Psoriasis is an inflammatory chronic disease of the body, accompanied by a predominant skin lesion with the formation of erythematous spots and plaques with clear borders 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 established the exact and reliable cause of psoriasis, but a hereditary factor is clearly marked, which, in combination with triggering factors, contributes to the triggering moment of the appearance of this disease. A relationship between the occurrence of psoriasis and the antigens of the HLA system has been established.
Between 1 and 5% of the world's population suffers from this very unpleasant disease, and fair-skinned people are at greater risk of developing psoriasis than black people.
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 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, a manifestation of psoriatic arthritis is possible, which significantly worsens the patient's quality of life.
Most often, rashes are localized on the scalp, on the surface of the elbows and knees, in the area of skin folds and genitals. The 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 revealed by medicine, some doctors speak of autoimmune causes. The second theory that explains the appearance of the disease is a violation of the normal process of maturation and division of skin cells. Heredity and stress are also believed to be the cause.
Genetic predisposition to psoriasis, allergies and frequent disruption of the skin's barrier function (strong friction, chemical exposure, exposure to products containing alcohol) can provoke an exacerbation of the disease.
- Köbner's 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 that causes guttate psoriasis;
- Use of drugs (especially beta-blockers, lithium, angiotensin-converting enzyme inhibitors);
- Severe emotional stress;
- Alcohol consumption;
- Smoking tobacco;
- obesity;
- Hormonal imbalance, especially in women during menopause and pregnancy;
- Disturbances in the digestive system.
The main reason for 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 are located in the lower layer of the epidermis begin to grow rapidly and put pressure on the cells that are located above. This process is accompanied by significant peeling of the skin and is called parakeratosis. Overstimulation by the immune system is thought to be the key to this mechanism.
Symptoms and signs of psoriasis
Rashes associated with psoriasis are asymptomatic or accompanied by itching. Most often, they are localized on the scalp, extensor surfaces of the knees and elbows, sacrum and buttocks (especially in the gluteal fold), as well as in the genital area. Fingernails and toenails, eyebrow skin, armpits and navel can be affected. Rashes can merge with the lesions and cover large anatomical areas and areas of skin between them. Depending on the type of psoriasis, the rash may have different external manifestations.
As a rule, the rashes are located discreetly and are represented by erythematous papules or plaques that are covered with dense, silvery, shiny scales. The rash 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 disrupts his self-image. In addition to changing the patient's appearance, treating skin rashes and maintaining the cleanliness of clothes and bedclothes requires a lot of time, which significantly reduces the patient's quality of life.
Types of psoriasis
vulgar (plain or chronic plaque) psoriasis, in which the rashes look like individual plaques covered with silvery peeling. Plaques may fuse as the disease progresses. Among all subtypes, this type of psoriasis is the most common and accounts for approximately 90%.reverse psoriasis accompanied by rashes that appear in the area of natural folds and may form cracks.guttate psoriasis characterized by multiple skin rashes with a diameter of 0. 5-1. 5 cm. It often forms after streptococcal pharyngitis.palmoplantar psoriasis manifests as plaques on the palms and soles that may coalesce.nail psoriasis affects the nail plates in the form of point-like depressions and furrows with discoloration and thickening of the nail. Nail changes in psoriasis often resemble changes in 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 onset of redness in patients with psoriatic plaques when the plaques themselves are mild or absent. It usually occurs due to improper treatment of psoriasis vulgaris.
Methods for diagnosing psoriasis
When symptoms of psoriasis appear, the patient should consult a dermatologist. He will conduct 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 of the hands and nails. The seborrheic type of psoriasis requires a special differential diagnosis to exclude seborrheic eczema, pityriasis rosea and papular syphilis.
In the case of active disease and large lesions of areas of the epidermis, visual analysis of scrapings is used. In the process of scraping, peeling is intensified. At the place of the removed scale, a smooth thin film is visible, which separates under mechanical impact and reveals a moistened surface with droplets 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 appear against the background of psoriasis.
In rare cases, diagnosis requires a biopsy. If non-classical clinical features are present, the need for this should be considered. There is mild, moderate and severe severity of the disease depending on the affected area of the skin. Damage to less than 10% of the skin corresponds to mild severity. There are more complex 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. Because of this, many psoriasis treatments have been developed. Often these methods are combined, including both drug and non-drug interventions.
The treatment plan is drawn up depending on the severity of the disease, the affected area of the skin and the severity of the symptoms such as redness, itching, peeling. Age and sex, 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 reduction of clinical manifestations (rash and other symptoms), improvement of the patient's general condition and restoration of his working capacity.
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. Do not forget 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 peeling 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 is used as an additional method for effective treatment of psoriasis when ointments do not help. Medicines reduce the inflammatory process, eliminate swelling and itching, block the increased activity of skin cells. 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
medicated shampoos : 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 are no options for a complete cure of psoriasis. Any treatment of 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, despite the slow chronic course of the disease, because the prolonged absence of therapy can lead to damage to the patient.