For many centuries, mankind has tried to reveal all the secrets of this mysterious skin disease, but still much remains unknown. According to statistics, psoriasis affects from 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 decreasing and disappearing, sometimes increasing.
Causes and risk factors for psoriasis
Psoriasisis a long-term inflammatory process of the skin, which is considered an autoimmune disease (related to an allergic response to its tissues). It is a chronic skin disease that affects the cells of the outer layer of the epidermis. The condition usually presents as red, silvery scaly skin on the legs, knees, back, chest, etc. In most cases, psoriasis starts in small spots on 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 that 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 an immune system response that 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 multifactorial disease that manifests itself differently in each patient. Researching the mechanisms underlying psoriasis can help develop more effective treatments, reduce the risk of complications and improve patients' quality of life.
Effect on metabolism
Metabolic disorders significantly affect the condition of the skin and immunity in patients with psoriasis. Increased metabolism leads to the formation of toxins and free radicals that contribute to inflammatory reactions. There is an imbalance in various metabolisms.
- In 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.
- During fat metabolism, there is an increase in the content of lipids and cholesterol in the blood.
- Reducing calories and eating plant-based foods can reduce the activity of psoriatic inflammation.
- Disturbances almost always occur in carbohydrate metabolism.
- The metabolism of vitamins and minerals is also disturbed, which is manifested by a decrease in the content of vitamins C, A, B6, B12, iron, copper and zinc in the blood, but an increase in the content of vitamin C.
Infectious cause
This theory was widespread in the last century. It has been thought that psoriasis can 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 a relapse of psoriasis. Special attention is paid to the virus 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
Inheriting a predisposition to autoimmune reactions is a risk factor for psoriasis. If close relatives of a person suffer from this disease, then the probability of development increases. Several genes may be associated with psoriasis, including the PSORS1-PSORS9 complexes, 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, having 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 an 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 immunological response, increased irritability or depression, constant fatigue, drowsiness and apathy, which in turn can lead to psoriasis.
Endocrine
Endocrine disorders that occur in psoriasis are quite common and can have a significant impact on the development of the disease. However, the relationship 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, pituitary and adrenal glands. Women may have problems with their menstrual cycle, and men with sexual function.
Symptoms and characteristics of psoriasis
Psoriasis manifests itself not only in skin rashes, but also in other symptoms. It often begins in childhood or adolescence and is associated with hormonal disorders, autonomic-vascular dystonia and stress.
The first signs arefatigueAndmood swings. The main symptom is small pink bumps on the skin, called papules, covered with whitish scales. The papules are surrounded by a lighter rim.
Over time, the elements of the rash can combine into large plaques of an unusual shape. The base of each papule isinflammatory infiltrate. The following types of rashes are distinguished:
- accurate (no more than 1 mm in diameter);
- drop-shaped – (drop-shaped papules up to 2 mm in size);
- coin-shaped – (round papules-coins up to 5 mm in size).
The rash also has its own characteristics:
- stearin stain - if you scrape the surface of the papule;
- terminal film - after cleaning the papules from scales, you can see a transparent film;
- blood dew (Auspitz phenomenon) – if the integrity of the film is broken, small blood droplets 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 show 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 stages of development of psoriasis
Currently, there are three main stages of psoriasis development:
- A progressive stage, which is characterized by the constant formation of new skin rashes, which are accompanied by severe itching.
- The stationary stage, in which new formations stop appearing, and existing ones begin to heal.
- A regressive stage where ridges 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.
- Medium grade, which is characterized by 3-10% skin damage.
- Severe, where 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 be different. Depending on these characteristics, different forms of psoriasis are distinguished.
Common (vulgar, plain)
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 psoriasis of the elbows 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, exacerbation occurs.
Guttate psoriasis
Associated with bacterial (most commonly 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 extremities, body, or face. Papules have a scaly surface and can develop into erosions and ulcers, increasing the risk of infection.
This condition can develop rapidly 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 engaged in manual labor and is often accompanied by severe itching and can lead to nail complications. Several subtypes of this type of psoriasis include:
- Fan-shaped plaque: large elements on the palmar and plantar surfaces with white scales that coalesce into fan-shaped plaques. This subtype is most often found on the hands.
- Rounds: ring-shaped scaly elements on the palmar and plantar surfaces.
- Callosal: growth of rough epithelium with callus formation.
- Pustular: This is a distinct subtype of Barber's palmar psoriasis. In the areas located under the big toes, blisters and pustules containing pus appear, which causes severe itching. The sores coalesce, then dry and crust over. Characteristic elements of psoriasis also appear in other parts of the body.
Psoriasis of the legs can be associated with varicose veins and occurs mainly on the lower legs.
Nail psoriasis
It can appear as an independent 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 dimples are usually more noticeable and painful to pressure than other types of dermatitis. In addition, symptoms include spontaneous detachment of the nail, subungual hemorrhages (especially when wearing tight shoes), changes in the color and surface of the nail, such as trachyonychia and koilonychia.
Psoriasis of the scalp
It can manifest itself as an independent disease or as part of a general pathological process. One of the characteristic signs is weeping and the formation of crusts on part or the entire surface of the head. In this case, hair growth is not impaired because the function of the hair roots is not impaired. However, getting wet poses a threat of infection, which can lead to damage to the hair follicles.
Seborrheic psoriasis
It occurs as a result of disruption of skin glands that produce viscous sebum, causing skin irritation and promoting inflammation - dermatitis. This condition quickly spreads over the entire head, covering it in the form of a hat and is accompanied by severe itching. The areas behind the ears sometimes develop weeping and infection may develop. Scalp covered with dandruff and crusts can look like a psoriatic ring.
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 can coalesce, forming large areas of redness and swelling. If the functioning of the sebaceous glands is impaired, the process may be accompanied by weeping, crusting and an increased risk of infection.
Genital psoriasis
Psoriasis on the genitals is a concomitant process that is usually accompanied by characteristic psoriasis rashes all over the body, which makes it easier to diagnose.
Psoriatic rashes on the penis in men, the labia majora in women and the perineal areas are oval in shape and slightly raised above the surface of the skin. They are pink and scaly. It is practically not accompanied by itching. Sometimes the lesion process spreads to the mucous membranes 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 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 relapse, and the rash can become moist, wet 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 inflammation of the joints and the development of psoriatic polyarthritis, which can lead to joint dysfunction. In addition, the systemic autoimmune process caused by psoriasis can lead to the development of other autoimmune diseases, serious cardiovascular and digestive pathologies and neurological reactions.
Neglecting 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 skin irritants. In psoriatic erythroderma, the skin becomes deep pink with a clear distinction between the affected and healthy areas, as well as small and large peeling. This condition requires emergency medical attention.
Complications of psoriasis
Lack of timely and adequate treatment of psoriasis can seriously damage vital organs and systems of the body, such as joints, heart, kidneys and nervous system. These consequences can lead to injury or even death.
Diagnosis
Psoriasis is usually diagnosed based on the typical symptoms of skin lesions and their location. In some complicated cases, further tests may be needed to rule out other skin conditions.
Laboratory tests may include:
- Complete blood count, which can detect leukocytosis and anemia in psoriasis.
- Rheumatoid factor (RF) is a protein whose levels can be elevated 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 against the human immunodeficiency virus (HIV) can be detected in the sudden onset of psoriasis.
Other tests, such as joint X-rays and skin biopsies, may be used in more complex cases to assess the severity of joint damage and differentiate psoriasis from other skin conditions.
Treatment
Treatment of psoriasis requires a complex approach, including local treatment of skin lesions, medication, 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);
- lotions and shampoos based on salicylic acid, as well as photosensitizers;
- drugs for oral administration (retinoids, preparations with vitamin D and others);
- physiotherapy procedures;
- Daily baths with bath oil, oatmeal infusion, or sea salt can help soften the skin and reduce the inflammation that occurs with psoriasis. It is important to avoid hot water and scrubs and use a moisturizer after bathing;
- light therapy, which involves exposing the skin to ultraviolet light, can also be helpful (avoid burns);
- photochemotherapy using medium wave radiation;
- compliance with a special diet and general regimen.
When developing a treatment program, the gender and age of the patient, the presence of concomitant diseases, the general state of health and the impact of external factors are taken into account. Sometimes, to be cured, it is enough to change your 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 the pathology, achieve long-term remission and free the patient from unpleasant rashes and related problems. A 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 guarantees 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, stage of the disease and the specific nature of the lesion, so it is recommended first of all to consult a specialist and prescribe treatment measures based on clinical recommendations.
Prevention
Psoriasis is a disease that can be successfully treated if you consult a doctor in 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 at the workplace can be dangerous.
However, psoriasis can cause complications, such as psoriatic arthritis, which can limit work ability and lead to disability.
Psoriasis prevention is an important part of treatment. After recovery, patients should revise their lifestyle, get rid of bad habits, take care of the treatment of other chronic diseases, monitor their diet and increase physical activity, spend more time outdoors and do sports.
Nutrition for psoriasis
Diet for psoriasis is not strict, but proper nutrition plays an important role in complex treatment. When dietary recommendations are made, patients are advised to:
- Avoid foods to which the body is hypersensitive and exclude them from the diet.
- Prefer fresh fruits, vegetables, berries, lean roasted or boiled 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 oranges, honey, nuts, cocoa and eggs.
- Avoid fatty foods of animal origin.