Psoriasis is a chronic dermatological disease, whose pathogenesis is an abnormally rapid growth of skin cells, which leads to the appearance on the surface of the skin of compacted areas of various colors.
Today, psoriasis has become the most common non -infectious dermatological disease.Psoriasis does not have a gender predisposition: both men and women suffer them equally.You can get this pathology at any age, but more often the first signs of the disease appear up to 20 years.
Psoriasis is quite poor in therapy, partly due to the fact that so far the etiology and pathogenesis of this pathology are not yet clear.In addition, there are no specific means of prevention of psoriasis, since it is impossible to determine if a person has a predisposition to the disease.
The reasons for development
At the moment, scientists cannot unequivocally answer the question "Why is psoriasis develop?"Two main factors of the development of the disease are distinguished: this is a genetic predisposition and hyperreactivity of the immunity system.
It has been established to date thatThe predisposition to the development of psoriasis is inherited.But the difficulty lies in the fact that it is extremely difficult to track how this predisposition is inherited and after the influence of which factors can develop psoriasis.
It is believed that the following factors can induce the development of psoriasis:
- Frequent skin hypothermia, as well as the effect of dry climate on it;
- Infectious processes;
- Frequent tensions;
- The use of some groups of pharmaceutical products: non -steroidal anti -inflammatory drugs (especially aspirin), some hypotonic and psychotropic drugs;
Pathogenesis
At the moment, psoriasis pathogenesis has not finally clarified.Two main pathogenesis can be distinguished:
- Rape of skin keratinization.
- Immunity system interruption.
Together, the above factors lead to the fact that the cells of the lower layers of the epidermis for an unknown reason begin to share very quickly.This process leads to a reactive increase in the wetting speed of the upper layer of the epidermal cells, which is manifested externally by the detachment of the skin.
Symptoms
The disease always begins acutely, without obstacles to the development of the pathological process.As a general rule, the first elements of the eruption are located in the place where the skin was damaged.
At the beginning of the symptoms of psoriasis, pink or red papules appear on the skin.This process is accompanied by itching.The size of the elements varies from a few millimeters to 1.5 centimeters (in some cases, the elements even reach large sizes).Then, the elements of the eruption are covered with easily separated silver scales.
Sometimes, psoriasis damages nail plates.This pathology externally resembles fungal damage to the nails and is manifested by the following symptoms:
- There are many small recesses on the nail surface;
- The edge of the thick nail plate and acquires an opaque and yellowish color;
Another characteristic manifestation of psoriasis is psoriatic arthritis (symmetrical damage to joints and periarticular tissues).Most of the time, the pathological process is developed in the interphased joints of the feet and hands.At the beginning, the disease manifests itself by pain and swelling, and then the deformation of the affected joint develops, which can even lead to the patient's disability.It should be noted that in rare cases, damage is also possible.Sometimes, psoriatic arthritis develops even in the spine joints.
Guys
The following types of psoriasis are distinguished depending on the gravity and characteristics of clinical manifestations:
- Planper.This type is the most common: it is diagnosed in almost 90% of people suffering from psoriasis.The elements of the eruption, theoretically, can occur in any area of the skin.However, the most typical locations are the lower back, the scalp and the extensors of the upper and lower extremities (the area of the elbows and knees).It should be noted that with this form of psoriasis, the pathological elements do not appear in the face, palms and plants remain intact.Externally, this form seems like an inflamed silver cover with scales.When the plates are shown from under the scale, Lymph is released.With additional injury, the plate begins to bleed.The shape of the psoriasis plaque is also characterized by the appearance of the "paraffin lakes" called, the confluence of several plates in an element.
- Inverse psoriasis (flexion or intertrigonic surface psoriasis).This form is quite rare.The elements of the eruption have the shape of red spots, which do not stand out on the surface of the skin intact.Typical location of this form of psoriasis: skin folds (axillary cavities, inguinal folds, skin under chest in women).In addition, due to the characteristics of the location, a fungal infection often joins reverse psoriasis.
- Genital psoriasis.This form develops more frequently in girls, mainly in adolescence (up to 16 years).Often, the development of the pathological process is preceded by streptococcal infection (for example, angina).The eruptions with a rock psoriasis resemble an ordinary allergic eruption, small points that have a color from gray to lilac, not protruding on the surface of the skin.Such rashes may appear in any area of the skin.The skin in which eruptions are found, as a rule, has an inflamed appearance.
- Pustulenia psoriasis.It is a more severe way than the previous one.With pustular psoriasis, small painful pusions full of pus appear in the patient's body.This form can happen both local and general.With pustular psoriasis, the general condition of patients often worsens, body temperature increases.With the generalized form of pustular psoriasis, hospitalization is necessary.
- Erytroderma is the most severe form of psoriasis.With him, almost all the patient's skin is damaged.This form is accompanied by chills, an increase in body temperature to high numbers, a strong deterioration in the patient's condition.This disease requires urgent medical intervention, in the absence of which a fatal result can occur.
Gravity
There are many different gradations of psoriasis in terms of gravity.However, in clinical routine practice, the simplest of them is used more frequently, which does not require any special research method.
Thus, distinguishThree grades of psoriasisDepending on the prevalence of the pathological process:
- Light formThis form is established in cases where the patient is affected by the psoriasis of less than 3% of the skin.
- Moderate form.This diagnosis is performed with psoriasis damage 3 to 10% of the patient's skin.
- Heavy form.This form is displayed taking into account the skin injury and clinical manifestations.Therefore, this form is displayed with an injury of more than 10% of the skin or with a significant deterioration in the patient's well.It should be noted that psoriasis is considered severe in the presence of psoriatic arthritis, regardless of the degree of prevalence of the pathological process.
The course of disease and prognosis
Psoriasis is a disease with a course similar to a wave, that is, it has periods of remission (when symptoms practically disappear) and exacerbation.As a general rule, the process is aggravated during low season periods.
The prognosis for psoriasis depends on the shape of disease and gravity.As a general rule, with classic forms of psoriasis, the prognosis is favorable, but in severe forms, disability is possible and even death.
Despite the favorable forecast in most forms of psoriasis, do not forget the social aspect of this disease.In the acute period of the disease, the skin and the hairy part of the human head are covered with peeled plaques, which often perceive them by others as a manifestation of any contagious disease.Because of this, those who surround them begin to reject the patient, which makes it closed and, often, depression.
Diagnosis
The basis for diagnosis is the clinical manifestations of the disease., the characteristics of its current, as well as the data inspection data.There are a number of characteristic symptoms that are determined for the diagnosis of psoriasis:
- "Film psoriatic": if it cleans the surface of the peeled papule, then it becomes soft and bright.
- "Stearin staining": when psoriatic elements are shown, their surface becomes whitish and frightful.
- "Rocío de Blood": Yes, after the manifestation of the previous symptoms, do not stop the sling of the elements, then its surface is covered with drops of blood (capillary bleeding appears).
Three symptoms described above are called "psoriatic triad" and are the main diagnostic method of psoriasis.However, there are several more signs that are determined in a certain stage of the disease:
- In the acute stage of psoriasis, Pilnov's symptoms are caused (psoriatic elements are surrounded by a red edge) and kebner (new rashes actively appear in the damaged areas of the skin).
- The regression stages also determine the Voronov symptom (around the elements a bright light edge of a small wrinkled skin is determined).
Of the laboratory and the instrumental methods, the following are used:
- Microscopy of scales and mass with potassium hydroxide (for differential diagnosis with fungal skin damage).
- In complex clinical cases, with an atypical course, the pathological elements resort to the realization of a biopsy.
- With psoriatic arthritis, blood analysis indicators (mainly the ESR and rheumatoid factor) are examined and perform an X line of the affected joints (for the differential diagnosis with arthritis of another etiology).
Treatment
The treatment of psoriasis is a long and complex process.Unfortunately, since psoriasis is a chronic disease, the objective of therapy is not the patient's cure, but the achievement of prolonged remission and the prevention of exacerbations.The treatment depends on the stage, the form and severity of psoriasis.It should be noted that a dermatologist must prescribe a set of medical measures and only after an exhaustive examination of the patient and the verification of the diagnosis.
Diet.The treatment of psoriasis should begin with the correction of the patient's daily diet.If we talk about general recommendations, then people with psoriasis should reduce the amount of proteins in the diet and increase the amount of carbohydrates due to the consumption of vegetables and fruits.It is also necessary to exclude those products that can cause psoriasis exacerbation: alcohol, chocolate, several spicy spices, as well as limit the use of garlic and onion.It is also worth limiting the consumption of fried meat and fish, smoked meats.
In addition, when compiling an optimal diet, the patient's predisposition should be taken into account to the allergies to any product and, if possible, exclude them.The optimal diet is the use of a large number of fresh and vegetables and lean varieties of meat and fish.
Pharmacological treatmentFor the treatment of psoriasis, pharmaceutical products are used in several forms of release: ointments, tablets, injections, etc.
In addition to local medicines, system therapy is also used when medications are prescribed in the form of tablets or injections.The following medications are more frequently prescribed:
- Immunosuppressants.They have an overwhelming effect on the immunity system.It is prescribed only in severe cases that are not susceptible to other therapy methods, since it has a lot of side effects and is difficult to transfer.
- Cytostatics.Its action aims to reduce the rate of cell division, which leads to a decrease in the development rate of psoriasis and a decrease in peeling.It is used only in very severe cases, with resistance to other therapy methods.
- Several homeopathic drugs.Unfortunately, these medications are not suitable for all patients and do not always have the necessary effect.
Photochemotherapy.Lighting is one of the main methods of psoriasis therapy.
In conclusion, it is worth noting that psoriasis is a complex and not completely studied disease.A doctor qualified by treatment must be done.Remember that no miraculous method praised on the Internet will help you get rid of psoriasis yourself.
The same can be said about popular medicine: all its methods will benefit only in combination with basic remedies prescribed by the treating doctor.
Therefore, we can conclude that to achieve success in the treatment, the patient must use only those methods that he agreed with his treating doctor, as well as observe all his recommendations.This is the only way to achieve good success in the treatment and prolonged remission of psoriasis.