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 simultaneously: from hereditary predisposition (psoriasis in relatives) to disorders of the nervous, endocrine, immune systems and other factors.
The reasons
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 inside the body, does not depend on external threats).
The top layer of the skin (epidermis) consists mainly of keratinocytes - cells that produce keratin. Keratin is a protein, its properties make it possible to perform the protective function of the skin. Keratinocytes form in the deep layers of the epidermis and move slowly to its surface, during movement they mature and acquire new properties.
At the end of their "maturation", keratinocytes form a stratum corneum on the surface of the skin. Then the keratinized cells die and exfoliate from the living, thus ending the life path of keratinocytes. This ensures continuous renewal of the skin.
The normal path of keratinocytes from the deep layer to the surface takes a month. With psoriasis, their life expectancy is reduced to a few days, leading to scaly, psoriatic lesions, as the skin does not have time to get rid of keratin cells.
When they appear, psoriatic plaques are usually accompanied by itching and redness. This shows an autoimmune reaction in the deep layers of the skin, leading to swelling of the thick layer of skin (dermis). The dermis contains blood and lymph vessels.
It is not certain why the process of keratinocyte formation is accelerated, but it is known that a hereditary factor plays a significant role.
The development of common psoriasis can begin due to:
- mental trauma and constant stress;
- 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, which occurs when the skin is scraped.
Stearin stain(increased peeling after scraping, giving the surface of the papules a resemblance to a crushed drop of stearin).
Thermo film(appearance after complete removal of scales on a wet, thin, shiny, translucent surface).
Accurate bleeding(the appearance of droplets of blood that do not merge with each other).
What happens to the skin in psoriasis?
In psoriasis, the structure of the skin is disrupted, the epidermis becomes thinner, the processes of keratinization of the skin (accumulation of keratin protein) are disrupted and some layers of the normal epidermis disappear. In the next stage of the disease, there are groups of cells responsible for inflammation in the protective superficial stratum corneum of the epidermis and in the area of parakeratosis, around the dilated vessels of the skin.
Characteristic plaques and scales appear on the surface of the skin.
Psoriasis is not only a common disease, it has many manifestations and is even disguised as other diseases.
Localization of psoriasis:
- elbows and knees;
- cross and cross;
- scalp (seborrheic psoriasis);
- flexion surfaces and folds of the skin: the inner surface of the elbow and knee joints, groin and armpits, the area under the breast (reverse psoriasis);
- palms and soles of the feet (palmar-plantar psoriasis);
- nail plate psoriasis.
Common symptoms of psoriasis
The main symptoms of psoriasis are:
- psoriatic plaques;
- tightening of the affected area of skin;
- itching.
Symptoms by type of psoriasis:
- exudative psoriasis (the affected areas of the skin peel off and get wet, a yellow crust forms on the surface of the rash);
- intertriginous psoriasis (more common in children, the foci appear red, with a slight peeling, sometimes wet can be confused with a 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 conical plaque);
- guttate psoriasis (abundant rash of small papules).
Types of psoriasis
- Psoriasis common (vulgar, plaque);
- Generalized psoriasis (widespread, postular);
- Drop-shaped psoriasis (by type of rash);
- Arthropathic psoriasis (with joint damage);
- Other types of psoriasis (seborrheic and others).
Psoriasis vulgaris 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 location of the rash is the scalp and trunk area. There is usually a clear link between the appearance of rashes and the action of the provoking factor.
Provoking factors for psoriasis can be stress, skin trauma, a recent infectious disease and regular alcohol consumption.
Usually the exacerbation of the disease occurs during the cold season - this is the winter type of psoriasis. The summer type is rarer. Mixed forms of psoriasis are now being noted. Over time, the number of rashes increases. They form characteristic psoriatic plaques. Kebner's phenomenon is observed - the appearance of new plaques at the sites of skin injuries. As a rule, patients have plaques that remain on the skin even without exacerbation.
The disease proceeds cyclically:
- Progressive stage (increase in the number of rashes);
- Stationary stage (new rashes do not appear);
- Regressive stage (regression of rashes, the appearance in their place on skin areas without pigment).
Psoriasis vulgaris, photo
Diagnosis
When diagnosing psoriasis in the first place requires a detailed examination of the skin.
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 rule out the presence of other events with similar manifestations. For the final diagnosis, blood tests, smears and skin biopsies are performed if necessary. If the joints are affected, magnetic resonance imaging (MRI) is prescribed and X-rays are taken to identify the lesions.
Psoriasis vulgaris, treatment
Psoriasis is a systemic disease with cutaneous manifestations and requires complex treatment: both local and systemic therapy. The disease is chronic and treatment is aimed at reducing the number and severity of exacerbations and achieving 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 for patients with psoriasis to handle the skin carefully and carefully, not to injure it, in order to avoid exacerbation and the appearance of new plaques.
Diet for psoriasis
Often psoriasis is accompanied by liver disease, so it is important to avoid alcohol, fatty, fried, smoked foods. It is just as important to be moderate in your carbohydrate intake, as this changes the pH of the skin and increases the risk of a rash infection.
Prevention
Prevention of psoriasis is about maintaining a healthy lifestyle. This helps prevent other diseases, as the body's immune system is protected from stress and can withstand external threats.
Measures to prevent psoriasis include:
- proper skin care;
- relaxing massage to improve blood circulation;
- proper nutrition is recommended to avoid allergenic foods and to exclude (limit) the intake of spicy, fatty, pickled, smoked, salty foods, as well as citrus fruits;
- dairy-vegetable diet;
- sufficient moisture in the body;
- elimination of alcohol and smoking and other bad habits;
- increased physical activity;
- outdoor walks;
- avoiding stressful situations;
- intake of vitamins from groups A, B, C, D, E;
- choice of wide clothes made of natural materials that will not rub and cause irritation.
Remedies for psoriasis
Systemic therapy for psoriasis is aimed at reducing the proliferation of skin epithelium, stabilizing the keratinization of skin cells and cell membranes. For this, preparations based on vitamin A (retinoids), cytostatics are used. The most modern treatments use so-called biological preparations, which neutralize substances that cause inflammation.
For many years, UFOs have been used - treatment with ultraviolet rays of group B (in solariums, rays of group A), 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. Medications are prescribed depending on the stage of psoriasis.
Progressive stage
- exfoliating ointments and lotions;
- anti-inflammatory hormonal ointments with calcitriol;
- emollients to relieve itching and dry skin.
Stationary stage
- UVB therapy;
- concentrated exfoliating ointments;
- emollients to restore the skin and reduce dryness.
Regression stage
- concentrated exfoliating ointments;
- emollients to restore the skin and reduce dryness.
Psoriasis cream
Psoriasis creams and ointments have different uses and are used at 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 learning abilities and different activities. When used in children, they try to avoid the application of hormonal drugs on the face and neck, the area of skin folds - places where the skin is thinner. Topical preparations based on calcipotriol (a derivative of vitamin D) also have an anti-inflammatory effect. This is a later generation of drugs. They are currently not used during pregnancy and lactation.
Salicylic ointment and salicylic acid lotion are designed to remove scaly skin flakes. Salicylic acid not only has an exfoliating effect, but also increases the effectiveness of topical hormonal drugs. In the stationary and regressive stages, when the inflammation has become less active, salicylic acid-based agents are used at higher concentrations.
Remedies to restore the structure of the skin and eliminate dryness are used throughout the treatment period, as well as in conjunction with ultraviolet radiation to reduce itchy skin. Once the inflammation subsides, these products help maintain the skin's protective properties and reduce the risk of new breakouts.
An effective cream for psoriasis
The modern approach to care and care for dry skin is based on the saturation of the epidermis with moisture and is called corneotherapy (derived from "corneo" - corneal, or horny, layer of the epidermis).
Corneotherapy is aimed at restoring the stratum corneum 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 means - softeners.
How do softeners work?
within 1 hour after applying emollients: - the condition of the skin improves due to the fact that the emollients "lock" the moisture in it.
6 hours after application of emollients: - the structure of the skin is restored due to the content of special restorative natural lipids (ceramides and other useful fats).
24 hours after application of emollients: - clinical improvement of the skin condition due to the penetration of moisturizing components into the deep layers of the epidermis and restoration of the superficial layers of the skin (up to 24 hours from the beginning of application).