Psoriasis
Overview
Psoriasis is a chronic relapsing immune-mediated inflammatory skin disease characterized by well-demarcated red plaques with silvery scales and pinpoint bleeding on scraping, sometimes with itching, nail changes, and painful swollen joints. Chinese medicine calls it "white bi" or "pine-bark lichen," often from constitutional blood heat triggered by external pathogens, emotions, or diet, with blood-heat, blood-dryness, blood-stasis, and fire-toxin patterns. Treatment aims at control and remission under dermatology care; psoriatic arthritis must be watched for.
Pattern differentiation (clinical patterns)
Internal Blood Heat
Bright-red lesions with increasing scales and marked itch, sore throat, dry mouth, irritability, dry stools, red tongue yellow coating, wiry rolling rapid pulse.
Clear heat and cool blood; resolve toxin and dispel plaques.
Blood Deficiency with Wind-Dryness
Long-standing pale-red dry scaly itchy lesions, dull complexion, dizziness, fatigue, pale tongue thin coating, deep fine pulse.
Nourish blood and yin; moisten the skin and calm wind.
Exuberant Fire Toxin
Widespread bright-red lesions with heavy scaling or pustules, fever, thirst, agitation, deep-red tongue yellow coating, surging rapid pulse.
Clear heat and drain fire; cool blood and resolve toxin.
Connections
Daily care & prevention
Apply moisturizer regularly; avoid scratching, skin injury (Koebner phenomenon), hot washes, and dryness; stop smoking, limit alcohol, manage weight, reduce infections and stress, and follow prescribed topical/phototherapy/systemic treatment—do not self-use potent long-term steroids or folk remedies. Massage Quchi (LI11), Xuehai (SP10), Sanyinjiao (SP6), and Zusanli (ST36). Painful swollen joints, rapidly spreading lesions, or pustules with fever need prompt care.
When to seek medical care
Generalized redness and scaling with fever/chills, marked edema, or numerous pustules (erythrodermic/generalized pustular psoriasis) is an emergency; chest tightness, severe infection, or onset in pregnancy needs urgent care; painful swollen stiff joints require ruling out psoriatic arthritis.