Pathogenesis of Psoriasis Lesions at Special Sites and Integrated Traditional Chinese and Western Medicine Strategies for Collaborative Prevention and Treatment

Abstract

Psoriasis is an immune-mediated chronic, relapsing, inflammatory systemic disease. Lesions at special sites such as the scalp, nails, palms and soles, genitals, and body folds constitute difficult points in clinical diagnosis and treatment owing to their complex anatomical structures and distinctive local microenvironments. Although modern medicine has achieved remarkable progress in targeted therapy and systemic intervention, limitations remain for special sites, including poor drug penetration, high recurrence rates, and risks of long-term immunosuppression. Traditional Chinese medicine (TCM), grounded in the theory of syndrome differentiation according to lesion location, offers an effective complement to individualized treatment at special sites. This article systematically reviews the modern immunological mechanisms and TCM pathogenesis theories of psoriasis at special sites, explores in depth the mechanisms by which integrated Chinese and Western medicine collaboratively suppresses inflammation and regulates immune homeostasis, and innovatively proposes a site- and stage-specific integrated diagnostic and therapeutic framework. Specifically, during the progressive stage, biologics or systemic agents are used to rapidly control inflammation while TCM serves as an adjunct to relieve symptoms; during the stationary stage, systemic therapy is maintained or individually adjusted on the basis of continuous evaluation, supplemented by TCM for consolidation; and during the resolving stage, maintenance, dose reduction, or discontinuation is determined by recurrence risk, with TCM applied for adjunctive conditioning and long-term management, thus forming a three-tier intervention pathway. This integrated strategy provides a theoretical basis and practical reference for the stratified clinical treatment of psoriasis at special sites.