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If patients have rapidly expanding disease, such that they’re getting new spots every week and the existing ones are getting bigger, we talk about starting oral steroids, which help to slow the spread of disease. Sometimes I give low dose steroids every other day, or only on Saturday and Sunday. We’ll continue this until the disease has stabilized and another treatment has started working for them. For patients with a lot of disease (more than 80% or so of their body covered), I will discuss Benoquin or monobenzone treatment, which “bleaches” or removes the rest of their color so that they look even, without spots. This isn’t for everybody, since it’s permanent and may decrease their chances of responding to the new treatments we keep talking about, so it’s a big decision that shouldn’t be taken lightly. For a very small number of patients, we discuss taking new treatments like JAK inhibitors, but usually patients have to pay the high costs of these medicines themselves. I have also had one or two patients travel to the Dead Sea to get intensive sun therapy for a few weeks, and they have had good resp**es.如果病人的疾病迅速扩大，比如他们每周都有新的病灶，而现有的病灶越来越大，我们就会讨论开始口服类固醇，这有助于减缓疾病的传播。有时候我每隔一天给人注射低剂量的类固醇，或者只在周六和周日。我们会一直这样，直到疾病稳定下来，另一种治疗方法开始对他们有效。对于患有大量疾病的患者（超过80%的患者全身覆盖），我将讨论benokin或单辅区的治疗方法，这些方法“漂白”或去除其余的颜色，使他们看起来均匀，没有斑点。这不是每个人都能做到的，因为它是永久性的，而且可能会减少他们对我们一直在谈论的新疗法做出反应的机会，所以这是一个不应该轻易做出的重大决定。对于极少数的患者，我们讨论采取新的治疗方法，比如jak抑制剂，但通常患者必须自己支付这些药物的高昂费用。几个星期以来，我还让一两个病人去死海接受强化阳光治疗，他们的反应很好。
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发表于 2019-6-28 10:31:59
楼主
发表于 2019-6-28 10:56:25
