For many centuries, humanity has tried to discover all the secrets of this mysterious skin disease, but there is still much to discover. According to statistics, psoriasis affects between 4 and 7 percent of the population, and both men and women are equally susceptible to it. Usually, the first signs of psoriasis appear during puberty and can accompany a person throughout his life, sometimes decreasing and disappearing, sometimes increasing in strength.
Causes and risk factors of psoriasis.
PsoriasisIt is a prolonged inflammatory process of the skin, which is considered an autoimmune disease (associated with an allergic response to its tissues). This is a chronic skin disease that affects the cells of the outer layer of the epidermis. The condition usually appears as red and silvery, scaly skin on the feet, knees, back, chest, etc. In most cases, psoriasis starts in small areas of skin, which can then spread to large areas of the body. There are many causes and risk factors that can contribute to the development of this disease, and there are several theories to explain its appearance.
autoimmune cause
Some studies suggest that psoriasis may occur due to a combination of genetic and environmental factors such as infections, trauma, stress, and certain medications. These factors can trigger a reaction from the immune system, which begins to fight the body's tissues, including the skin.
However, the processes underlying psoriasis are not yet fully understood. It is important to note that psoriasis is a multiple disease that manifests itself differently in each patient. Studying the underlying mechanisms of psoriasis can help develop more effective treatments, reduce the risk of complications, and improve patients' quality of life.
Impact of metabolism
Metabolic disorders significantly affect the condition of the skin and immunity in patients with psoriasis. Increased metabolism leads to the formation of toxins and free radicals, which contribute to inflammatory reactions. There is an imbalance in various metabolisms.
- With disturbances in protein metabolism in patients with psoriasis, the albumin content in the blood decreases and the globulin content increases, which increases their sensitization.
- In fat metabolism, an increase in the content of lipids and cholesterol in the blood is observed.
- Reducing calories and eating plant foods can reduce psoriatic inflammation activity.
- Alterations in carbohydrate metabolism almost always occur.
- The metabolism of vitamins and minerals is also affected, which is manifested by a decrease in the content of vitamins C, A, B6, B12, iron, copper and zinc in the blood, but an increase in the content of vitamin C.
infectious cause
This theory was very widespread in the last century. It was believed that psoriasis could be caused by certain bacteria (streptococci), fungi and viruses, but these hypotheses have not been scientifically confirmed. However, dermatologists point out that any acute infectious process or chronic infection can cause psoriasis to recur. Special attention is paid to the viral theory. Recent research shows that RNA viruses, such as HIV and other retroviruses, can influence the genetic apparatus and cause the appearance of genes that predispose to the development of psoriasis.
Genetic predisposition
Inheritance of a predisposition to autoimmune reactions is a risk factor for psoriasis. If a person's close relatives suffer from this disease, the likelihood of developing it increases. Several genes may be associated with psoriasis, including PSORS1-PSORS9 complexes, and PSORS1 is thought to be particularly active. It contains the genes HLA-C, HLA-Cw6, CCHCR1 and CDSN, which may contribute to the development of the disease. Genes influence metabolism, immunity and the development of autoimmune processes. However, the presence of these genes does not mean that a person will necessarily develop psoriasis. The development of the disease may be due to other factors.
neurogenic cause
Excessive tension on the nervous system, prolonged stress and imbalance of the autonomic nervous system, which provides innervation to blood vessels and internal organs, may be risk factors for the development of psoriasis. These factors can cause an imbalance in the endocrine system, changes in metabolic processes and alterations in the immune response, increased irritability or depression, constant fatigue, drowsiness and apathy, which in turn can cause psoriasis.
Endocrine
Endocrine disorders that occur with psoriasis are quite common and can have a significant impact on the development of the disease. However, the relationship between them and psoriasis is not entirely clear and has not been demonstrated. Experts believe that psoriasis patients often suffer from dysfunction of the thyroid gland, pituitary gland, and adrenal glands. Women may experience problems with the menstrual cycle and men with sexual function.
Symptoms and characteristics of psoriasis.
Psoriasis manifests itself not only with skin rashes, but also with other symptoms. It often begins in childhood or adolescence and is associated with hormonal disorders, vegetative-vascular dystonia and stress.
The first signs arefatigueANDchange of humor. The main symptom is small pink bumps on the skin called papules, covered with whitish scales. The papules are surrounded by a brighter border.
Over time, the elements of the rash can combine to form large, unusually shaped plaques. The base of each papule isinflammatory infiltrate. The following types of rash are distinguished:
- punctual (no more than 1 mm in diameter);
- teardrop-shaped – (droplet-shaped papules up to 2 mm in size);
- coin-shaped – (round coin-papules up to 5 mm in size).
The rash also has its own characteristics:
- stearic staining: if you scrape the surface of the papule;
- terminal film: after cleaning the scale papules, a transparent film can be seen;
- Blood spray (Auspitz phenomenon): If the integrity of the film is damaged, small droplets of blood may appear.
Is psoriasis contagious?
Many people believe that psoriasis is contagious, so they try to avoid contact with people who suffer from it. This can make the patient want to distance themselves from others and cause serious psychological problems. However, studies have shown that psoriasis is not transmitted through contact with the patient. If all family members suffer from this disease, this only indicates the presence of a genetic factor in the development of the pathology.
Classification and stages of development of psoriasis.
Currently, three main stages are distinguished in the development of psoriasis:
- A progressive stage, which is characterized by the constant formation of new skin rashes, which are accompanied by intense itching.
- The stationary stage, in which new formations stop appearing and existing ones begin to heal.
- A regressive stage in which borders appear around the rash and the skin affected by the rash becomes darker due to increased pigmentation.
In addition, there are several degrees of severity of the pathology:
- Mild degree, when no more than 3% of the skin surface is affected.
- Medium degree, characterized by 3 to 10% skin damage.
- Severe degree, in which the disease affects more than 10%.
Types of psoriasis
PsoriasisIt is a chronic skin disease that can manifest itself in various ways. The rashes, their location and damage to other systems and organs may differ. Depending on these characteristics, various forms of psoriasis are distinguished.
Simple (vulgar, plate)
Plaque psoriasis is the most common form of this disease. Its symptoms include the appearance of bright pink papules covered with white scales.
Elbow psoriasis
This is a typical manifestation of mild plaque psoriasis. A characteristic feature of psoriasis on the elbows is the presence of one or more permanent "duty" plaques on the extensor side of the elbow joints. If these elements are exposed to trauma, an exacerbation occurs.
Guttate psoriasis
Associated with bacterial (most often streptococcal) and viral infections, this type of psoriasis can cause inflammation. This condition usually occurs in children and begins with the appearance of small red, tear-shaped papules on the skin of the extremities, body or face. Papules have a scaly surface and can develop into erosions and ulcers, increasing the risk of infection.
This condition can develop rapidly or gradually become chronic, followed by periods of exacerbation and attenuation of symptoms. In rare cases, psoriasis can be more severe.
Palmoplantar psoriasis
This type of psoriasis often develops in people who do manual work and is often accompanied by severe itching and can cause nail complications. Various subtypes of this type of psoriasis include:
- Fan-shaped plate: large elements on the palmar and plantar surfaces with white scales that merge into fan-shaped plates. This subtype is most commonly found on the hands.
- Circular: ring-shaped scaly elements on the palmar and plantar surfaces.
- Callus: growth of rough epithelium with callus formation.
- Pustular: This is a distinct subtype of Barber psoriasis on the palms and soles. Blisters and pustules containing pus appear in the areas under the big toe, causing intense itching. The ulcers fuse together, then dry out and form scabs. The characteristic elements of psoriasis also appear in other parts of the body.
Psoriasis in the legs can be associated with varicose veins and manifests mainly in the lower legs.
nail psoriasis
It can occur as a separate disease or as a complication of another type of psoriasis. The main symptom is small dimples on the nail plate, which have different depths. These dimples are usually more noticeable and painful when pressed than other types of dermatitis. Additionally, symptoms include spontaneous nail separation, subungual hemorrhages (especially when wearing tight shoes), changes in nail color and surface, such as trachyonychia and koilonychia.
Scalp psoriasis
It can manifest itself as an independent disease or as part of a general pathological process. One of the characteristic features is weeping and the formation of scabs on part or the entire surface of the head. In this case, hair growth is not affected, since the function of the hair roots is not affected. However, getting wet creates a threat of infection, which can damage hair follicles.
Seborrheic psoriasis
It occurs as a result of the alteration of the skin glands, which produce viscous sebum, causing skin irritation and promoting inflammation: dermatitis. This condition quickly spreads to the entire head, covering it in the form of a cap and is accompanied by intense itching. In the areas behind the ears, weeping sometimes develops and an infection may develop. A scalp covered in dandruff and scabs can resemble a psoriatic crown.
Psoriasis on the face
It usually appears in the area of the nasolabial triangle, eyelids, above the eyebrows and in the areas behind the ears. The rashes may coalesce and form large areas of redness and swelling. If the functioning of the sebaceous glands is disturbed, the process may be accompanied by crying, scabbing and an increased risk of infection.
Psoriasis on the genitals.
Psoriasis affecting the genitals is a concomitant process that is usually accompanied by rashes characteristic of psoriasis throughout the body, which makes its diagnosis easier.
Psoriatic rashes on the penis in men, labia majora in women, and surrounding skin areas are oval in shape and slightly raised above the skin surface. They are pink and flaky. It is practically not accompanied by itching. Sometimes the injury process extends to the mucous membranes and can take the form of vulvovaginitis in women and balanoposthitis in men.
In obese people, atypical psoriatic rashes can be observed in the folds located near the genitals (inguinal, intergluteal). In these areas, areas of intense red color appear, which have a mirror-like surface and do not come off due to constant humidity.
Why is psoriasis dangerous?
Psoriasis can become very serious when the rash covers more than 10% of the skin. This condition is difficult and prone to recurrence, and the rash can become clammy, wet, and susceptible to infection. Only timely and effective treatment of psoriasis can prevent the spread of the disease.
In some cases, psoriasis can be complicated by joint inflammation and the development of psoriatic polyarthritis, which can lead to joint dysfunction. Furthermore, the systemic autoimmune process caused by psoriasis can lead to the development of other autoimmune diseases, serious cardiovascular and digestive pathologies, and neurological reactions.
Ignoring timely treatment of psoriasis can lead to complications, such as psoriatic erythroderma, which can occur due to improper treatment of psoriasis or as a result of exposure to various skin irritants. In psoriatic erythroderma, the skin acquires a deep pink color with a clear distinction between affected and healthy areas, as well as small and large peelings. This condition requires emergency medical attention.
Complications of psoriasis
Lack of timely and adequate treatment for psoriasis can seriously damage vital organs and systems of the body, such as the joints, heart, kidneys, and nervous system. These consequences can lead to disability or even death.
Diagnosis
Typically, the diagnosis of psoriasis is made based on the typical symptoms of the skin lesions and their location. In some complex cases, additional tests may be required to rule out other skin diseases.
Laboratory tests may include:
- Complete blood count, which can detect leukocytosis and anemia in psoriasis.
- Rheumatoid factor (RF) is a protein whose levels can be elevated in systemic inflammatory diseases that involve joint damage, but in psoriasis its levels are usually normal.
- The erythrocyte sedimentation rate (ESR) is also usually normal, except in pustular psoriasis and psoriatic erythroderma.
- Uric acid levels may be elevated in psoriasis, which can cause confusion with gout.
- Antibodies against the human immunodeficiency virus (HIV) can be detected with the sudden onset of psoriasis.
In more complex cases, other tests, such as joint x-rays and skin biopsies, may be used to evaluate the severity of joint damage and distinguish psoriasis from other skin diseases.
Treatment
Treatment of psoriasis requires a comprehensive approach, including local treatment of skin lesions, medications, phototherapy, and prevention of exposure to factors that worsen the disease. The choice of treatment method depends on the type and severity of psoriasis. Treatment may include:
- external preparations (external ointments, petroleum jelly, paraffin, vegetable oils and creams with anti-inflammatory effect, the amount of which depends on the nature of the injury and is used daily);
- lotions and shampoos based on salicylic acid, as well as photosensitizers;
- medications for oral administration (retinoids, vitamin D preparations and others);
- physiotherapeutic procedures;
- Daily baths with bath oil, oatmeal infusion, or sea salt can help soften the skin and reduce the inflammation that occurs with psoriasis. It is important to avoid hot water and exfoliants, and use moisturizing cream after bathing;
- phototherapy, which involves exposing the skin to ultraviolet light, may also be helpful (prevent burns);
- photochemotherapy using medium wave radiation;
- Compliance with a special diet and general regimen.
When developing a treatment program, the patient's sex and age, the presence of concomitant diseases, general health, and the impact of external factors are taken into account. Sometimes, to cure it, it is enough to change your lifestyle, and in other cases, various treatments are prescribed.
In addition to traditional methods, psoriasis treatment may include the use of modern laser technologies. Laser therapy can reduce the symptoms of pathology, achieve long-term remission and relieve the patient from unpleasant rashes and related problems. A special feature of laser therapy is that a special excimer laser acts only on the affected areas of the skin, without affecting healthy ones, which ensures a quick recovery without side effects. Laser therapy is safe and painless, requires no preparation, and can be used regularly so the patient can live without restrictions.
The effectiveness of treatment depends on many factors, including hereditary predisposition, provoking factors, the stage of the disease and the specific nature of the lesion, therefore it is recommended to first consult with a specialist and prescribe treatment measures based on clinical recommendations.
Prevention
Psoriasis is a disease that can be successfully treated if you consult a doctor in a timely manner and receive qualified help. In the simple form of psoriasis, the patient can work without restrictions, except for work in chemical plants, where being in the workplace can be dangerous.
However, psoriasis can cause complications, such as psoriatic arthritis, which can limit work performance and lead to disability.
Preventing psoriasis is an important part of treatment. After recovery, patients need to reconsider their lifestyle, get rid of bad habits, deal with the treatment of other chronic diseases, monitor their diet and increase physical activity, spending more time in the fresh air and playing sports.
Nutrition for psoriasis
The psoriasis diet is not strict, but proper nutrition plays an important role in complex treatment. When making nutritional recommendations, patients are advised to:
- Avoid foods to which the body is hypersensitive and exclude them from the diet.
- Prefer fresh fruits, vegetables, berries, baked or boiled lean meats and drink more.
- Avoid the following foods: onions, garlic, radishes, concentrated tea, coffee, alcohol, sweets, salty and acidic foods, as well as foods that can cause an allergic reaction such as oranges, honey, nuts, cocoa and eggs.
- Avoid fatty foods of animal origin.