For many centuries, mankind has tried to discover all the secrets of this mysterious skin disease, but still many things remain unknown. According to statistics, psoriasis affects 4 to 7 percent of the population, and 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 diminishing and disappearing, sometimes increasing in strength.
Causes and risk factors for psoriasis
Psoriasisis a long-term 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 skin with silvery scales on the legs, knees, back, chest, etc. In most cases, psoriasis starts in small areas of the 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 occurrence.
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 still not fully understood. It is important to note that psoriasis is a multifaceted disease that manifests differently in each patient. Studying the mechanisms of psoriasis can help to develop more effective treatments, reduce the risk of complications and improve the quality of life of patients.
Influence of metabolism
Metabolic disorders significantly affect skin condition 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 the different metabolism.
- With disorders of protein metabolism in patients with psoriasis, the content of albumin in the blood decreases and the content of globulins increases, which increases their sensitization.
- In fat metabolism, there is an increase in the content of lipids and cholesterol in the blood.
- Reducing calories and eating plant foods can reduce the activity of psoriatic inflammation.
- Disorders in carbohydrate metabolism almost always occur.
- The metabolism of vitamins and minerals is also impaired, which is manifested by a decrease in the content of vitamins C, A, B6, B12, iron, copper and zinc in the blood, but with an increase in the content of vitamin C.
Infectious cause
This theory was 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 return. Special attention is paid to the viral theory. Recent research shows that RNA viruses, such as HIV and other retroviruses, can affect 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, then the chances of developing it increase. Several genes may be associated with psoriasis, including the PSORS1-PSORS9 complex, with PSORS1 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 can be caused by other factors.
Neurogenic cause
Excessive stress on the nervous system, prolonged stress and imbalance in the autonomic nervous system, which provides the innervation of blood vessels and internal organs, can be risk factors for the development of psoriasis. These factors can cause an imbalance in the endocrine system, changes in metabolic processes and disturbances in the immune response, increased irritability or depression, constant fatigue, drowsiness and apathy, which in turn can lead to 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 link between them and psoriasis is not entirely clear and has not been proven. Experts believe that patients with psoriasis often suffer from dysfunction of the thyroid gland, pituitary gland and adrenal gland. Women may have problems with the menstrual cycle and men with sexual function.
Symptoms and characteristics of psoriasis
Psoriasis manifests itself not only in reddening of the skin, but also in other symptoms. It often begins in childhood or adolescence and is associated with hormonal disorders, vegetative-vascular dystonia and stress.
The first signs arefatigueANDmood swings. The main symptom is small pink bumps on the skin called papules, covered with white scales. The papules are surrounded by a brighter rim.
Over time, the elements of the rash can combine into large plates of unusual shape. The base of each papule isinflammatory infiltrate. The following types of rash are distinguished:
- precise point (no more than 1 mm in diameter);
- teardrop-shaped - (point papules up to 2 mm in size);
- coin-shaped – (round coin-shaped papules up to 5 mm).
Redness also has its own characteristics:
- stearic stain - if you scratch the surface of the papule;
- terminal film - after cleaning the papule from scales, you can see a transparent film;
- bloody dew (Auspitz phenomenon) - if the integrity of the film is damaged, small drops 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 withdraw from others and lead to 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 development stages of psoriasis
At the moment, there are three main stages in the development of psoriasis:
- A progressive phase, which is characterized by the continuous formation of new skin rashes, which are accompanied by severe itching.
- The stationary phase, in which new formations stop appearing, and existing ones begin to heal.
- A regressive phase in which the lips appear around the rash and the skin affected by the rash becomes darker in color 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.
- Average degree, which is characterized by 3-10% damage to the skin.
- Severe degree, in which the disease affects more than 10%.
Types of psoriasis
Psoriasisis a chronic skin disease that can manifest itself in different ways. Rashes, their location and damage to other systems and organs can vary. Depending on these characteristics, different 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 elbow psoriasis 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, deterioration occurs.
Pharyngeal psoriasis
Associated with bacterial (most often streptococcal) and viral infections, this type of psoriasis can cause inflammation. This condition often occurs in children and begins with the appearance of small, red, teardrop-shaped papules on the skin of the limbs, body or face. Papules have a scaly surface and can develop into erosions and ulcers, increasing the risk of infection.
This condition can develop quickly or gradually become chronic, followed by periods of exacerbation and remission of symptoms. In rare cases, psoriasis can be more severe.
Palmoplantar psoriasis
This type of psoriasis often develops in people involved in manual labor and is often accompanied by severe itching and can lead to nail complications. Some subtypes of this type of psoriasis include:
- Fan-shaped plaques: large elements on the palmar and plantar surfaces with white scales that coalesce into fan-shaped plaques. This subtype is most commonly found on the hands.
- Circular: ring-shaped scaly elements on the palmar and plantar surfaces.
- Callosal: rough epithelial growth with callus formation.
- Pustular: This is a distinct subtype of Barber's palms and soles psoriasis. In the areas located under the big toes, blisters and pustules containing pus appear, which causes severe itching. Ulcers coalesce, then dry and form crusts. The characteristic elements of psoriasis also appear in other parts of the body.
Leg psoriasis can be associated with varicose veins and occurs mainly on the lower legs.
Psoriasis of the nails
It can appear 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 bumps are usually more visible and painful to the touch than other types of dermatitis. In addition, symptoms include spontaneous splitting of the nail, subungual hemorrhage (especially when wearing tight shoes), changes in the color and surface of the nail, such as trachyonychia and koilonychia.
Scalp psoriasis
It can appear as an independent disease or as part of a general pathological process. One of the characteristic features is weeping and the formation of a crust on a part or on the entire surface of the head. In this case, hair growth is not damaged, as the function of the hair roots is not damaged. However, moisture creates a threat of infection, which can lead to damage to the hair follicles.
Seborrheic psoriasis
It occurs as a result of the breakdown of skin glands, which produce viscous sebum, causing skin irritation and inciting inflammation - dermatitis. This condition quickly spreads over the entire head, covering it in the form of a hat, and is accompanied by severe itching. In the areas behind the ears, sometimes weeping develops and infection can develop. A scalp covered with dandruff and crusting can look like a psoriatic crown.
Psoriasis on the face
It usually appears in the area of the nasolabial triangle, the eyelids, above the eyebrows and in the areas behind the ears. Rashes may coalesce, forming large areas of redness and swelling. If the functioning of the sebaceous glands is impaired, the process may be accompanied by weeping, crust formation and increased risk of infection.
Genital psoriasis
Psoriasis affecting the genitals is a concomitant process that is usually accompanied by the characteristic rash of psoriasis all over the body, which makes it easier to diagnose.
Psoriatic rashes on the penis in men, the labia majora in women and the surrounding areas of the skin are oval in shape and slightly raised above the surface of the skin. They are pink and crispy. It is practically not accompanied by itching. Sometimes the lesion process spreads to the mucosa 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 peel off due to constant wetting.
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 moist, moist 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. Moreover, 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 the 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 irritating factors on the skin. With psoriatic erythroderma, the skin becomes deep pink with a clear distinction between affected and healthy areas, as well as small and large skin. This condition requires urgent medical attention.
Complications of psoriasis
Lack of timely and adequate treatment for psoriasis can seriously damage the body's vital organs and systems, such as the joints, heart, kidneys and nervous system. These consequences can lead to disability or even death.
Diagnosing
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 reveal leukocytosis and anemia in psoriasis.
- Rheumatoid factor (RF) is a protein whose levels can be increased in systemic inflammatory diseases involving 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 can be elevated in psoriasis, which can lead to confusion with gout.
- Antibodies to the human immunodeficiency virus (HIV) can be detected with the sudden onset of psoriasis.
Other tests, such as x-rays of the joints and skin biopsies, may be used in more complex cases to assess the severity of joint damage and to differentiate psoriasis from other skin conditions.
Treatment
Treatment of psoriasis requires a comprehensive approach, including local treatment of skin lesions, medications, light therapy and prevention of exposure to factors that aggravate 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 effects, the amount of which depends on the nature of the lesion and is used daily);
- creams 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 soothe the skin and reduce the inflammation that occurs with psoriasis. It is important to avoid hot water and scrubs, and to use moisturizer after washing;
- light therapy, which involves exposing the skin to ultraviolet light, may also be helpful (avoid burns);
- photochemotherapy using medium wave radiation;
- compliance with a special diet and general regime.
During the development of a treatment program, the gender and age of the patient, the presence of concomitant diseases, general health and the influence of external factors are taken into account. Sometimes, to cure it, it is enough to change the lifestyle, and in other cases, several courses of treatment are prescribed.
In addition to traditional methods, the treatment of psoriasis may include the use of modern laser technologies. Laser therapy can reduce the symptoms of pathology, achieve long-term remission and free 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 the healthy ones, which ensures quick recovery without side effects. Laser therapy is safe and painless, requires no preparation and can be used regularly so that 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, so it is recommended to first consult a specialist and prescribe treatment measures based on clinical recommendations.
Preventing
Psoriasis is a disease that can be successfully treated if you consult a doctor at the right time and get qualified help. In the simple form of psoriasis, the patient can work without any restrictions, except for work in chemical plants, where staying in the workplace can be dangerous.
However, psoriasis can cause complications, such as psoriatic arthritis, which can limit work performance and lead to disability.
Psoriasis prevention is an important part of treatment. After recovery, patients should review their lifestyle, get rid of bad habits, take care of the treatment of other chronic diseases, monitor their diet and increase physical activity, spending more time outside and playingsports.
Nutrition for psoriasis
Diet for psoriasis is not strict, but proper nutrition plays an important role in complex treatment. When giving nutritional recommendations, patients are advised to:
- Avoid foods to which the body is highly sensitive and exclude them from the diet.
- Prefer fresh fruits, vegetables, berries, baked or boiled lean meat and drink more.
- Avoid the following foods: onions, garlic, radishes, concentrated tea, coffee, alcohol, sweets, salty and sour foods, as well as foods that can cause an allergic reaction such as orange fruits, honey, nuts, cocoa and eggs.
- Avoid fatty foods of animal origin.