Psoriasis

Psoriasis (scaly lichen) is a chronic non-infectious autoimmune skin disease of unknown origin.Its most common manifestations are peeling of the skin (including the scalp) and the presence of rashes.Psoriasis can cause pathological changes in other organs: nails, spine, joints and kidneys are most often affected.

The disease causes severe psychological discomfort to the patient;due to the presence of defects in appearance, it becomes difficult for a person to adapt to the team and communicate with people.Severe forms of psoriasis can lead to disability.It is impossible to completely cure the pathology.However, proper treatment allows you to achieve a stable remission and restore the previous quality of life.

What is psoriasis?

The main symptom of the disease is the presence of psoriatic plaques - flaky pink spots of different sizes, which are accompanied by itching.They are most often located on the scalp (may also be on the hairline, behind the ears), elbows, knees, and can also appear on the genitals, buttocks, waist and other parts of the body.Sometimes plaques appear on old scars.The pink color of the rash is due to the fact that the vessels in the affected areas are dilated.

Psoriasis develops due to a malfunction of the immune system.In each layer of the epidermis (5 in total - basal, spinous, granular, shiny and horny) there are keratinocytes (about 90% of them in the entire epidermis).Depending on which layer they are in, keratinocytes perform different functions (regeneration, synthesis of keratin or other proteins, prevention of dehydration of the skin, protection of the lower layers of the skin).

Keratinocytes are constantly renewed.Their synthesis takes place in the basal layer.Then they move higher, where each time they perform a new function.Reaching the stratum corneum, they lose their nucleus and become corneocytes (special bags containing keratin).Now their function is a barrier.After living out their lives, corneocytes are exfoliated from the surface of the skin.Keratinocytes live for about 2-4 weeks, after which they are replaced by new ones.

In psoriasis, under the influence of a malfunction of the immune system, keratinocytes begin to divide much faster and their lifespan decreases.Peeling occurs, accompanied by inflammation of the epidermis and dermis.

Psoriasis can develop in a person of any age (in total, about 4% of the world's population suffers from it).Most often, however, the disease occurs in people under 20 and over 55 years of age.Fair-skinned people suffer from psoriasis quite often;among representatives of the Negroid race, the pathology is found much less often.

Causes of psoriasis

The exact causes of psoriasis are not yet known.However, the most common are 2 theories about the origin of this disease:

1. Hereditary disease – it is believed that the tendency to develop psoriasis is passed down genetically.
2. Consequence of immune disorders caused by infections, bad lifestyle, climatic conditions and bad habits.

Reference!In 40% of patients suffering from this pathology, relatives also suffered from psoriasis.Also, close relatives of patients often had a latent form of psoriasis, manifested by changes in the structure of capillaries.

Most often, the "push" for starting the development of psoriasis is emotional overload (in 50% of cases), focal infections, metabolic disorders, diabetes mellitus, liver disease and the use of certain drugs (most often glucocorticosteroids, beta-blockers, lithium salts).

There are other factors that "trigger" the disease or provoke its exacerbation:

• Injuries, fractures.
• Frostbite.
• Sunburn.
• Smoking tobacco.
• Alcohol abuse.
• obesity.
• Chemical skin damage.
• Food allergies.
• Parasitic infestations.
• Pregnancy and childbirth.
• Other skin diseases - eczema, dermatitis.

Reference!It is absolutely known that psoriasis is not contagious.The development of pathology in people whose close relatives suffer from this disease is explained by a genetic predisposition.Psoriasis is not passed from person to person.

Types and stages of psoriasis

There are many forms of psoriasis, but some of the most common are:

1. Common psoriasisdevelops most often.It is characterized by the presence of itchy plaques with a scaly surface on the skin.Also, with this form, discoloration of the nails and the appearance of small white spots on them is often observed.In some cases (at an advanced stage) the nails move away from the nail bed.
2. Guttate psoriasismanifests itself as a small rash localized mainly on the chest and back.The rash is accompanied by itching in the areas where the skin is affected.Usually, the symptoms of the disease disappear after 4-6 months and do not appear again.However, the patient may subsequently develop another form of psoriasis.This happens about half of the time.Guttate psoriasis is usually seen in children and adolescents.It often develops as a result of an infection, most often after a bacterial throat infection.
3. Reversible psoriasisresponds well to treatment, sometimes it is possible to achieve a stable remission without relapses.Red, weeping plaques appear only in some parts of the body, in the folds, and do not spread further.Rashes usually appear in the groin area or under the mammary glands, also in the armpits.Reversible psoriasis most often develops in older patients.
4. Pustular psoriasisis a severe and dangerous form.In some cases, it develops quickly and suddenly.It is characterized by the appearance of blisters with purulent content on the feet and palms, after which the affected skin thickens and begins to actively peel off.Later the rash spreads over large areas.In advanced cases, the skin of the entire body may be affected.Pustular psoriasis can be life-threatening.It mainly affects adults.

Psoriasis develops in 3 stages:

1. Progressive.
2. Stationary.
3. Regressive.

Progressive stagecharacterized by the appearance of multiple nodular rashes and their spread to new areas of the body.Plaques gradually increase in size.

At a stationary stagethe appearance of rashes stops.Existing plaques stop increasing in size, but active peeling begins over the entire affected surface.

In a regressive stageplaques become denser, their elements dissolve, peeling decreases.After that, spots devoid of pigment remain at the site of the rash.

Reference! Psoriasis can also be classified according to seasonality: there is a summer and winter form, according to the development of exacerbations.Most often, relapses still occur more often in the autumn-winter period than in the spring-summer period.

Symptoms of psoriasis

The symptoms of psoriasis are:

• Pink rashes or white patches covered with scales.
• Itching in the affected areas.
• Vascular changes.
• Signs of inflammation in the affected tissues.
• Deterioration of the appearance and condition of the nails.

Reference!About 1 in 10 patients develop arthritis as a result of psoriasis.Therefore, it is necessary to start treatment as early as possible to prevent the development of complications.

Diagnosis

Psoriasis has a very characteristic clinical picture, so the diagnosis is usually not difficult.If you scrape the papules (plaques), then 3 main phenomena are observed:

1. Stearin stain - with a slight scraping, the peeling intensifies, and the rash looks like a grated drop of stearin.
2. Terminal film - if you remove the scales from the surface of the poster, it has a shiny, moist surface.
3. Blood dew - if you scratch the final film, drops of blood appear on it.

In some cases, a piece of dead skin is taken for analysis for differential diagnosis.

Treatment of psoriasis

The main goal of medical measures is not to cure the patient (since this is impossible), but to achieve a stable remission.Comprehensive treatment is carried out, the plan of which is developed in accordance with the course of the disease in a particular person.It includes:

• Local drug therapy - ointments, creams, shampoos, aerosols, lotions.
• General drug therapy - injections with antihistamines, sedatives, vitamins, treatment with immunosuppressants, cytostatics, retinoids, corticosteroid hormones.
• Supportive therapy - the patient is prescribed ultraviolet radiation along with taking a dermatotropic agent.
• The use of detoxification methods - the appointment of immunomodulators, procedures that clean the blood.
• In some cases, you take nonsteroidal anti-inflammatory drugs.

If concomitant diseases are diagnosed, they are also treated.

Lifestyle with psoriasis

The patient should take into account that the treatment of the disease will continue throughout his life.In many ways, the duration of remission depends on this.It is important to give up bad habits (smoking, drinking alcohol).It is also necessary to follow a diet.Exclude from the diet citrus fruits, whole milk, chocolate, honey, eggs, foods containing red pigment (strawberries, watermelons) and other foods that can provoke the development of allergic reactions.It is also advisable to avoid spicy, fatty, fried, smoked foods, rich meat and fish broths.Condiments are excluded: ketchup, mayonnaise, mustard, etc.You should limit your intake of sugar and salt.You should pay attention to products containing fiber, omega acids, vitamins A, E, C, group B, as well as zinc and calcium.

The following simple measures will help alleviate the condition:

• Refusal of a long time in water - you should swim and shower less often, it is recommended to take a short shower.
• Hard towels should be replaced with a soft sponge or cotton cloth, and regular soap with a pH-neutral product.
• After a shower, you should not wipe yourself, but pat your skin with a towel - this way you will avoid damaging the plaques and increasing itching.
• After water treatments, the skin should be moisturized with a cream.
• It is necessary to give preference to spacious, light clothes made of soft natural fabrics, since the pressure of clothes on the skin can provoke the development of new rashes.
• Itching often forces the patient to scratch, which can cause injury to the skin - to avoid further damage, it is better to cut your nails short.
• Drying of the skin should be avoided, so avoiding air conditioning will be beneficial, as well as humidifying indoor air.
• Although sunbathing can be beneficial for psoriasis, excessive exposure to UV light can worsen the condition - you should consult your doctor about your sun exposure regimen.
• Any risk of skin irritation should be avoided.
• Cuts and wounds can cause new rashes to appear, so you need to protect yourself from them.
• Stress is a common factor in aggravating the disease, so it is necessary to avoid traumatic situations whenever possible.
• It is necessary to avoid physical inactivity (inactivity) - moderate physical activity will benefit the condition of the whole organism.

If you feel worse, you should immediately consult a doctor to prevent the progression of the disease to a more severe stage or the appearance of complications.