Psoriasis is a chronic inflammatory disease of the body, accompanied by a predominant lesion of the skin with the formation of spots and erythematous plaques that have clear boundaries and silvery scales on the surface.
The course of this disease is characterized by periods of exacerbation and remission (decrease in symptomatic manifestations). Unfortunately, medicine has not yet identified the exact and reliable cause of psoriasis, but a hereditary factor has been clearly observed, which, in combination with triggering factors, contributes to the triggering moment of the onset of this disease. A relationship has been revealed between the appearance of psoriasis and antigens of the HLA system.
Between 1 and 5% of the world's population suffers from this unpleasant disease, and light-skinned people are at greater risk of developing psoriasis than black people.
The disease can manifest itself at any age, but the periods from 20 to 30 years and from 50 to 60 years are considered critical.
Important!Psoriasis is not contagious to others, but it causes discomfort to the patient himself, since the rashes that appear during the disease are not only a cosmetic defect, but are also accompanied by unpleasant itching. In addition, the manifestation of psoriatic arthritis is possible, which significantly worsens the patient's quality of life.
Basically, the rashes are located on the scalp, on the surface of the elbows and knees, in the areas of skin folds and on the genitals. The nails, buttocks and the area around the eyebrows can often be affected. The nature and appearance of the rash depends on the type of psoriasis.
Causes of psoriasis
The nature of the onset of psoriasis has not yet been revealed by medicine; Some doctors talk about autoimmune causes. The second theory that explains the appearance of the disease is an alteration in the normal process of maturation and division of skin cells. Heredity and stress are also considered the cause.
A genetic predisposition to psoriasis, allergies and frequent disruption of the skin barrier function (strong friction, chemical exposure, influence of alcohol-containing products) can lead to an exacerbation of the disease.
To known triggers that causepsoriasis, relate:
- The Koebner phenomenon is the appearance of fresh rashes at the site of skin irritation in the acute phase of some dermatoses;
- Sunburn or other types of burns;
- HIV infection;
- Beta-hemolytic streptococcal infection, which causes guttate psoriasis;
- Use of medications (especially beta blockers, lithium, angiotensin-converting enzyme inhibitors);
- Severe emotional stress;
- alcohol consumption;
- Smoking tobacco;
- Obesity;
- Hormonal imbalance, especially in women during menopause and pregnancy;
- Alterations in the digestive system.
The main cause of the development of the disease is excessive and accelerated growth and division of skin cells in combination with the inflammatory process in the dermis. In other words, skin cells in the bottom layer of the epidermis begin to grow rapidly and put pressure on the cells above. This process is accompanied by significant peeling of the skin and is called parakeratosis. Excessive stimulation by the immune system is believed to be the main link in the emergence of this mechanism.
Symptoms and signs of psoriasis.
The rashes associated with psoriasis are asymptomatic or accompanied by itching. Most often they are located on the scalp, the extensor surfaces of the knees and elbows, the sacrum and buttocks (especially in the gluteal fold) and in the genital area. The fingernails and toenails, the skin of the eyebrows, armpits and navel may be affected. The rashes may merge with the lesions and cover large anatomical areas and areas of skin between them. Depending on the type of psoriasis, the rash can have different external manifestations.
As a rule, the rashes are localized inconspicuously and are represented by erythematous papules or plaques, which are covered with dense, silvery, shiny scales. The rash appears gradually. Remissions and exacerbations occur spontaneously or after exposure to provoking factors.
5-30% of patients developpsoriasic arthritis, which can cause disability to the patient. This process can lead to joint destruction.
Important!Psoriasis does not threaten the patient's life, but it does alter the patient's self-image. In addition to the fact that the patient's appearance changes, a large amount of time is also required to treat skin rashes and maintain the cleanliness of clothing and bedding, which greatly reduces the patient's quality of life.
Types of psoriasis
- vulgar(Common or chronic plaque psoriasis), in which the rashes have the appearance of individual plaques covered with silvery scaling. The plaques may fuse as the disease progresses. Among all subtypes, this type of psoriasis is the most common and accounts for approximately 90%.
- inverse psoriasisaccompanied by rashes that appear in the area of natural folds and can form cracks.
- guttate psoriasisIt is characterized by multiple skin rashes with a diameter of 0. 5 to 1. 5 cm, which often form after strep throat.
- palmoplantar psoriasisIt manifests itself as plaques on the palms and soles, which can fuse.
- nail psoriasisIt affects the nail plates in the form of pinpoint indentations and grooves with discoloration and thickening of the nail. Nail changes with psoriasis often resemble changes from a fungal infection.
- pustular psoriasisaccompanied by the formation of pustules on the palms, soles or possibly damage to one of the fingers. There may also be a generalized form.
- erythrodermic psoriasisIt manifests as a sudden or gradual appearance of redness in patients with psoriatic plaques, when the plaques themselves are mild or absent. It usually appears due to inadequate treatment of psoriasis vulgaris.
Methods for diagnosing psoriasis.
When symptoms of psoriasis appear, the patient should consult a dermatologist. He or she will perform an external examination of the affected areas of skin and collect a complete medical history.
Psoriasis has a general similarity to other dermatological diseases, especially in the early stages of manifestation. It is important to exclude the presence of fungal infections of the hands and nails. The seborrheic type of psoriasis requires a special differential diagnosis to exclude seborrheic eczema, pityriasis rosea, and papular syphilis.
In case of active disease and large lesions of areas of the epidermis, visual analysis of scrapings is used. In the scraping process, peeling is intensified. Instead of the removed incrustations, a thin, smooth film is seen that is detached by mechanical action and reveals a surface moistened with drops of blood.
Diagnosing psoriasis in most cases is not difficult, it is enough to examine the patient's skin. The doctor must rule out errors in the diagnosis and determine the presence of other diseases and other pathologies that occur against the background of psoriasis.
In rare cases, diagnosis requires a biopsy. If non-classical clinical signs occur, the need for this should be considered. The severity of the disease is mild, moderate and severe depending on the area of skin affected. Damage to less than 10% of the skin corresponds to mild severity. There are more sophisticated methods to assess disease severity, but they are used in clinical trials.
Psoriasis treatment
There are a large number of factors on which the development of the disease and its various manifestations depend. For this reason, many treatments have been developed for psoriasis. These methods are often combined and include pharmacological and non-pharmacological interventions.
The treatment plan is made based on the severity of the disease, the area of skin affected, and the severity of symptoms such as redness, itching, and peeling. The age and sex, stage of the disease and general condition of the patient, as well as the presence of concomitant diseases, are also taken into account, as they may limit the choice of treatment methods.
Treatment of psoriasis should lead to a reduction in clinical manifestations (skin rashes and other symptoms), an improvement in the patient's general condition and the restoration of his ability to work.
In the treatment of psoriasis it is necessary to follow a diet and take proper care of the skin, since there is a risk of liver damage. In such cases, it is recommended to reduce the amount of fatty foods in the patient's diet, abandon alcohol, sweets (simple sugars) and starchy foods. The diet should focus on proteins: lean meats, fish, dairy products, vegetables and fruits. Be sure to pay attention to allergic reactions or intolerance to certain products.
To improve the patient's quality of life and get rid of the disease, it is necessary to use an integrated approach:
- Local treatment–Ointments and creams cope well with peeling and itching in small areas where the disease is localized. Hormonal ointments, salicylic acid, retinoids, and moisturizing creams are especially effective in treating psoriasis on the face and hands.
- drug therapyIt is used as an additional method of effective psoriasis treatment when ointments do not help. The drugs reduce the inflammatory process, eliminate swelling and itching, and block the increased activity of skin cells. But it is worth considering that the tablets have many side effects (increased fatigue, lack of appetite, high blood pressure). Therefore, it is very important to follow all the doctor's recommendations regarding the dosage of the medication.
- When psoriasis is located on the head and neck, usemedicated therapeutic shampoos: antifungal, tar, containing corticosteroids. The shampoo eliminates pathogens of pathological inflammation, removes scales, relieves itching and burning.
- Therapeutic antihistamine injections.Block intense itching, biological drugs have a beneficial effect on the immune system.
Unfortunately, today there is no possibility of completely curing psoriasis. Any treatment for psoriasis is aimed at eliminating the signs of the disease for a long time and prolonging remission. But treatment of psoriasis is necessary, despite the slow chronic course of the disease, since prolonged absence of treatment can cause disability in the patient.