Psoriasis: symptoms, treatment and prevention

Psoriasis- one of the most common diseases, the frequency of which among the population is constantly increasing every year. And if we consider that absolutely all age groups are susceptible to this pathology and its simple form quickly turns into more complex, then the question of proper therapy and prevention is really very acute.

According to statistics, approximately every 30th inhabitant of the planet suffers from this disease to one degree or another. What to do for those who get psoriasis? What medicines and folk remedies can be treated? How to properly organize your diet? Let's finally put all the dots.

Psoriasis and its causes

Psoriasis is an autoimmune disease with a rather unclear etiology - the exact cause, despite numerous studies in this area, is still unknown. It is believed that this pathology is a consequence of genetically determined changes in the immune system, resulting in the development of chronic inflammation of the skin. However, its multifactorial nature is not excluded - in other words, participation, along with heredity and the influence of the external environment.

It should be noted that, according to scientists, predisposing factors are quite different for different age groups: for example, if different types of bacterial infections, including streptococcal infections, are thought to cause triggers in children, then in adults, stress stimuli andNicotine abuse is paramount, and alcohol, obesity, and the use of certain medications (such as adrenaline receptor blockers).

It is impossible to completely cure psoriasis, but modern medicine is fully capable of significantly alleviating the course of the disease and maintaining long-term remission in the patient.

There are several theories that explain the appearance of psoriasis:

• infectious and parasitic;
• neurogenic;
• endocrine;
• metabolic;
• immunological;
• hereditary;
• theory of molecular mimicry.

As with many other conditions, the cause of skin problems must be found in the gut. Its length is from 4 to 6 meters, and the inner surface is covered with villas, the total area of which is comparable to the size of a tennis court - this allows the absorption processes to proceed much more efficiently. Interestingly, the cells of the lining of the small intestine are completely renewed every 3-5 days. In addition, up to 70% of human immunocytes are concentrated here. So, one of the most common causes of psoriasis is considered to be ruptured bowel syndrome (LEPS).

Deviation from the normal functioning of the intestinal mucosa is fraught with malabsorption, ie violation of the absorption of essential nutrients (proteins, fats, carbohydrates, vitamins, minerals). In addition, the negative impact on the body of toxins and allergens increases: in such conditions it is much easier for them to enter the bloodstream. The direct link between psoriasis and inflammatory bowel disease has been proven in numerous studies.

Other works of scientists confirm that a special microflora is formed on the skin of a patient with psoriasis, which is significantly different from the microbiome of healthy skin.

In the area of psoriatic lesions is concentrated a mass of various bacteria, whose stability is significantly lower than that of normal skin - in particular, there is colonization by Staphylococcus aureus, which has an extremely negative effect on the course of the inflammatory process.

Types of psoriasis

1. Plaque psoriasis. . . In 90% of cases, dermatologists are faced with this particular form of the disease, also known as simple or ordinary. First, individual small areas appear on the skin, raised above the level of the healthy dermis. These inflamed areas are called psoriatic plaques. Gradually they grow, merging with adjacent spots into one whole.
2. Reverse psoriasis.This diagnosis is made in patients who develop smooth red spots in the folds of the skin and inside the folds - in the groin, inner thighs, under the breast. Unlike ordinary psoriasis, the foci of inflammation are practically not covered with scales, but due to their location and constant friction cause serious discomfort to patients. In addition, there is a risk of re-infection with streptococci or fungi, as in places where spots are located, due to high humidity and temperature, ideal conditions are created for the reproduction of microorganisms.
3. Guttate psoriasis.This type of disease got its name from the shape of the formations. The lesions are in the form of a drop raised above the level of healthy skin. A common trigger for this form of psoriasis is a previous streptococcal infection, as mentioned earlier. The thing is that the patient's immunity affected during the fight against the infection is severely weakened - his resources are not unlimited and, like all living things, it takes time to recover - and against this background the autoimmune disease is activated.
4. Pustular psoriasis.It is considered the most severe form, accompanied by the formation of bubbles filled with clear liquid. Inflammation of the skin begins around the foci, swelling and thickening appear. In secondary exacerbations, which are quite likely, the blisters fill with pus. Localized foci of pustular psoriasis on the hands and feet. In difficult cases, there are ubiquitous blisters on the body, their rapid growth and the risk of infection on the entire surface of the skin.

5. Nail psoriasis.This type of disease changes the appearance and structure of the nail plates of the hands and feet. Nails thicken, lose their natural color, emit an unpleasant odor. The skin around the nail bed becomes rough, thick ridges form. In advanced cases, the nails may disappear without subsequent regrowth.
6. Psoriatic arthritis.In this case, the disease affects the joints and connective tissues. Inflammation most often affects the distal phalanges of the limbs. There is psoriatic dactylitis - swelling of the fingers. The hip and knee joints are also exposed to the devastating effects of ongoing disease. Injuries with loss of ability to move independently are common.
7. Psoriatic erythroderma.Scaly spots appear on the skin while peeling of the affected layer is observed. Patients experience extreme discomfort due to constant itching and swelling. Most often, this diagnosis is made in patients who have already been treated for simple psoriasis but have not completed therapy or changed the medication.

Symptoms of the disease

The first manifestation of psoriasis is a small rash on the skin. The papules grow rapidly, growing to spots with a diameter of 4 to 8 cm, they become more and more, and dry scales form on the surface. In advanced cases, individual spots merge with each other and the lesion affects large areas of the body. Psoriatic papules can be distinguished from other skin diseases by their round shape with clear borders, red or bright pink color and silvery-white scales. They appear first on those areas of the skin whose integrity is damaged as a result of abrasions, wounds, frostbite, constant rubbing. There are three characteristic signs confirming the onset of psoriasis:

1. The phenomenon of stearin spots- Dry particles are easily separated from the affected surface, revealing an area that resembles a drop of wax or sterol.
2. Psoriatic phenomenon(terminal) film. Further cleaning of the papules from the scales allows you to see a transparent and moist film, the skin under which is inflamed.
3. Auspitz phenomenon. . . The removal of the final film leads to the appearance of the smallest drops of blood on the surface of the stain.

This triad of psoriasis is unique - its presence allows you to make the right diagnosis. Nevertheless, different parts of the body have their own characteristics of the disease.

• Psoriasis on the body.The back, neck, abdomen, thighs and lower legs are most commonly affected by guttate psoriasis. Small papules, which resemble drops in shape, gradually grow, rising above the surface of the skin. This form of the disease is often diagnosed in people who have had a staph infection.

• Psoriasis on the hands.The most common sites of psoriatic papules on the hands are the elbows and interdigital spaces - while as a rule there is a form of plaque in which individual small fragments merge into a lesion area covered with dry scales. The forearms are much less often affected.
• Psoriasis of the legs.The disease begins with single rashes in the knee area. Inflamed areas bother patients with severe peeling and itching, rapidly increase in size and merge with neighboring ones.
• On the palms and soles of the feet.In most cases, there is a simultaneous lesion of both the palms and the soles of the feet, but in some patients the disease affects the stratum corneum of the purely upper or lower limbs. The growth of psoriatic papules results in thickening, roughening of the skin with further cracking.
• Scalp psoriasis.First, rashes appear on the forehead, back of the head, and also behind the ears. First, patients notice single scaly formations that grow, merge with those nearby, and over time can affect the entire scalp. The papules are very itchy, thus causing a constant urge to scratch the skin - the resulting wounds and cracks are likely to become the gateway to infection. Dry particles are released from the damaging formations - first small, somewhat similar to dandruff, and then larger scales.

• On the face, ears, neck.The localization of psoriatic papules on the face is rather an exception in the usual clinical picture. In rare cases, when this happens, the disease affects the areas around the eyes and eyelids, as well as the cheeks and tongue. The formations of the neck quickly spread further - to the back or head. The ears are the site of development of seborrheic psoriasis. Papules can appear both inside the cartilage and outside. When making a diagnosis, it is important not to confuse the disease with seborrheic eczema, which has similar symptoms.
• On the nails.There are three possibilities for the initial manifestation of psoriasis on the nail plates. The first is the appearance of small punctate depressions. The second is thickening of the nails, change in their natural color to gray or yellow. With the further development of nail psoriasis, the plaque exfoliates, the upper particles are easily removed. Finally, the third is the deformation of the nail, accompanied by a loss of smoothness of the plate and the appearance of depressed areas.

• Symptoms of psoriasis in children.At an early age the disease proceeds in different ways: the main localization of red scaly rashes are the skin folds: inguinal, in the elbow and knee joints, on the neck. The papules are very itchy, the children experience constant pain, become irritable and restless. In general, all clinical variants observed in children are similar to those observed in adults. The differences relate to pure manifestations, the location of the pathological process and the course of the disease itself.

4 stages of psoriasis

Clinical dermatology, based on differences in symptoms, the extent of skin lesions and the duration, distinguishes three stages of psoriasis. However, there is an opinion that the initial stage should be recognized as another full stage in the development of the disease.

1. Initial phase.The first sign of psoriatic lesions are small rashes. The places of their appearance can be different and depend on the type of disease. The primary papules are no more than 3 mm in size, painted in a pale pink color, which after 3-4 days is replaced by a gray color - dead particles of the dermis are formed on the spot. This process is accompanied by itching and burning, and general health deteriorates. In general, the formation of plaques in the initial stage takes up to three weeks and during this time a person has a chance to slow down the development of the pathology.
2. Progressive.At this stage, the disease affects significant areas of the skin: for example, in normal psoriasis, plaques form, in other forms - characteristic papules. In the process of disease development, individual spots merge with each other, covered with gray scales. The symptom that determines the progressive stage is the Koebner phenomenon (isomorphic reaction). Any damage to the skin after some time is accompanied by the appearance of a psoriasis rash at this site. Another confirmation that the disease is actively developing is the appearance of drops of dew-like blood after removal of the plaque. The duration of this stage depends on the type of lesion. On average, it takes from two weeks to two months.
3. Stationary stage.During this period, a thick gray-white or gray crust is formed. The pink rims disappear. The skin becomes rough, dry particles are constantly exfoliated from it. The itching and burning sensation becomes less annoying, but also does not disappear completely. New papules do not form. This stage can be quite long.
4. Regression stage.The last stage of the disease, during which there is a gradual reduction and resorption of plaques. The itching no longer bothers me. A clear sign of regression is Voronov's symptom when the papules are surrounded by white rings. The fading of spots occurs from the center to the periphery, as a result of which strange patterns form on the skin. By the end of the regression stage, only areas of the skin that are slightly different in shade from the healthy ones resemble psoriasis. It is not necessary to talk about complete recovery in case of psoriasis. The end of the regression stage indicates that the disease cycle is complete, which can return at any time. To prolong remission, it is necessary to pay attention to health: avoid provoking factors, follow a diet, see a dermatologist.

Psoriasis examination plan

1. General clinical blood test.
2. Study of the content of vitamins D, B12, folic acid in the blood.
3. Blood test for ALT (alanine aminotransferase), AST (aspartate aminotransferase), direct bilirubin, alkaline phosphatase, gamma-glutamyl transferase, lipid profile cholesterol, creatinine, glucose, insulin, total protein.
4. Blood for rheumatoid factor, c-reactive protein, uric acid, ASLO.
5. Ferritin, transferrin, serum iron are indicators of anemia (especially chronic diseases).
6. Shield panel: TSH, T4 sv, TK sv.
7. Coprogram.
8. KhMS according to Osipov.
9. Ultrasound of the abdominal organs.

Traditional treatment of psoriasis

Early therapy.

The earlier a person who finds the first signs of skin lesions goes to the doctor, the more likely it is to take timely measures that will prevent the rapid development of the disease and its transition to a chronic form - and therefore significantly improve the overall standard of living.

One of the most commonly prescribed drugs at the beginning of the disease is salicylic ointment. It has anti-inflammatory and antimicrobial effect, has a keratolytic effect, due to which the plaques are cleared of keratin particles. Naphthalene ointment is also used to reduce itching.

Therapy at a progressive stage.

At this stage, an integrated approach to treatment is required and only an experienced specialist can provide it. Treatment is aimed at relieving symptoms, ridding the body of toxins. Intramuscular injections of calcium gluconate are often prescribed to normalize metabolic processes. Sodium thiosulfate relieves inflammation and eliminates the symptoms of intoxication.

Special moisturizers and salicylic ointment are used to moisturize inflamed skin. Tar-containing agents are contraindicated at a progressive stage: they are irritating and increase the patient's suffering.

When the intensity of the inflammation decreases, physiotherapy procedures can be started. Patients with psoriasis are shown ultraviolet radiation, PUVA therapy and paraffin applications. Corticosteroids and cytostatics are not used unnecessarily, these powerful drugs are needed extremely in difficult and advanced cases.

To reduce allergic reactions, antihistamines and sedatives are prescribed to reduce nervousness. Diuretics help reduce the swelling of inflamed skin and remove toxins from the body.

Inpatient therapy.

At this stage, the inflammation disappears, the plaques are covered with a dry crust, therefore means are needed that will relieve the discomfort from the appearance of scales. These are tar shampoos, oil-based emulsions.

In many patients, ultraviolet radiation and the PUVA technique have a good effect. If there is no improvement, doctors prescribe cytostatics.

Regression therapy.

In the last period of the disease cycle, constant adjustment of treatment methods is required, depending on the current condition of the patient. Prevention replaces active therapeutic actions.

The patient receives recommendations to change the diet and lifestyle in general. To avoid recurrence of the skin lesion, it is necessary to avoid stressful situations that cause the formation of psoriatic plaques.

Doctors usually give patients the following advice:

• reconsider your lifestyle: make adjustments in the diet, sleep enough, move more;
• ensure normal vitamin levelsD, iron, B vitamins, proteins in the body;
• normalize the digestive tract: exclude hypoacidity, impaired bile flow, SIBO and CIGR (syndromes of excessive bacterial and fungal growth, respectively);
• get rid of foci of chronic infection: sanitize the oral cavity, undergo treatment by an ENT doctor;
• deal with concomitant somatic pathology: hypothyroidism, insulin resistance, metabolic syndrome, etc.

Traditional methods of eliminating psoriasis

• Initial phase.At the first signs of skin lesions, juniper and lavender oil are effective. They soothe irritated areas of the dermis, promote the healing of minor injuries, relieve the feeling of tightness. A few drops of oil are added to a cream that is neutral in composition, for example for children, and applied to the rash that appears. Another popular method of dealing with the initial manifestations of psoriasis is the use of 3 percent hydrogen peroxide. Any measures, even the most seemingly harmless, can be applied after consultation with a dermatologist. Changes in diet, avoiding unhealthy foods and alcohol are also common recommendations of traditional healers.

• Progressive stage.At the stage of rapid development of the disease, an infusion of celandine is added to the healing oils and hydrogen peroxide. To prepare it, you will need fresh or dried plant stems and salt water. Alcoholic tinctures are contraindicated, they can worsen the condition of the affected skin. It is necessary to insist the celandine for at least a few hours and before applying the healing solution on the plates, treat them with birch tar.
• Stationary stage.At the stage of stopping the formation of new papules, you can use proven folk methods that will definitely not harm the patient. These include the use of sulfur ointment, salicylic solution.
• Regression stage.In the last stage of the disease, hirudotherapy (leech therapy) is often used. Although this method is not officially recognized by traditional medicine, many experts do not rule out its effectiveness. The procedures are performed within 3 - 10 days, depending on the patient's health condition.

Prevention of psoriasis: how to prevent the development of the disease

• Skin care.To minimize the likelihood of psoriatic damage in the presence of genetic predisposition, simple ways to maintain skin health will help: water and hardening procedures (bathing in the sea, baths with herbal extracts and salts, contrast showers, douching with lukewarmwater in the air, etc. ); use soft sponges and avoid hard towels that can damage the skin; the use of detergents, natural in composition, without aggressive chemical components.
• UV rays.Several studies have shown the beneficial effects of sun exposure on skin prone to psoriatic plaque. Moderate doses of ultraviolet light help accelerate tissue regeneration and reduce inflammation. You should not abuse sunbathing: an excess of rays can provoke an exacerbation of the disease.

• Clothing.Synthetic fabrics, tight-fitting styles, plenty of belts and buckles - all this is contraindicated for patients with psoriasis, even in remission. Clothing should be natural, hypoallergenic, loose, not cause inconvenience, which can lead to the return of severe symptoms. Dark tones should be avoided for aesthetic reasons; silvery white scales are less visible on light clothing.
• Injuries.For patients with psoriasis, any small wound, scratch, abrasion can lead to the return of the progressive stage and secondary skin infection. They must be extremely careful to avoid injury.
• Cosmetic and household products.Not all remedies are suitable for maintaining cleanliness for people with such diagnoses. When choosing shower gels, soaps, shampoos, it is important to pay attention to their composition, giving preference to those that contain natural ingredients. It is better to buy therapeutic series of care products that are sold in pharmacies. Solid scrubs are absolutely contraindicated: they are able to restart the disease process due to the slightest injuries to the skin. Household chemicals should also be chosen based on health safety, do not use aggressive cleaning powders based on chlorine and bases. Gloves should be worn when cleaning to avoid adverse effects on the skin of the hands.
• Vitamin therapy.Maintaining a balance of vitamins is shown to everyone, and especially to people with chronic dermatitis. Complex preparations keep the body in good condition, help it fight viruses and prevent metabolic disorders.

Psoriasis- This is not a death sentence, but a very serious reason to reconsider the rules you lived by before. Your allies in the path of domestication of the disease should be competent specialists - dermatologists, nutritionists, therapists. With their help, as well as through a deliberate approach to treatment, you can learn to live comfortably, regardless of your diagnosis.