Psoriasis is one of the most common skin diseases; every hundred inhabitants suffer from skin diseases.
Psoriasis is a disease for development in which several factors are important at once: from hereditary predisposition (psoriasis in relatives) to disorders of nervous function, endocrine, immune system 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 in the body, does not depend on external threats).
The top layer of skin (epidermis) is mainly composed of keratinocytes - the cells that produce keratin. Keratin is a protein, its efficacy allows it to carry out the protective function of the skin. Keratinocytes form in the inner layer of the epidermis and slowly move to its surface, during their movement mature and acquire new properties.
At the end of their "maturation, " keratinocytes form the stratum corneum on the surface of the skin. Then the keratinized cells die and are exfoliated from the living ones, therefore, the life path of the keratinocytes ends. This ensures continuous skin renewal.
The normal passage of keratinocytes from the inner layer to the surface takes a month. With psoriasis, their life expectancy is reduced to a few days, this leads to the appearance of scaly psoriatic foci, as the skin does not have time to get rid of the keratinized cells.
When it appears, psoriatic plaques are usually accompanied by itching and redness. This indicates an autoimmune reaction in the deep layers of the skin, resulting in swelling of the thick layers of the skin (dermis). The dermis contains blood and lymph vessels.
It is not clear why the process of keratinocyte formation is accelerated, but it is known that hereditary factors play an important role.
The development of normal psoriasis can begin because:
- mental trauma and persistent stressful situations;
- damage to the skin;
- transmitted infectious diseases;
- taking some medication;
- hormonal disorders;
- allergic reactions (special allergens: citrus fruits, eggs, chocolate);
- alcohol intoxication;
- climate change.
The psoriatic triad is a hallmark of the disease that occurs when the skin is scraped.
Stearin stain(increased exfoliation after scraping, giving the surface of the papule resembling a drop of crushed stearin).
Thermal film(appearance after removal of scales wet, thin, shiny, translucent surface scales).
Precise bleeding(appearance of blood droplets 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 process of keratinization of the skin (accumulation of keratin proteins) is disrupted, and some layers of normal epidermis are lost. In the later stages of the disease, a group of cells responsible for inflammation are found in the superficial layer of the stratum corneum of the epidermis and in the zone of parakeratosis, around the dilated skin ducts.
Typical plaques and scales appear on the surface of the skin.
Psoriasis is not just a common disease, it has many manifestations and even masquerades as another disease.
Location of psoriasis localization:
- elbows and knees;
- sacrum and waist;
- 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 (inverted psoriasis);
- palms and surfaces of the feet (palmar-plantar psoriasis);
- psoriasis on the nail plate.
Common symptoms of psoriasis
The main symptoms of psoriasis are:
- psoriatic plaques;
- congestion of the affected skin area;
- itchy.
Symptoms by type of psoriasis:
- exudative psoriasis (the affected area of skin is flaky and wet, a yellow crust is formed on the surface of the rash);
- associated psoriasis (more common in children, the focus of its occurrence is red, with slight exfoliation, sometimes wet can be confused with diaper rash);
- chronic psoriasis (it is characterized by large plaques that do not disappear for a long time);
- rupioid psoriasis (another form of chronic psoriasis, characterized by conical plaques);
- guttate psoriasis (rash on small papules).
Types of psoriasis
- Common psoriasis (vulgar, plaque);
- Generalized psoriasis (widespread, postular);
- Psoriasis in the form of tear drops (according to the 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 a rash, often in large numbers, in common places: on the elbows and knees. In addition, the hallmark of the rash is the scalp and trunk area. There is usually a clear relationship between the appearance of the rash and the action of the provoking factors.
The provoking factors in psoriasis are stress, skin trauma, recent infectious diseases, and regular alcohol intake.
Usually, exacerbation of the disease occurs in the winter - this is a type of winter psoriasis. Summer types are more rare. Mixed forms of psoriasis are now observed. Over time, the number of rashes increases. They form special psoriatic plaques. The Kebner phenomenon is observed - the appearance of new plaques at the site of skin trauma. As a rule, patients have plaques that remain on the skin even if they do not worsen.
The disease occurs cyclically:
- Progressive stage (increased number of rashes);
- Stationary stage (new rash does not appear);
- Regressive stage (regression of the rash, the appearance in place of their skin without pigment).
Psoriasis vulgaris, photo
Diagnostics
When diagnosing psoriasis, first of all, a detailed examination of the skin is required.
Thin skin, bleeding in places, loose plaques are signs of psoriasis. If there are these symptoms, the doctor performs some diagnostic measures to exclude the presence of other events with similar manifestations. For the final diagnosis, blood tests, smears, and skin biopsies are performed as needed. If the joint is affected, magnetic resonance imaging (MRI) is prescribed, and X-rays are taken to identify the lesion.
Psoriasis vulgaris, treatment
Psoriasis is a systemic disease with cutaneous manifestations, and complex treatment is required: local and systemic therapy. The disease is chronic and treatment aims to reduce the amount and severity of deterioration and achieve a skin condition that is acceptable to the patient.
In the progressive stage of psoriasis, all aggressive procedures are canceled: ultraviolet irradiation, bathing. It is important that patients with psoriasis treat the skin with care and caution, do not injure it to avoid deterioration and the appearance of new plaques.
Diet for psoriasis
Often psoriasis is accompanied by liver disease, so it is important to avoid alcohol, fatty foods, fried, smoke. It is just as important as moderate carbohydrate intake, as this changes the pH of the skin and increases the risk of rash infections.
Prophylaxis
Psoriasis prevention is about maintaining a healthy lifestyle. This helps prevent the occurrence of other diseases, because the immune system is protected from stress and can withstand threats from the outside.
Psoriasis prevention measures include:
- appropriate skin care;
- relaxing massage to improve blood circulation;
- proper nutrition, it is recommended to avoid allergenic foods and exclude (limit) the intake of spicy, fatty, pickled, smoked, salty foods, as well as citrus fruits;
- dairy vegetable diet;
- adequate moisture in the body;
- elimination of alcohol and smoking and other bad habits;
- increased physical activity;
- walking in the open air;
- avoid stressful situations;
- taking vitamins of groups A, B, C, D, E;
- a choice of loose clothing from natural materials that will not break and cause irritation.
Means for the treatment of psoriasis
Systemic therapy for psoriasis aims to reduce the proliferation of skin epithelium, stabilize the keratinization of skin cells and cell membranes. For this, preparations based on vitamin A (retinoids), cytostatics are used. From the most modern treatments, so -called biology is used, which neutralizes the substances that cause inflammation.
For years, UFOs have been used - treatment with ultraviolet rays of group B (in tanning spots, 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 special substances that increase the sensitivity of the skin to it.
An effective remedy for psoriasis
Local treatment is no less important than systemic treatment. It helps reduce skin inflammation. Such medications are prescribed depending on the stage of psoriasis.
Progressive stage
- ointments and exfoliating lotions;
- anti-inflammatory hormone ointment with calcitriol;
- emollient to relieve itchy and dry skin.
Stationary stage
- UVB therapy;
- concentrated exfoliating ointment;
- emollient to restore the skin and reduce dryness.
Regressive stage
- concentrated exfoliating ointment;
- emollient to restore the skin and reduce dryness.
Psoriasis cream
Creams and ointments for psoriasis have different purposes and are used at different stages of the disease. hormonal ointments and anti-inflammatory creams are used to stop the inflammatory process on the skin. There are several classes of hormone medications. They have different absorption abilities and activities. When used in children, they try to avoid the application of hormone medications to the face and neck area, the skin fold area - places where the skin is thinner. Local preparations based on calcipotriol (a derivative of vitamin D) also have anti-inflammatory effects. This is a later generation drug. They are not used during pregnancy and lactation.
Salicylic ointments and salicylic acid lotions are designed to remove skin flakes with severe exfoliation. Salicylic acid not only has an exfoliating effect, but also enhances the effectiveness of local hormone medications. At stationary and regressive levels, when inflammation becomes less active, salicylic acid -based agents are applied at higher concentrations.
Methods to restore the structure of the skin and eliminate dryness are used throughout the treatment period, as well as in conjunction with ultraviolet irradiation to reduce itching on the skin. Once the deterioration subsides, this product helps maintain the protective properties of the skin and reduces the risk of new acne.
An effective cream for psoriasis
The modern approach to care and relief for dry skin is based on the saturation of the epidermis with moisture and is called corneotherapy (derived from the "corneo" - the corneal layer, or horn, of the epidermis).
Corneotherapy aims to restore the stratum corneum of the epidermis and its protective function, which makes it possible to improve the overall condition of the skin. The work of the founder of corneotherapy Albert Kligman made it possible to create a special tool - emollient.
How do emollients work?
within 1 hour after using the emollient: - the condition of the skin improves, due to the fact that the emollient "locks" moisture in it.
6 hours after the use of emollients: - skin structure is restored due to the content of special natural lipids (ceramides and other useful fats).
24 hours after the use of emollients: - Clinical improvement of skin condition occurs due to the penetration of moisturizing components into the inner layer of the epidermis and the restoration of the skin surface layer (up to 24 hours from the beginning of use).