Psoriasis (translated from the Greek "psora" - "skin disease, scabs") is a chronic pathology of a non-infectious nature, also known as squamous lichen, which mainly affects the skin of the knee and elbow joints, the lumbar area and the head. There is also psoriasis of the joints, bones, nails, external genitalia, and internal organs, but these forms are rarely diagnosed. Pathology is difficult to cure, therefore, when the first symptoms appear, red rashes, an urgent need to consult a doctor.
Symptoms
Stearin stain
The first sign of psoriasis, which is part of the triad of pathological symptoms. It is characterized by increased flaking after scraping the affected surface with a spatula. Over time, there is a separation of the silvery-white scaly papules. Their removal is not difficult, as they loosen and weakly adhere to the psoriatic papule. The surface of the neoplasms (eruptions) turns white and the particles crumble and look like chips.
The first phenomenon of the triad is explained by the development of parakeratosis (improper functioning of the epithelium, leading to a violation of the formation of the stratum corneum). To combat deviations at the initial stage, non-hormonal local agents (creams, ointments) are used.
Terminal film
It is characterized by the removal of a thin layer of tissue from the papules, which has a shiny structure and looks like polyethylene. It is easily separated by any impact (pressure, friction, etc. ) after removing the dried flakes.
The terminal film is the last layer that is removed from the skin. An additional scraping leads to the last stage of the triad: drip bleeding.
At this stage, medicinal herbal baths, drugs with antiallergic effect, ointments are used naturally (without corticosteroids and hormones).
Point bleeding
After removal of the terminal film, there is drip bleeding in the affected area of the skin (auspicious symptom or "bloody dew") and there is an accelerated growth of neoplasms, sometimes reaching the size of a pea andcalled lenticulars. In some cases, the papules grow to the diameter of a small coin and differ as nummular. With the progression of the disease, their growth increases and when they combine, psoriatic plaques are formed.
For treatment, retinoids, immunomodulators, anti-inflammatory drugs, physiotherapy are used.
Others
The disease can be recognized by other characteristic signs, the main of which are 4:
- The border is red, not covered with scales, which forms around the papules.
- On a clean area of the skin, small rashes are visible (they usually appear before the progressive stage of psoriasis).
- A symptom that helps to distinguish psoriasis from seborrheic dermatitis is characteristic of the active stage of the pathology. It is accompanied by the appearance of papules with clear boundaries on the scalp, this does not occur with seborrheic dermatitis.
- A light, shiny fur border appears around the formation. The symptom is typical of the regression stage of the disease and appears when the papules disappear.
How it looks
In most cases, the onset of the pathology is imperceptible: at an early stage, psoriasis affects small areas of the skin, mainly on the curves of the limbs, the head and along the hairline.
Attention!The initial manifestations occur at the site of constant mechanical irritation of the skin, for example, where clothing is rubbed and pressed.
Common symptoms:
- Itch;
- excessive dryness of the skin;
- peeling of pathological elements;
- general deterioration of health (weakness, lethargy, fever).
There are 3 stages of development of pathological papules:
- Progressive.The appearance of a rash of a bright pink hue, surrounded by a rich and slightly vague rim. In the center of the papules, the skin peels off, giving the formations a white color. At this stage, the rash may appear at the site of scratches, skin lesions, bites, cuts, punctures, or burns.
- Stationary.It begins 1 to 4 weeks after the onset of the disease. New plaques do not appear, the old ones acquire a light color, the intensity of the peeling decreases.
- Regressive.The color of the plaques and papules fades, their infiltration decreases, and the formations dissolve. The average length of the decay period is 2 to 6-8 months.
Symptoms of the disease according to the types:
- License plate(common or vulgar). The most common type of pathology. On various parts of the body (most often on the elbows, knees, head), oval or round plates of a red hue appear, covered with silvery-white scales on top.
- SeborrheicIt occurs mainly on the scalp. It manifests as flaking and itching, spreading to the area behind the ears and the skin along the hairline.
- Pustularthe type is considered the most serious form, develops rapidly and affects large areas of the skin. Painful rashes appear on the body, which are accompanied by a local increase in temperature, weakness, headache and diarrhea. Vesicles filled with exudate soon form in the lesions. In the future, the spots progress, merge with each other and form large lesions on the body.
- Intertriginous.Typical for children, accompanied by the appearance of bright red papules, with slight scaling (it may not be there).
- Exudative.The affected areas of the skin not only shed, but also become moist and yellowish crusts form on the surface of the plates.
- Psoriatic erythroderma.Red plaques with silver, yellow, or white scales are seen all over the body. It is accompanied by an increase in lymph nodes, an increase in body temperature. In the future, the formations merge into large spots that cause irritation and itching.
- Psoriasic arthritis.It is accompanied by "joint syndrome", in which the skin of the joint area is affected (in the wrists, phalanges of the fingers, spine, etc. ), and if measures are not taken in time, the diseaseaffects the joints.
- Tearaccompanied by profuse eruptions, consisting of many small plaques. In this case, the papules are in the form of drops, their color is from bright red to purple.
- Point.It is characterized by the formation of small spots in various areas of the body, which resemble dots, and there may be no desquamation of the dermis.
- Rupioid.One of the types of chronic psoriasis. Crusts appear on the formations, they become higher, taking the shape of a cone.
- Oldmanifests itself in large papules that do not pass for a long time, sometimes papillomas and warts form on them.
- Psoriatic onychialeads to deformation of the nails, the appearance of yellowish-brown spots under them.
- Palmo-plantar.Appears on palms and soles. The main symptoms are thickening of the skin, dryness, cracks.
- Mucous membrane psoriasisIt affects the oral cavity and causes the appearance of plaques on the mucosa.
Location of psoriasis
Hands
In most cases, rashes appear on the surface of the elbows or between the toes. Less frequently, papules are noted on the forearm.
Attention!The hands are characterized by a plaque-like pathology, but others are also found. Its sign is small specks of a red hue, quickly covered with white scales, the affected skin hardens.
Legs
Psoriatic formations mainly occur on the legs in the knee area, but it is possible for them to form on other parts of the legs.
The first rash is single and small with a clear outline, but loose, inflamed, and very scaly. These pinpoint papules spread rapidly to form conglomerates.
Head
It often develops against the background of seborrhea, affects the hairline and forms the so-called psoriatic crown. The skin formations gradually grow and spread over the entire surface, resembling dandruff. This localization occurs quite often, less often a rash appears on the ears or behind them.
Hands' nails
The nail plate can be affected by the type:
- Thimble- specific form of psoriasis. Small holes appear on the nails, resembling needle stick marks.
- Onychomycosis- the nail changes color, becomes dull, thickens noticeably and begins to peel off. Through the plaque, a psoriatic papule is seen surrounded by a reddish border, similar to an oil stain.
Body
It usually manifests as characteristic papules that fuse together. Psoriasis is more common on the back, less frequently on the neck, abdomen, hips, the formations can be in the form of a drop, point and plaque.
Face
Rarely affected, the rash is found in the nasolabial folds, in the area of the temples and eyebrows, around the eyes. Rarely, the pathology affects the edge of the lips, the rash resembles herpes.
Palms and feet
Both areas are affected simultaneously, but there have been cases where the pathology developed only on the feet or palms. On the soles of the feet, the disease is often combined with fungal pathology, which greatly complicates diagnosis and therapy.
This type of psoriasis is divided into 3 types:
- Papular plaque- the formations are dense, do not protrude from the skin, it is difficult to separate the scales from the plate. The rash occurs in the marginal areas, accompanied by edema and keratosis.
- Psoriatic callus- round and dense papules, made up of keratinized epidermis. The layer of skin gradually thickens and thickens. As a result, it is easily injured, cracks appear. There is practically no redness, the size of the growths is from 2-3 millimeters to 2-3 centimeters.
- Vesicular-pustular- It manifests itself in the form of serous-purulent papules. The bubbles reach 2 millimeters in diameter and tend to coalesce.
Joints
Pathology can affect a person's joints, leading to a change in the structure of their tissues, which, with progression, leads to pain and deformation. External symptoms: a reddish rash appears on the skin. Internal signs: joints hurt, especially during sleep, movement stiffness, swelling is felt.
Important!First, psoriasis affects the small joints of the feet and hands, then it spreads to the knee and elbow, and at an advanced stage, the intervertebral joints already suffer.
Itching or not
In most cases, psoriatic disease is accompanied by itching of varying degrees of intensity, sometimes not just in spots, but all over the body. In the initial stage, the itching is mild and gradually increases.
The degree of intensity also depends on the location of the pathology. For example, psoriasis on the head is very itchy, while the skin flakes and falls off in large scales, larger than normal dandruff. In the stationary stage, the itching subsides, often giving way to a burning sensation. During remission, all major symptoms are mild.
The itching worsens with:
- relapse;
- climate change;
- general intoxication;
- digestive tract diseases;
- adhesion of scabies, allergies;
- HIV infections.
The skin itches a lot after drinking coffee, alcoholic drinks, hot and spicy foods, chocolate and other allergens.
How to distinguish
For eczema
- The nature of the eruption.With eczema, the blisters or blisters fill with fluid that periodically oozes. Psoriasis is characterized by the appearance of dry scaly papules, when they are removed, blood appears.
- Skin itch.For eczema, the body itches more than with psoriatic pathology.
- Colour.In psoriasis, the scales have a silver tint and in eczema, the affected areas turn bright red or scarlet.
- Sore areasEczema affects the soft and sensitive areas of the skin, the armpits, and the groin. Psoriasis is characterized by a rash in rough, hard and thick layers of skin (knees, elbows, head and others).
- The causes of the disease.Psoriasis is often caused by neurogenic factors, and eczema is caused by allergies and body malfunctions.
- Characteristics for rashes on the hands.With psoriasis, holes form in the nail plate, and eczema is similar to a fungal infection.
For seborrheic dermatitis
The clinical manifestations of the diseases are similar, but there are several characteristics by which you can distinguish them:
- for psoriasis, an unhealthy glow of the skin and bloody cracks are characteristic, and this is not observed with seborrheic dermatitis;
- dermatitis, unlike psoriasis, is not accompanied by thickening of the skin and its severe dryness;
- with psoriasis, the scales are silver and the seborrhea is yellow or white;
- the seborrheic scales are easily removed, but the psoriatic ones are not;
- dermatitis is most often observed in places of accumulation of the sebaceous glands and squamous disease throughout the body;
- scalp psoriasis noticeably protrudes beyond the hair growth area and seborrheic pathology does not cross this line;
- the lesion area with squamous lichen is much larger than that of dermatitis.
Mushroom
- Psoriasis appears in the presence of various provoking factors, for example, heredity, mechanical damage to the skin, poor functioning of the immune system, etc. The causative agent of the second disease is only the spores of parasitic fungi.
- Psoriatic pathology is not contagious, it is not transmitted by airborne droplets, sexually, or by contact.
Attention!The fungus (onychomycosis) affects any contact, even in public places: a sauna, a swimming pool, gyms, etc. It is transmitted from animals and people.
- With psoriasis of the head, the structure of the hair does not change, while fungal diseases cause brittleness, dryness and hair loss.
- Unlike squamous lichen, leg and foot onychomycosis is accompanied by an unpleasant odor.
- With the defeat of scaly nails, their structure already changes at the initial stage, and with a fungus for a long time, the structure and color of the nail plates do not change.
Pink lichen
The hallmark of psoriasis is the "psoriatic triad. "The disease grows gradually and goes through 3 stages. Pityriasis rosea (pityriasis) develops rapidly and is constantly progressing. Also, pityriasis is a contagious disease, but lichen squamous is not.
From neurodermatitis
- Atopic dermatitis (neurodermatitis) is of allergic origin and is triggered by a certain substance, for example, pollen from plants, food, animal hair, etc. The causes of psoriasis are different (heredity, reduced immunity, psychosomatic, mechanical damage to the skin, etc. ).
- With neurodermatitis, the skin becomes dry and rough, and with psoriasis it becomes scaly and bleeds.
- Plaques with dermatitis consist of small separate elements, in the case of shingles, the papules are uniform and covered with silvery scales.
- The color of the rash in psoriasis is much brighter than in neurodermatitis.
For gout
The difference between gouty and psoriatic arthritis lies in the cause of development. Gout occurs when uric acid crystals settle on the cartilage of the joints. Deviation from the norm can be caused by: high blood pressure, obesity, taking diuretics, drinking alcohol, etc.
Symptoms of psoriasis and gout are similar: severe pain at night, stiffness in movement, redness, and swelling in the affected area. However, with psoriasis, in most cases, characteristic red rashes appear first and then pain.
Other distinctive symptoms of gouty arthritis include:
- the presence of white nodules in the area of the affected joint;
- signs of kidney stones (back pain, blood in urine and others).