Psoriasis: symptoms, treatment and prevention

Psoriasis- one of the most common diseases, the frequency of which in the population is constantly increasing every year. And if we consider that absolutely all age categories are susceptible to this pathology, and its simple form quickly turns into a more complex one, then the question of proper therapy and prevention is really very acute.

According to statistics, approximately every 30 inhabitants of the planet suffers from this ailment to one degree or another. What to do for those with psoriasis? What medicines and home remedies can be tried? How to organize your meals correctly? Let's finally put all the points.

Psoriasis and its causes.

Psoriasis is an autoimmune disease with a fairly vague etiology; the exact cause, despite numerous studies in this area, is still unknown. This pathology is believed to be a consequence of genetically determined changes in the immune system, as a result of which chronic inflammation of the skin develops. However, its multifactorial nature is also not excluded, in other words, participation, along with heredity, and the influence of the external environment.

It should be noted that predisposing factors, according to scientists, are quite different for different age groups: for example, if various types of bacterial infections, including, in particular, streptococcal infections, are considered to be triggers in children, then in adults. , stress stimuli and nicotine abuse are paramount, and alcohol, obesity and the use of certain medications (eg, adrenaline receptor blockers).

It is impossible to completely cure psoriasis, however, modern medicine is quite capable of significantly alleviating the course of the disease and maintaining a long-term remission in the patient.

There are several theories to explain the appearance of psoriasis:

• infectious and parasitic;
• neurogenic
• endocrine;
• metabolic;
• immunological
• hereditary;
• molecular mimicry theory.

As with many other conditions, the cause of skin problems must be found in the intestine. Its length is 4 to 6 meters and the inner surface is covered with villi, the total area of which is comparable to the size of a tennis court, which allows absorption processes to develop much more efficiently. Interestingly, the cells of the mucous membrane of the small intestine are completely renewed every 3-5 days. Here, in addition, up to 70% of human immunocytes are concentrated. Therefore, one of the most common causes of psoriasis is considered to be Leaky Gut Syndrome (LEPS).

Deviation from the normal functioning of the intestinal mucosa is fraught with malabsorption, that is, a violation of the assimilation of basic nutrients (proteins, fats, carbohydrates, vitamins, minerals). In addition, it increases the negative impact on the body of toxins and allergens: in such conditions, it is much easier for them to enter the bloodstream. The direct link between psoriasis and inflammatory bowel disease has been shown in numerous studies.

Other works by scientists confirm that a special microflora forms on the skin of a psoriasis patient, which is significantly different from the microbiome of healthy skin.

In the area of psoriatic lesions, a mass of various bacteria is concentrated, the stability of which is significantly less than that of normal skin; in particular, a colonization by Staphylococcus aureus is observed, which has an extremely negative effect on the course of the inflammatory process.

Types of psoriasis

1. Plaque psoriasis. . . In 90% of cases, dermatologists are faced with this particular form of the disease, also known as simple or ordinary. First, small separate areas appear on the skin, raised above the level of the healthy dermis. These inflamed areas are called psoriatic plaques. Gradually, they grow, merging with neighboring places into a whole.
2. Inverse psoriasis.This diagnosis is given to patients who develop smooth red spots on the skin folds and within the folds, in the groin area, on the inner thighs, under the breast. Unlike simple psoriasis, the foci of inflammation are practically not covered with scales, but due to their location and constant friction, they cause severe discomfort to patients. In addition, there is a danger of reinfection by streptococci or fungi, since in places where spots are located, due to high humidity and temperature, ideal conditions are created for the reproduction of microorganisms.
3. Guttate psoriasis.This type of disease owes its name to the shape of the formations. The lesions are drop-shaped, elevated above the level of healthy skin. A common trigger for this form of psoriasis is a previous strep infection, as we mentioned earlier. The fact is that the patient's immunity, affected during the fight against infection, is severely weakened - his resources are not unlimited and, like all living beings, it takes time to recover - and it is in this context that an activated autoimmune disease occurs. .
4. Pustular psoriasis.It is considered the most serious form, accompanied by the formation of blisters filled with a clear liquid. Inflammation of the skin begins around the foci, swelling and thickening appear. With a secondary exacerbation, the probability of which is quite high, the blisters fill with pus. Localized foci of pustular psoriasis on the arms and legs. In difficult cases, there is a ubiquitous location of blisters on the body, their rapid growth, and the danger of infection of the entire skin surface.

5. Nail psoriasis.This type of disease changes the appearance and structure of the nail plates on the hands and feet. Nails thicken, lose their natural color, emit an unpleasant smell. The skin around the nail bed thickens and thick ridges form. In advanced cases, the nails can disappear without regrowing.
6. Psoriasic arthritis.In this case, the disease affects the joints and connective tissues. Most often, the inflammation affects the distal phalanges of the extremities. There is psoriatic dactylitis - swelling of the fingers. The hip and knee joints are also exposed to the devastating effects of the ongoing disease. Cases of disability with loss of the ability to move independently are frequent.
7. Psoriatic erythroderma.Scaly spots appear on the skin, while peeling of the affected layer is observed. Patients experience extreme discomfort due to constant itching and swelling. Most often, this diagnosis is made in patients who have already been treated for simple psoriasis, but have not completed therapy or have switched drugs.

Symptoms of the disease.

The first manifestation of psoriasis is a small rash on the skin. Papules grow rapidly, grow to spots with a diameter of 4 to 8 cm, become more and more, and dry scales form on the surface. In advanced cases, the individual spots merge with each other and the lesion affects large areas of the body. Psoriatic papules can be distinguished from other skin diseases by their round shape with clear borders, bright red or pink color, and silvery-white scales. They appear first on those areas of the skin, the integrity of which is violated as a result of abrasions, wounds, frostbite, constant friction. There are three characteristic signs that confirm the onset of psoriasis development:

1. Stearin stain phenomenon- the dry particles are easily separated from the affected surface, revealing an area that looks like a drop of wax or sterol.
2. Psoriatic phenomenon(terminal) movie. Additional cleaning of the papules of the scales allows you to see a transparent, moist film, the skin under which is inflamed.
3. Auspitz phenomenon. . . Removal of the terminal film leads to the appearance of the smallest blood droplets on the surface of the stain.

This triad of psoriasis is unique: its presence allows an unequivocal correct diagnosis to be made. However, different parts of the body have their own characteristics of manifestation of the disease.

• Psoriasis in the body.Guttate psoriasis most often affects the back, neck, abdomen, thighs, and lower legs. Small papules, which resemble drops in shape, gradually grow and rise above the surface of the skin. This form of the disease is often diagnosed in people who have had a staph infection.

• Psoriasis on the hands.The most common places for the appearance of psoriatic papules on the hands are the elbows and the interdigital spaces, while, as a rule, a plaque shape is observed, in which small individual fragments fuse into a single covered lesion areawith dry scales. The forearms are much less likely to be affected.
• Psoriasis on the legs.The disease begins with single rashes in the knee area. Inflamed areas bother patients with severe scaling and itching, rapidly increasing in size and merging with neighboring ones.
• On palms and feet.In most cases, the simultaneous defeat of the palms and feet is recorded, but in some patients the ailment affects the stratum corneum of the purely upper or lower extremities. As a result of the growth of psoriatic papules, thickening occurs, thickening of the skin with more cracks.
• Scalp psoriasis.First of all, rashes appear on the forehead, the back of the head, and also behind the ears. First, patients notice in themselves unique scaly formations that grow, merge with those located nearby, and over time can affect the entire scalp. The papules are very itchy, causing a constant urge to scratch the skin; The resulting wounds and cracks are likely to become the gateway for infection. Dry particles are separated from harmful formations: first small, somewhat similar to dandruff, and then larger flakes.

• On the face, ears, neck.The location of psoriatic papules on the face is rather an exception in the usual clinical picture. In rare cases, when this happens, the ailment affects the areas around the eyes and eyelids, as well as the cheeks and tongue. The formations on the neck quickly spread further towards the back or head. The ears are the site of development for seborrheic psoriasis. Papules can appear both inside and outside the cartilaginous layer. When making a diagnosis, it is important not to confuse the condition with seborrheic eczema, which has similar symptoms.
• In the nails.There are three options for the initial manifestation of nail plate psoriasis. The first is the appearance of small pinpoint depressions. The second is a thickening of the nails, a change from their natural color to gray or yellow. With the further development of nail psoriasis, the plaque exfoliates and the upper particles are easily separated. And, finally, the third is a deformation of the nail, accompanied by a loss of smoothness of the plate and the appearance of depressed areas.

• Symptoms of psoriasis in children.At an early age, the disease progresses differently: the main localization of red scaly rashes is the skin folds - inguinal, on the elbow, and popliteal folds, on the neck. Papules are very itchy, children experience constant torment, become irritable and restless. In general, all the clinical variants seen in children are similar to those seen in adults. The differences refer purely to the manifestations, the location of the pathological process and the course of the disease itself.

4 stages of psoriasis

Clinical dermatology, based on differences in symptoms, degree of skin lesions, and duration, distinguishes three stages in the course of psoriasis. However, there is an opinion that the initial stage should be recognized as another complete stage in the development of the disease.

1. Initial stage.The first sign of psoriatic lesions are small rashes. The places of its appearance can be different and depend on the type of disease. Primary papules are no more than 3 mm, they are painted in a pale pink color, which after 3-4 days is replaced by a gray bloom - dead particles of the dermis are formed on the spot. This process is accompanied by itching and burning, and general health worsens. In general, the formation of plaques in the initial stage takes up to three weeks, and at this time a person has a chance to slow down the development of pathology.
2. Progressive.At this stage, the ailment affects important areas of the skin: for example, with normal psoriasis, plaques form, with other forms - characteristic papules of them. In the process of development of the disease, individual spots merge with each other, covered with gray scales. The symptom by which the progressive stage is determined is the Köbner phenomenon (isomorphic reaction). Any damage to the skin after a while is accompanied by the appearance of a psoriasis rash in this place. Another confirmation that the disease is actively developing is the appearance of dew-like drops of blood after the removal of plaque. The duration of this stage depends on the type of injury. On average, it takes from two weeks to two months.
3. Stationary stage.During this period, a thick, grayish-white or gray crust forms. The pink rims disappear. The skin becomes rough, the dry particles are constantly exfoliating. The itching and burning sensation becomes less bothersome, but it doesn't go away completely either. No new papules form. This stage can be quite long.
4. Regressive stage.The final stage of the development of the disease, during which there is a gradual reduction and resorption of plaques. The itching no longer bothers me. A clear sign of regression is the Voronov symptom, when the papules are surrounded by white rings. The fading of the spots occurs from the center to the periphery, as a result of which strange patterns are formed on the skin. At the end of the regressive stage, only the areas of the skin that have a slightly different tone from the healthy areas are reminiscent of psoriasis. It is not necessary to speak of a complete recovery in the case of psoriasis. The end of the regressive stage indicates that the disease cycle is complete, which can return at any time. In order for remission to be prolonged, it is necessary to pay attention to health: avoid provoking factors, follow a diet, be observed by a dermatologist.

Exam plan for psoriasis

1. General clinical blood analysis.
2. Research on the content of vitamins D, B12, folic acid in blood.
3. Blood test for ALT (alanine aminotransferase), AST (aspartate aminotransferase), direct bilirubin, alkaline phosphatase, gamma-glutamyl transferase, cholesterol with lipid profile, creatinine, glucose, insulin, total protein.
4. Blood for rheumatoid factor, c-reactive protein, uric acid, ASLO.
5. Ferritin, transferrin, and serum iron are indicators of anemia (particularly chronic diseases).
6. Thyroid panel: TSH, T4 sv, TK sv.
7. Coprogram.
8. KhMS according to Osipov.
9. Ultrasound of the abdominal organs.

Traditional treatments for psoriasis

Early therapy.

The earlier a person who has discovered the first signs of skin lesions consults a doctor, the more likely there is to take timely measures that will prevent the rapid development of the disease and its transition to a chronic form, and thus significantly improve the levelgeneral life.

One of the most commonly prescribed medications at the onset of the disease is salicylic ointment. It has an anti-inflammatory and antimicrobial effect, it has a keratolytic effect, due to which the plaques are removed from the keratinized particles. To reduce itching, naphthalene ointment is also used.

Therapy in progressive stage.

At this stage, an integrated approach to treatment is required, and only an experienced specialist can provide it. Treatment aims to relieve symptoms and remove toxins from the body. To normalize metabolic processes, intramuscular injections of calcium gluconate are often prescribed. Sodium thiosulfate relieves inflammation and eliminates manifestations of intoxication.

To hydrate inflamed skin, special emulsions and salicylic ointment are used. Tar-containing means are contraindicated at a progressive stage: they act irritating and increase the suffering of the patient.

When the intensity of inflammation decreases, physiotherapy procedures can be connected. Psoriasis patients are shown ultraviolet radiation, PUVA therapy, and paraffin applications. Corticosteroids and cytostatics are not used unnecessarily, these powerful drugs are only necessary in difficult and advanced cases.

To reduce allergic manifestations, antihistamines are prescribed and sedatives are prescribed to reduce nervousness. Diuretics help reduce the swelling of inflamed skin and remove toxins from the body.

Stationary therapy.

At this stage, the inflammation subsides, the plates are covered with a dry crust, therefore, funds are needed to relieve discomfort from the appearance of scales. These are tar shampoos, oil-based emulsions.

In many patients, UV irradiation and the PUVA technique have a good effect. If there is no improvement, doctors prescribe cytostatics.

Regressive stage therapy.

In the final period of the disease cycle, constant correction of treatment methods is required, depending on the current condition of the patient. Prevention is replacing active therapeutic actions.

The patient receives recommendations to change the diet and lifestyle in general. To avoid the reappearance of the skin lesion, it is necessary to avoid stressful situations that trigger the formation of psoriatic plaques.

Typically, doctors give patients the following advice:

• reconsider lifestyle- Make diet adjustments, get enough sleep, move more;
• ensure normal vitamin levelsD, iron, B vitamins, protein in the body;
• normalize the digestive tract- exclude hypoacidity, poor bile outlet, SIBO and CIGR (syndromes of excessive bacterial growth and, consequently, fungi);
• get rid of chronic infection foci- disinfect the oral cavity, undergo treatment with an otolaryngologist;
• deal with concomitant somatic pathology: hypothyroidism, insulin resistance, metabolic syndrome, etc.

Traditional methods to get rid of psoriasis.

• Initial stage.At the first sign of skin lesions, juniper and lavender oils are effective. They soothe irritated areas of the dermis, promote the healing of minor injuries, relieve the feeling of tightness. A few drops of oil are added to a cream with a neutral composition, for example for children, and applied to the rash that appears. Another popular method of treating the initial manifestations of psoriasis is the use of 3 percent hydrogen peroxide. Any measure, even the most harmless at first glance, can be applied after consulting a dermatologist. Diet changes, avoiding unhealthy foods, and alcohol are also common recommendations from traditional healers.

• Progressive stage.In the rapidly developing stage of the disease, an infusion of celandine is added to the healing oils and hydrogen peroxide. To prepare it, you will need fresh or dried plant stems and salt water. Alcoholic tinctures are contraindicated, they can worsen the condition of the affected skin. It is necessary to insist on the celandine for at least several hours, and before applying the healing solution to the plates, treat them with birch tar.
• Stationary stage.At the completion stage of the formation of new papules, you can use proven folk methods that will definitely not harm the patient. These include the use of sulfuric ointment, salicylic solution.
• Regressive stage.In the final stage of the course of the disease, hirudotherapy (leech therapy) is often used. Although this method is not officially recognized by traditional medicine, many experts do not rule out its effectiveness. The procedures are carried out within 3 to 10 days, depending on the patient's health status.

Prevention of psoriasis: how to prevent the development of the disease.

• Skin care.To minimize the likelihood of psoriatic damage in the presence of a genetic predisposition, simple ways to maintain skin health will help: water and hardening procedures (bathing in the sea, baths with herbal extracts and salts, contrast showers, wettingwith cold water in the air, etc. ); use soft sponges and avoid hard cloths that can damage the skin; the use of detergents, of natural composition, without aggressive chemical components.
• Ultraviolet rays.Several studies have shown the beneficial effect of sun exposure on skin prone to psoriatic plaque formation. Moderate doses of UV light help accelerate tissue regeneration and reduce inflammation. Sunbathing should not be abused: an excess of rays can aggravate the disease.

• Clothing.Synthetic fabrics, tight styles, a large number of belts and bras - all this is contraindicated for patients with psoriasis, even in remission. Clothing should be natural, hypoallergenic, loose fitting, not causing any inconvenience that could lead to the reappearance of pronounced symptoms. Dark tones should be avoided for aesthetic reasons; silvery-white scales are less visible on light-colored clothing.
• InjuriesFor psoriasis patients, any small wound, scratch, or abrasion can cause the progressive stage to return and secondary skin infection. They must be very careful to avoid injury.
• Cosmetic and household products.Not all remedies are adequate to maintain cleanliness for people with such diagnoses. When choosing shower gels, soaps, shampoos, it is important to pay attention to their composition, giving preference to those containing natural ingredients. It is better to buy therapeutic series of care products that are sold in pharmacies. Solid particle scrubs are absolutely contraindicated: they can start the disease process again due to the smallest lesions on the skin. Household chemicals should also be selected on the basis of health safety, do not use aggressive cleaning powders based on chlorine and alkali. Gloves should be worn when cleaning to avoid negative effects on the skin of the hands.
• Vitamin therapy.Maintaining the balance of vitamins is indicated for everyone, and especially for people with chronic dermatitis. Complex preparations keep the body in good condition, help it resist viruses and prevent metabolic disorders.

Psoriasis- this is not a death sentence, but a very serious reason to reconsider the rules you lived by before. Your allies on the path of domestication of the disease must be competent professionals: dermatologists, nutritionists, therapists. With their help, as well as through a deliberate approach to treatment, you can learn to live comfortably, despite your diagnosis.