Psoriasis is one of the most common skin diseases; every hundredth inhabitant suffers from it.
Psoriasis is a disease for the development of which several factors are important at the same time: from hereditary predisposition (psoriasis to relatives) to disorders in the functioning of the nervous system, endocrine, immune and other factors.
reason
The causes of psoriasis are not fully understood.
The principle of the mechanism of the disease is to disrupt the division of skin cells, which causes an autoimmune reaction (autoimmune reaction - occurs within the body, does not depend on external threats).
The upper layer of the skin (epidermis) is mainly made up of keratinocytes - the cells that produce keratin. Keratin is a protein, its properties make it possible to perform the protective function of the skin. Keratinocytes are formed in the deep layers of the epidermis and slowly move to its surface, during movement they mature and acquire new properties.
At the end of their "maturation", keratinocytes form a layer of cornea on the surface of the skin. Then the keratinized cells die and stratify from the living ones, so the life path of the keratinocytes ends. This ensures continuous skin rejuvenation.
The normal path of keratinocytes from the deep layer to the surface lasts one month. With psoriasis, their life is reduced to a few days, this leads to the appearance of scaly, psoriatic foci, as the skin does not have time to get rid of keratinized cells.
When they appear, psoriatic plaques are usually accompanied by itching and redness. This indicates an autoimmune reaction in the deeper layers of the skin, resulting in swelling of the thicker layer of skin (dermatitis). The dermis contains blood and lymph vessels.
It is not certain why the process of keratinocyte formation accelerates, but it is known that an inherited factor plays an important role.
The development of common psoriasis can start due to:
- mental trauma and ongoing stressful conditions;
- skin damage;
- transmitted infectious disease;
- taking certain medications;
- hormonal disorders;
- allergic reactions (typical allergens: citrus fruits, eggs, chocolate);
- alcohol intoxication;
- climate change.
The psoriatic triad is a characteristic symptom of the disease that occurs when the skin is scratched.
Stearine stain(skin added after scratching, giving the surface of the papule a resemblance to a crushed drop of stearin).
Thermal film(appearance after complete removal of scales of a wet, thin, glossy, translucent surface).
Accurate bleeding(appearance of blood droplets not merging with each other).
What happens to the skin in psoriasis?
In psoriasis, the structure of the skin is disturbed, the epidermis becomes thinner, the processes of skin keratinization (accumulation of keratin proteins) are interrupted and some layers of the normal epidermis disappear. In the next stage of the disease, clusters of cells responsible for inflammation are found in the superficial protective layer of the epidermis and in the area of parakeratosis, around the enlarged vessels of the skin.
Characteristic plaques and scales appear on the surface of the skin.
Psoriasis is not just a common disease, it has many manifestations and is even disguised as other diseases.
Locations of psoriasis:
- elbows and knees;
- sacrum and groin;
- scalp (seborrheic psoriasis);
- flexion surfaces and skin folds: inner surface of elbow and knee joints, hips and armpits, under breast area (reverse psoriasis);
- palms and soles of the feet (palmar-foot psoriasis);
- psoriasis of the nail plates.
Common symptoms of psoriasis
The main symptoms of psoriasis are:
- psoriatic plaques;
- tightness of the affected area of skin;
- scratching
Symptoms by type of psoriasis:
- exudative psoriasis (affected areas of skin peel and wet, a yellow crust forms on the surface of the rash);
- intertriginous psoriasis (most common in children, the foci of onset are red, with light skin, sometimes wet ones can be confused with diaper rash);
- old psoriasis (characterized by large plaques that do not disappear for a long time);
- rupioid psoriasis (another form of chronic psoriasis, characterized by a cone-shaped plaque);
- psoriasis guttate (abundant rash of small papules).
Types of psoriasis
- Common psoriasis (vulgar, plaque);
- Generalized psoriasis (widespread, postural);
- In the form of tears from psoriasis (according to the type of rash);
- Arthropathic psoriasis (with joint damage);
- Other types of psoriasis (seborrheic and other).
Vulgar psoriasis is the most common form of the disease.
Psoriasis begins with the appearance of rashes, often few in number, in typical places: on the elbows and knees. Also, the characteristic localization of the rash is the head and trunk area. There is usually a clear link between the appearance of rashes and the action of the provoking factor.
Provocative factors in psoriasis can be stress, skin trauma, a recent infectious disease, and regular alcohol consumption.
Usually, the worsening of the disease occurs in the cold season - this is the winter type of psoriasis. The type of wine is rarer. Mixed forms of psoriasis are now observed. Over time, the number of rashes increases. They form characteristic psoriatic plaques. The Kebner phenomenon is observed - the appearance of new plaques at the sites of skin trauma. As a rule, patients have plaques that stay on the skin even without deterioration.
The disease occurs cyclically:
- Progressive phase (an increase in the number of rashes);
- Stationary phase (new rashes do not appear);
- Regressive phase (regression of rashes, the appearance in their place of pigment-free skin areas).
Psoriasis vulgaris, photo
Diagnosing
When diagnosing psoriasis, first of all, a thorough skin examination is required.
Thin skin, bleeding in places, loose plaques are signs of psoriasis. In the presence of these symptoms, the doctor performs a number of diagnostic measures to exclude the presence of other events with similar manifestations. For the final diagnosis, blood tests, stains and skin biopsies are performed as needed. If the joints are affected, magnetic resonance imaging (MRI) is prescribed and X-rays are taken to identify damage.
Psoriasis vulgaris, treatment
Psoriasis is a systemic disease with skin manifestations and requires complex treatment: both local and systemic therapy. The disease is chronic and treatment aims to reduce the number and severity of exacerbations and achieve a skin condition that is acceptable to the patient.
In the progressive stage of psoriasis, all aggressive procedures are canceled: ultraviolet radiation, baths. It is important that psoriasis patients treat the skin carefully and cautiously, not to hurt it to avoid deterioration and the appearance of new plaque.
Diet for psoriasis
Psoriasis is often associated with liver disease, so it is important to avoid alcohol, fatty, fried, smoked foods. Equally important is to be moderate in carbohydrate intake, as this changes the skin pH and increases the risk of rash infection.
Prophylaxis
Preventing psoriasis is about maintaining a healthy lifestyle. This helps prevent the onset of other diseases, as the body's immune system is protected from stress and can withstand external threats.
Psoriasis prevention measures include:
- proper skin care;
- relaxing massage to improve blood circulation;
- proper nutrition, it is advisable to avoid allergic foods and exclude (limit) the intake of spicy, fatty, pickled, smoked, salty, as well as citrus fruits;
- milk-vegetable diet;
- a sufficient amount of moisture in the body;
- elimination of alcohol and smoking and other bad habits;
- increased physical activity;
- walks in the open air;
- avoiding stressful situations;
- taking vitamins of groups A, B, C, D, E;
- choosing loose clothing of natural materials that will not tear and do not cause irritation.
Tools for treating psoriasis
Systemic therapy for psoriasis aims to reduce the proliferation of skin epithelium, stabilize the keratinization of skin cells and cell membranes. For this, preparations based on vitamin A (retinoids), cytostatics are used. From the most modern treatments, the so-called biological ones are used, which neutralize the substances that cause inflammation.
For many years, UFOs have been used to treat group B ultraviolet rays (in bed beds, group A rays), which reduce inflammation and contribute to the death of altered cells. PUVA therapy is the simultaneous use of ultraviolet radiation and a special substance that increases the sensitivity of the skin to it.
An effective remedy for psoriasis
Local treatment is no less important than systemic treatment. Helps reduce skin inflammation. The drug is prescribed depending on the stage of psoriasis.
Progressive phase
- ointments and lotions for peeling;
- hormonal anti-inflammatory ointment with calcitriol;
- emollient to relieve itching and dry skin.
Stationary phase
- UVB therapy;
- concentrated exfoliating oils;
- emollient to restore skin and reduce dryness.
Regressive phase
- concentrated exfoliating oils;
- emollient to restore skin and reduce dryness.
Psoriasis cream
Creams and ointments for psoriasis have different purposes and are used in different stages of the disease. Hormonal anti-inflammatory ointments and creams are used to stop inflammatory processes in the skin. There are several classes of hormonal drugs. They have different absorption capacities and different activities. When used in children, they try to avoid applying hormonal medications to the face and neck area, the area of skin folds - the places where the skin is thinnest. Topical preparations based on calcipotriol (a derivative of vitamin D) also have an anti-inflammatory effect. This is a later generation of drugs. Not currently used during pregnancy and lactation.
Salicylic ointment and salicylic acid lotion are created to remove skin flakes with severe flaking. Salicylic acid not only has a layering effect, but also increases the effectiveness of local hormonal drugs. In the stationary and regressive phase, when inflammation has become less active, salicylic acid-based agents are used in a higher concentration.
Means to restore skin structure and eliminate dryness are used throughout the treatment period, as well as in conjunction with ultraviolet radiation to reduce itching of the skin. Once inflamed, these products help preserve the skin's protective properties and reduce the risk of new outbreaks.
An effective cream for psoriasis
The modern approach to care and care for dry skin is based on saturating the wet epidermis and is called corneotherapy (derived from "corneo" - the corneal layer, or horn of the epidermis).
Corneotherapy aims to restore the corneal layer of the epidermis and its protective functions, which makes it possible to improve the condition of the skin as a whole. The works of the founder of corneotherapy Albert Kligman made possible the creation of special - emollients.
How do softeners work?
within 1 hour after applying emollients: - the condition of the skin improves, due to the fact that emollients "block" moisture in it.
6 hours after applying emollients: - the skin structure is restored due to the content of special natural restorative lipids (ceramides and other useful fats).
24 hours after application of emollients: - clinical improvement of the skin condition occurs due to the penetration of moisturizing ingredients in the deep layers of the epidermis and the restoration of the superficial layers of the skin (up to 24 hours from the beginning of application).