Psoriasis is a chronic inflammatory disease of the body, accompanied by a predominant skin lesion with the formation of erythematous spots and plaques that have clear boundaries and silvery scales on the surface.
The course of this disease is characterized by periods of exacerbation and remission (reduction of symptomatic manifestations). Unfortunately, medicine has not yet identified the exact and reliable cause of psoriasis, but a hereditary factor has been clearly noted, which, in combination with triggering factors, contributes to the triggering moment of the appearance of this disease. A link between the occurrence of psoriasis and antigens of the HLA system has been discovered.
Between 1 and 5% of the world's population suffer from this very unpleasant disease, and fair-skinned people are at greater risk of developing psoriasis than people of color.
The disease can appear at any age, but the periods of 20-30 years and 50-60 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.
Mostly, rashes are localized on the scalp, on the surface of the elbows and knees, in the areas of skin folds and genitals. 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 occurrence of psoriasis has not yet been discovered by medicine; some doctors talk about autoimmune causes. The second theory that explains the appearance of the disease is a disturbance in the normal process of maturation and division of skin cells. Heredity and stress are also considered triggers.
A genetic predisposition to psoriasis, allergies and frequent disruption of the skin barrier function (strong friction, chemical exposure, influence of alcohol-containing products) can provoke an exacerbation of the disease.
- 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;
- Obesity;
- Hormonal imbalance, especially in women during menopause and pregnancy;
- Disorders in the digestive system.
The main cause of the development of the disease is the excessive, accelerated growth and division of skin cells in combination with the inflammatory process in the dermis. In other words, the skin cells that lie in the lower layer of the epidermis begin to grow rapidly and put pressure on the cells that lie above. This process is accompanied by pronounced peeling of the skin and is called parakeratosis. It is believed that excessive stimulation by the immune system is the main link in the occurrence of this mechanism.
Symptoms and signs of psoriasis
Rashes associated with psoriasis are asymptomatic or accompanied by itching. Most often they are located on the scalp, extensor surfaces of the knees and elbows, sacrum and buttocks (especially in the gluteal fold) and in the genital area. Fingers and toenails, skin on the eyebrows, armpits and navel can be affected. 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, rashes are discretely located and are represented by erythematous papules or plaques, which are covered with dense, silvery, shiny scales. Redness appears gradually. Remissions and exacerbations occur spontaneously or after exposure to provoking factors.
5-30% of patients develop
Important!Psoriasis does not threaten the patient's life, but it spoils the patient's self-image. In addition to the fact that the patient's appearance changes, a great deal of time is needed to treat skin rashes and maintain cleanliness of clothes and bedding, which significantly 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 skin. Plaques may coalesce as the disease progresses. Among all subtypes, this type of psoriasis is the most common and accounts for approximately 90%.inverse psoriasis accompanied by redness that appears in the area of natural folds and can create cracks.guttate psoriasis characterized by multiple skin rashes with a diameter of 0. 5-1. 5 cm. They are often formed after streptococcal pharyngitis.palmoplantar psoriasis manifests as plaques on the palms and soles, which may coalesce.nail psoriasis affects the nail plates in the form of indentations and clear grooves with discoloration and thickening of the nail. Nail changes with psoriasis often resemble changes with a fungal infection.pustular psoriasis accompanied by the formation of pustules on the palms, soles or possibly damage to one of the fingers. It can also have a generalized form.erythrodermic psoriasis manifests as a sudden or gradual appearance of redness in patients with psoriatic plaques, when the plaques themselves are light or absent. It usually appears due to improper treatment of psoriasis vulgaris.
Methods for diagnosing psoriasis
When symptoms of psoriasis appear, the patient should consult a dermatologist. He will perform an external examination of the affected areas of the skin and collect a complete medical history.
Psoriasis has a general similarity with other dermatological diseases, especially in the first stages of manifestation. It is important to exclude the presence of fungal infections in the hands and nails. The seborrheic type of psoriasis requires special differential diagnosis to exclude seborrheic eczema, pityriasis rosea, and papular syphilis.
In case of active disease and large lesions of epidermal areas, visual analysis of scratches is used. In the process of scratching, the peeling is intensified. Instead of the removed scale, a smooth and thin film is visible, which breaks off under mechanical action and reveals a wet surface with drops of blood.
Diagnosing psoriasis in most cases is not difficult, it is enough to simply examine the patient's skin. The doctor must exclude errors in the diagnosis and determine the presence of other diseases and other pathologies that occur against the background of psoriasis.
In rare cases, the diagnosis requires a biopsy. If there are non-classical clinical signs, the need for it should be considered. There are mild, moderate and severe severity of the disease based on the area of skin affected. Damage to less than 10% of the skin corresponds to mild severity. There are more sophisticated methods for assessing the severity of the disease, but they are used in clinical trials.
Treatment of psoriasis
There are a large number of factors that depend on the development of the disease and its various manifestations. Therefore, many treatments for psoriasis have been developed. Often these methods are combined, including drug and non-drug interventions.
The treatment plan is drawn up depending on the severity of the disease, the area of the affected skin and the severity of symptoms such as redness, itching, skin. Age and gender, the stage of the disease and the general condition of the patient, the presence of concomitant diseases are also taken into account, as they can limit the choice of treatment methods.
Treatment of psoriasis should lead to a decrease in clinical manifestations (redness and other symptoms), improvement of the patient's general condition and restoration of his ability to work.
When treating psoriasis, it is necessary to follow a diet and take proper care of the skin, as 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, to give up alcohol, sweets (simple sugars) and starchy foods. The emphasis in the diet should be on proteins: lean meat, 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 skin and itching in small areas where the disease is localized. Hormonal ointments, salicylic acid, retinoids and moisturizing creams are particularly effective in treating psoriasis on the face and hands.Drug therapy it is used as an additional method of effective treatment of psoriasis when ointments do not help. Medicines reduce the inflammatory process, remove swelling and itching and block the growth of skin cell activity. But it is worth considering that tablets have many side effects (increased fatigue, lack of appetite, high blood pressure). Therefore, it is very important to follow all the recommendations of the doctor regarding the dosage of the drug.- When psoriasis is localized on the head and neck, use
therapeutic medicated shampoo : antifungal, tar, containing corticosteroids. The shampoo eliminates pathogens of pathological inflammation, removes scales, relieves itching and burning. Therapeutic antihistamine injections block severe itching, biological drugs have a beneficial effect on the immune system.
Unfortunately, today there is no possibility of a complete cure for psoriasis. Any treatment for psoriasis is aimed at eliminating the signs of the disease for a long time and prolonging the remission. But the treatment of psoriasis is necessary, regardless of the slow chronic course of the disease, since the prolonged lack of therapy can lead to the patient's disability.