### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
hello, this is sathya from tamilnadu,india.my brother affected by skin disease for past fifteen years.the disease is cured a while but returned after som six months when the doctor said to stop taking medicines.now a doctor in singapore found it as Psoriasis.please advise me on treatments so i will convey that to my brother.

### output:

Hi. Sathya, As you said your brother suffers from psoriasis from last 15 years. I would like to say few things about psoriasis.... Psoriasis is a chronic relapsing and autoimmune disease. There may be having scaly plaques on various parts of the body, scaly lesions on the scalp. Exact cause is not known. Genetic tendency, autoimmunity, stress, Chat Doctor. .etc. may be responsible for precipitation and exacerbation of psoriasis. You take him to consult dermatologist for firm diagnosis and treatment. I usually recommend cap accretion 10 mg twice a day along with methotrexate 15 mg weekly in three decided doses 12 hourly...for psoriasis. This may be taken for long time till good response. Blood tests may be done to monitor the treatment. For itching, you may take antihistamines like levocetirizin... Avoid steroid, as there may be severe flare up after stopping it. He may apply mild steroid cream or calcitriol point on the lesions on the psoriasis lesions. He may apply moisturizer to improve the skin texture. Furthermore, he should avoid soap bath for few weeks. And he should be free of stress and worries as that might worsen psoriasis. He might get good result. I hope you got my answer. Thanks.