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

### input:
Hello Doctor,I am suffering from Plaque Psoraisis skin disease from nearly 20 years now.I have been on following medicine since then:DIPSALIC F (Salycilic Acid Ointment)But along the way now these medicines are not giving results. Please suggest some other medicines which I can replace these for.Or some other treatement that can be more effective . I have patches on my scalp,beardline, on my back.

### output:

Hello. Thanks for writing to us at Chat Doctor Psoriasis has a chronic course, the course being fluctuated by remissions and relapses, however there is no permanent cure for psoriasis. Treatment depends on the severity of the disease. Topical treatment is the mainstay for limited disease; widespread or extensive disease would require systemic treatment in addition to topical treatment. One reason for lack of efficacy of topical treatment is when the disease is extensive Or is spreadingTopical treatment options for psoriasis plaques includes mainly potent topical steroids ointments/lotions, either plain or in combination with salicylic acid. The ointment which you have been using contains clobetasol propionate and salicylic acid combination. Other options include Topical vitamin D analogues like calcitriol, calcipotriene etc. in combination with or without steroids, are also effective for plaque psoriasis. However, topical therapy alone may not be sufficient for extensive disease Or spreading psoriasis. This might be a reason for lack of efficacy in your casein theses situations, Systemic treatment with Oral agents like methotrexate, Oral retinoids(Accretion), Oral cyclosporin can be started in addition to topical treatment would suggest that you seek an appointment with a dermatologist in your region. Your dermatologist would be able to assess the severity and extent of your disease and advice accordingly. Hope this helpsRegards