了2年，自己又好的差不多了保持2％一下目前稳定，
冬季偶尔有点。她得泛法好像没有原因没有乱用药，没有心情不好，没有炎症。
感觉好像没有规律可寻啊？大家是怎样得啊？保持稳定得多吗？

作者: 猪小P 时间: 2007-3-8 17:37
我最长时间保持两年一点痕迹都没有,现在是每年都会有新发的,好在可以控制.

作者: Demark 时间: 2007-3-9 00:01
<

>极好的话题.请老病友积极反馈.</P>
<

>我个人一直在死扛,扛了快两年了.从05年10月爆发到现在仅头上比较严重,除发病是由于激素引起,后停了激素,可以说基本什么药都没用,一年半内连一般止疼药都不敢服用,生怕招惹了自己的免疫系统.身上还有一点,但基本无碍.</P>
<

>要是头上也好了,那就谢天谢地了.</P>

作者: flypig 时间: 2007-3-9 00:36
<

>如果真能正确处理肯定不会很严重,但有几个可以正确处理呢,我猜想老病号也摸不透P的规律和药的特性.</P>

作者: wjwhpwj 时间: 2007-3-9 08:57
<

>蒽林是什么药各位P友帮忙解答一下吧</P>

作者: xibaolyq 时间: 2007-3-9 10:14
<STRONG>美国银屑病基金会手册：十一、银屑病与蒽林治疗</STRONG>
<DIV><FONT size=3>美国银屑病基金会手册：十一、银屑病与蒽林治疗<BR><BR>银屑病是一种非传染性的慢性皮肤病，其最常见的特征是皮肤上隆起的红色皮损和斑块，被干燥的银白色鳞屑覆盖。这种类型的银屑病称为斑块型银屑病。<BR>这些斑块由人体产生的过量皮肤细胞组成。目前有些研究者认为这种细胞生长加速现象是因为人体的免疫系统出现紊乱而激发的。<BR>许多治疗银屑病的目标是使细胞过度增殖现象正常化或得到延缓。其中之一便是蒽林。<BR><BR>一、蒽林是什么？<BR>蒽林是柯桠素的一种合成代用品, 柯桠素是在南美柯桠树树皮的柯桠粉中发现的，这种物质被用于治疗银屑病已超过一百年之久了。<BR>1、蒽林的疗效如何？<BR>蒽林用于治疗斑块状银屑病是非常有效的。但用于治疗点滴型银屑病却疗效不佳，该型的银屑病以小的斑点样皮损为特征。<BR>在一些患者蒽林也能获得长期的缓解。在住院治疗或日间治疗方案中使用，蒽林能产生数月至一年或更长的缓解期，但是具体效果因人而异。<BR>2、如何使用蒽林？<BR>蒽林可通过以下两种用法之一使用：泛发的、严重的银屑病用Ingram疗法；轻微的、局限的银屑病在家治疗。<BR><BR>二、Ingram疗法：住院治疗＋日间治疗方案<BR>Ingram疗法是将蒽林粘胶、煤焦油浴疗和紫外线照射结合。蒽林以稠厚的粘胶形式用于皮损（常指Lassar粘胶）。可用0.1%到5%或更强的制剂。一旦蒽林被清除以后，病人暴露于紫外线中，并可同时行煤焦油浴疗。通常先用低浓度的蒽林，然后逐渐增加浓度直至皮损被清除。<BR>蒽林能明显刺激或损伤被治疗皮损的周围正常皮肤。它也能污染衣物、被褥和周围设备使其变褐色或紫色并不容易被清洗。因此，该治疗需要一个特殊的治疗环境如住院治疗和日间治疗方案以及由熟练的医务人员监管。<BR>一般地，使用Ingram疗法接受住院或日间治疗方案的患者要求治疗三周，平均20天可清除皮损。<BR><BR>1、在家的蒽林治疗<BR>已经建立起新的疗法和新的治疗方案使得该药物治疗更容易在家庭进行。<BR>短期接触式蒽林治疗（Short-Contact Anthralin Therapy, S.C.A.T.）S.C.A.T.（也称为“分钟治疗”）是为那些部位局限的银屑病患者设计的。蒽林存留在受累皮肤上的时间比Ingram疗法要短很多。存留时间长短不一，从十分钟到一小时不等。随着皮肤对药物治疗变得不敏感，可指导病人逐渐增加接触时间。<BR>蒽林与其它治疗联合使用，包括UVB治疗、PUVA或外用的类固醇，可能会提高反应，但是在开始这种疗法之前先向您的医生咨询。<BR>S.C.A.T.产生的大部分刺激和污染作用可通过使用三乙醇胺预防，三乙醇胺是一种非类固醇类的化学药品，许多年来一直被用作肥皂和化妆品的稳定剂。其商品名为CuraStain，它可中和任何残留在皮肤上的蒽林。<BR>在蒽林被冲洗掉之前一到两分钟，先在皮肤上使用CuraStain，使皮肤表面形成一层保护膜，这可预防冲洗时造成污染，从而避免对未受累的皮肤产生刺激。在皮肤用毛巾擦干后再次使用以中和残留的蒽林。CuraStain是由Young制药厂（800-874-9686）生产的，在药店以非处方药出售。<BR><BR>2、蒽林制品（Anthra-Derm,Drithocreme,Lasan）<BR><BR>关于使用家用霜剂或软膏的建议：<BR>1、霜剂/软膏仅用于银屑病；请不要用于正常的皮肤。在用蒽林时您最好戴上塑料一次性手套。耳褶和颈部可用凡士林涂抹以避免与蒽林的接触造成刺激。<BR>2、蒽林霜剂应适当涂敷，任何剩余的部分都应被擦拭掉。<BR>3、蒽林会引起污染，被污染物为褐色。如果发生了污染，请用水清洗而不要用肥皂（参见去除蒽林污染的方法）。<BR>4、在使用蒽林以后，在周围正常的皮肤上看见褐色污点是一个好的现象，这说明蒽林正在起作用。当污点出现在皮损的中心时，银屑病正得到清除。皮肤和毛发上的污点最后可褪色并且消失。<BR>5、用完蒽林后要洗手；不要用蒽林污染的手指擦拭眼睛。不要在眼睛附近、面部或腹股沟区使用蒽林。<BR>6、如果眼睛受到刺激，请立即用水冲洗眼睛并让您的医生检查一下。<BR>7、必须使用新鲜的蒽林以使作用更有效。新鲜的蒽林粘胶或霜剂是亮黄色的。蒽林硬膏剂的保持期大约为六个月。当它被氧化和失去药效时，颜色会逐渐变暗。<BR>8、使用蒽林时遵循你的医生的指导是很重要的。因为有许多方法能使用它。当使用这种强效药物时，要始终与你的医生核对有关需要注意的事项。<BR>9、蒽林不会使皮肤产生光敏感（对紫外线反应增强），因此正常的日光浴是可以同时进行的。<BR><BR>蒽林与头皮型银屑病<BR>短期接触法治疗头皮银屑病是有效的，至少有一种蒽林制品对头皮型银屑病疗效尤其明确，它的商品名是Dritho-Scalp。<BR>蒽林应在头皮上存留十分钟左右然后再冲洗掉。每天这样使用能使对许多病人在数周内清除掉头皮上的银屑病。<BR>有时，对于那些对类固醇洗液和焦油洗发剂无反应的厚的鳞屑，可能需要更大用量的蒽林才能发挥作用。蒽林可与其它药物如水杨酸、矿物油或丙烯乙二醇混合使用，应将药物抹在头皮上并保留整夜。混合药物可在早晨洗头去清除掉，根据不同的反应，以后可以每日或间隔使用。<BR><BR>3、Micanol<BR>Micanol是一种较新的蒽林剂型，它可以减少普通蒽林制剂的污染和刺激性。Micanol是一种1%的蒽林霜剂，其活性成分在油脂保护层内形成“微胶囊”。这些保护层在体温下溶解，仅在用药部位的皮肤释放蒽林，而不会污染衣物、床单和浴室设备。<BR>联合使用S.C.A.T.和Micanol能明显降低蒽林的副作用。一项研究比较了Micanol和蒽林石油碱溶液的疗效和副作用，用药一周以后，使用Micanol的患者中仅9%出现皮肤刺激，而相比之下，使用蒽林石油溶液的患者出现这种副作用的占58%。仅5%使用Micanol的患者发现皮肤上有污染，而在使用蒽林/石油的患者中高达82%。<BR><BR>使用Micanol的方法：<BR><BR>将少量的Micanol用于皮损部位，避免与周围正常的皮肤接触。<BR>涂敷霜剂要完全，这样不容易污染；而且能确保完成了“溶解”过程。<BR>用完药后立即用凉水或温水洗手，热水能溶解油脂层并释放药物，从而导致污染或刺激。<BR>在规定的S.C.A.T.时间内保留Micanol不被清除，然后再用凉水或温水冲洗皮肤。应避免用热水和肥皂来清洗。<BR>Micanol被完全冲洗掉以后，可以用热水和肥皂冲洗或洗澡。<BR><BR>4、Micanol与头皮型银屑病<BR>如果正确使用，Micanol对头皮型银屑病非常有效，同时还能大大减少头发的污染问题，但要注意使用的方法。首先用洗发剂洗头发并冲洗，当头发仍潮湿时将头皮皮损暴露，把Micanol涂抹于皮损处，然后立即用凉水或温水洗手，这样能洗掉药物残存物又能防止保护层被破坏。在Micanol被完全从头皮和头发上冲洗掉以后，然后才能洗头。<BR><BR>什么时候不应该使用蒽林？<BR>大部分蒽林制剂禁用于面部和腹股沟区，你可从NPF得到更多有关治疗这些部位银屑病的信息，包括我们的手册“特殊部位的银屑病”和“生殖器银屑病”，也可向您的医生咨询。<BR>Micanol不推荐用于生殖器银屑病。在极其谨慎的情况下，Micanol才能被用于面部或皮肤皱褶的敏感区域，但是如果你感觉到刺激时应该立即停止使用。<BR>关于在妊娠期使用蒽林是否有问题目前还不清楚。正在使用蒽林的妊娠妇女应与她们的医生商量后再使用。<BR><BR>5、蒽林有副作用吗？<BR>目前还没有关于局部用蒽林治疗银屑病导致长期副作用的报道。但是它有两个主要的短期副作用--刺激正常皮肤以及污染衣物和皮肤。<BR>患者对蒽林的耐受各不相同，有些人不能耐受低至0.1%的浓度，而另一些人可耐受2-4%以上的浓度。<BR><BR>蒽林是如何出售的？<BR>蒽林是一种处方药，有霜剂和软膏两种剂型。霜剂的使用更方便而且产生的污染和刺激性更小，因为它能进入被涂敷的皮肤而且剩余的可用棉纸擦掉。<BR>软膏的优点是有超过1%的浓度的剂型。一项研究发现4%浓度的软膏作用15分钟能产生最快的药效。作用更强的软膏和Lassar粘胶则是由药剂师配制的。<BR><BR>蒽林软膏可用液体肥皂或沐浴清除掉。清除蒽林时可以使用低pH值的微酸性肥皂。<BR><BR>6、蒽林造成的污染的清除<BR>清洁剂能在织物内与蒽林“结合”，因此只要在完全冲洗后洗涤即可。<BR>白色织物：一般地，污染在织物上存留的时间越长，清除就越困难，但是存留时间长达24小时的污染也可以被从试验性织物（65%多元酯/35%棉，100%多元酯和100%棉）上清除掉，在高强度的氯漂白剂（如Clorox）中浸泡10分钟，然后用水冲洗并自然风干是比较可行的方法。<BR>染色的织物：1∶10稀释的氯漂白剂可以用于清除这种污染，但是在用稀释的漂白剂之前建议行漂白安全性试验以确保织物不褪色。<BR>白色塑料浴室帘子：最好的方法是立即处理（5分钟内），先使用95%酒精或一种能在杂货店买到的清洁用品Lestoil，然后再用水冲洗。如果污染5分钟内不被清除的话，可能用任何溶剂或家用化学用品都不能完全清除污染了。<BR>有裂缝的白色地板：擦洗清洁剂如Comet或Soft Scrub能清除地板上的污染，但是偶尔会残留暗褐色的污点。用含丙酮的清洁剂也很有效。<BR>浴盆或淋浴器：用含丙酮的清洁剂可能比较有效。餐具清洁剂可能有助于清除浴盆或淋浴器内残留的污染。使用CuraStain可以防止浴盆或淋浴器被污染，也可以用95%酒精。<BR><BR>Micanol污染的清除<BR>如果Micanol沾上衣物或浴室设备，首先用凉水或温水冲洗，但要注意禁用热水。然后对于衣物要用清洁剂和清水洗涤。残留在浴室设备上的沉积物可用清洁剂清除掉。<BR></FONT></DIV>

作者: woobinly 时间: 2007-3-9 11:56
<

>我从今年1月底发病到现在没有吃任何药，去医院看了看，大夫说让我抹点凡士林就可以了。这个病越治越厉害，结果我很高兴得接受了。有一段时间，发得很厉害，现在全身都是了，但是一直坚持用凡士林，因为这样身上还比较舒服点，但是还是会晚上不自觉地挠的满身都是血。</P>
<

>出差去了外地，所以没有太多的时间去看他了，结果最近洗澡的时候突然发现，身上的p都成了圆圈状，根据10年的病例经验，这是一个好现象，我想用不了几个月，他自己就会好了。看来这次死抗还是有效果的，但我想之所以会有效果和我现在的信念是分不开的，所以说大家不要太担心我们的病，只要坚持一定会有春天的。保持一颗好的心情，真的很重要。</P>

作者: xibaolyq 时间: 2007-3-9 17:50
<H2><FONT color=#f78d2a size=2>Topical treatments<BR></FONT>Anthralin<BR><IMG src="http://www.psoriasis.org/images/template/h_blue_rule.gif"></H2>
<H3>What is anthralin?</H3>Anthralin is a synthetic substitute for chrysarobin, found in Goa powder from the bark of the araroba tree of South America. This substance has been used to treat psoriasis for more than 100 years.
<H3>How well does anthralin work?</H3>Anthralin can be very effective in treating <a href="http://www.psoriasis.org/about/psoriasis/plaque.php" target="_blank" >plaque psoriasis</A>. It does not work as quickly or as thoroughly as superpotent topical <a href="http://www.psoriasis.org/treatment/psoriasis/steroids" target="_blank" >steroids</A>, but unlike steroids, it has no known long-term side effects.
<H3>How is anthralin used?</H3>Anthralin is available as a cream and a scalp formulation. A pharmacist can prepare higher-strength preparations of anthralin in a thick paste (often referred to as Lassar's paste).
<

>Anthralin has a long history as a safe treatment for psoriasis, but it can also be messy to use. Some practical guidelines for home use of anthralin include:
<UL>
<LI>Apply anthralin only to psoriasis; do not apply to unaffected skin. You may prefer to use plastic disposable gloves to apply anthralin.
<p>
<LI>Anthralin cream should be rubbed in well, and any excess should be wiped off.
<p>
<LI>Expect to see a brown stain on the surrounding skin if the anthralin comes into contact with the unaffected skin. When the stain occurs in the center of a lesion, the psoriasis is clearing. Stains on skin and hair will eventually fade and disappear.
<p>
<LI>Use old clothing and sheets when anthralin is on skin. Protective dressings (occlusion) can be used, unless otherwise instructed by your doctor. See tips for stain removal below.
<p>
<LI>Wash hands after applying anthralin.
<p>
<LI>Do not apply anthralin near eyes, on the face or in the groin area. Do not rub eyes with anthralin-contaminated fingers. Should eye irritation occur, rinse eyes with water and consult your doctor.
<p>
<LI>Anthralin must be fresh to work effectively. Fresh anthralin paste or cream is bright yellow. The shelf life of paste anthralin is about six months. </LI></UL>
<H3>Short-Contact Anthralin Therapy (SCAT)</H3>SCAT (also called "Minutes Therapy") is designed for patients with localized areas of psoriasis. Anthralin is left on the involved skin for a short period of time, ranging from 10 minutes to an hour. Patients may be instructed to gradually increase the amount of contact time as their skin becomes accustomed to the medication.
<H3>Anthralin on the scalp</H3>Short-contact use of anthralin may effectively treat <a href="http://www.psoriasis.org/about/psoriasis/scalp" target="_blank" >scalp psoriasis</A>. For many people, daily applications may clear psoriasis on the scalp in several weeks. Sometimes, a more potent application of anthralin is required to clear thick scales on the scalp that do not respond to <a href="http://www.psoriasis.org/treatment/psoriasis/steroids/" target="_blank" >steroid</A> lotions or <a href="http://www.psoriasis.org/treatment/psoriasis/topicals/tar.php" target="_blank" >tar-based</A> shampoos. In this case, the doctor can prescribe anthralin mixed with other agents, such as <a href="http://www.psoriasis.org/treatment/psoriasis/topicals/sal_acid.php" target="_blank" >salicylic acid</A>, mineral oil or propylene glycol. This mixture is massaged into the scalp and left on overnight, then removed in the morning by shampooing. Applying petroleum jelly to ear folds and the neck before applying anthralin will minimize contact with unaffected skin and reduce irritation.
<

>Anthralin stains are a particular problem for people who have very light hair. A neutral henna powder provides some protection against staining by coating the hair for three to four weeks. It can be diluted with warm water and left on the scalp for a half hour. Neutral henna is colorless, but it will interfere with a permanent or hair coloring. Neutral henna is available from beauty supply or health food stores.
<H3>

soriatec</H3>

soriatec is an anthralin formulation designed to reduce the risk of staining and irritation. It is a 1% anthralin cream in which the active ingredient is surrounded by a protective layer of lipids. These layers melt at body temperature, releasing the anthralin only on the skin where it is applied, not on clothes, bedding or bathroom fixtures.
<H3>Side effects of using anthralin</H3>Anthralin is known to be a skin irritant, and the irritation a patient experiences is directly related to the strength of the product being used and the individual's tolerance of the medication.
<

>It is not known if anthralin is safe during pregnancy. Women who become pregnant and are using anthralin should consult their doctor.
<H3>Staining from anthralin</H3>Much of the irritation and staining from anthralin use can be prevented with the application of triethanolamine, a nonsteroidal chemical used for many years as a stabilizer in soaps and cosmetics. Triethanolamine, known by the brand name CuraStain, neutralizes any anthralin residue remaining on the skin.
<

>CuraStain is first applied to the unaffected skin one or two minutes before anthralin is washed off, to form a protective film over the skin. This prevents smearing during removal, which would cause irritation of uninvolved skin. It is applied again after the skin is towel-dried to neutralize any remaining residue. CuraStain is manufactured by Young Pharmaceuticals, and is sold over the counter in drugstores.
<H4>Anthralin stain removal</H4>
<UL>
<LI><B>White fabric:</B> In general, the longer a stain remains on a fabric, the more difficult it is to remove. In one study, stains left up to a duration of 24 hours were removed from test fabrics (65% polyester/35% cotton, 100% polyester and 100% cotton) using a 10-minute soak in full-strength chlorine bleach, followed by a water rinse and air drying.
<p>
<LI><B>Colored fabric:</B> Chlorine bleach diluted by a ratio of 1-to-10 is sufficient to remove stains, but a bleach-safe test is recommended before applying the diluted bleach to assure color fastness.
<p>
<LI><B>White plastic shower curtain:</B> The best approach is immediate treatment (within five minutes) with 95% ethyl alcohol or Lestoil, a cleaning product found in some grocery stores, followed by a water rinse. If the exposure is longer than five minutes, anthralin stains may be impossible to remove with any solvent or tested household chemical.
<p>
<LI><B>White floor tile with crevices:</B> Scrub cleansers remove stains on floor tiles, but occasional dark brown spots may remain. Acetone-based cleansers are also effective at removing stains.
<p>
<LI><B>Tub or shower:</B> Acetone-based cleansers can help remove stains, as can dishwashing detergent. </LI></UL>
<H3>Using anthralin with other treatments</H3>Combining anthralin with other treatments, including <a href="http://www.psoriasis.org/treatment/psoriasis/phototherapy/uvb.php" target="_blank" >UVB</A> treatments, <a href="http://www.psoriasis.org/treatment/psoriasis/phototherapy/puva.php" target="_blank" >

UVA</A> (the use of the light-sensitizing drug psoralen plus ultraviolet light A), <a href="http://www.psoriasis.org/treatment/psoriasis/topicals/tazorac.php" target="_blank" >Tazorac</A> or <a href="http://www.psoriasis.org/treatment/psoriasis/steroids" target="_blank" >topical steroids</A>, may improve the response. Ask your doctor before initiating such a regimen.
<H4>The Ingram regimen</H4>The Ingram regimen combines anthralin paste, a <a href="http://www.psoriasis.org/treatment/psoriasis/topicals/tar.php" target="_blank" >coal tar</A> bath and <a href="http://www.psoriasis.org/treatment/psoriasis/phototherapy/" target="_blank" >UV exposure</A>. Anthralin is applied to lesions as a thick paste. Once the anthralin is removed, the patient is then exposed to UV and may also take coal tar baths. Generally, a patient using the Ingram regimen in the hospital or day treatment program will require three weeks of therapy, clearing in an average of 20 days.
<

><I>Updated June 2006</I></P>

作者: xibaolyq 时间: 2007-3-9 18:05
<H3>Severity of psoriasis</H3>
<UL>
<LI>The National Psoriasis Foundation defines mild psoriasis as affecting less than three percent of the body; 3 percent to 10 percent is considered moderate; more than ten percent is considered severe. The palm of the hand equals 1 percent of the skin. However, the severity of psoriasis is also measured by how psoriasis affects a person's quality of life. Psoriasis can have a serious impact even if it involves a small area, such as the palms of the hands or soles of the feet.
<p>
<LI>The majority of people with psoriasis have mild disease.
<p>
<LI>Nearly one-quarter of people with psoriasis have cases that are considered moderate to severe. </LI></UL>

作者: 8716000 时间: 2007-3-9 22:20
楼上的是外国人?怎么发的全是外文?[em01]

作者: pp也疯狂 时间: 2007-3-10 00:52
<

>蒽林到底是什么东西？是进口的药品吗？在哪里可以买到呢？</P>
<

>我怎么看着像松膏呀？</P>

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