For centuries, people have tried to reveal all the secrets of this mysterious skin disease, but there is still much that is unknown. According to statistics, psoriasis affects 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 in strength.
Causes and risk factors for psoriasis
Psoriasisis a long-term inflammatory process of the skin, which is considered an autoimmune disease (associated with an allergic reaction to its tissues). This is a chronic skin disease that affects the cells of the outer layer of the epidermis. This condition usually appears as red, silvery scaly skin on the legs, knees, back, chest, etc. In most cases, psoriasis starts in small patches of 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 to explain its occurrence.
Autoimmune causes
Some studies suggest that psoriasis may occur due to a combination of genetic and environmental factors such as infection, trauma, stress and certain medications. These factors can trigger a response from the immune system, which begins to fight the body's tissues, including the skin.
However, the process underlying psoriasis is still not fully understood. It is important to note that psoriasis is a diverse disease that manifests itself differently in each patient. Studying the mechanisms underlying psoriasis can help develop more effective treatments, reduce the risk of complications and improve patients' quality of life.
Metabolic effects
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, which contribute to the inflammatory response. There is an imbalance in various metabolisms.
- With disturbances in protein metabolism in patients with psoriasis, the albumin content in the blood decreases and the globulin content increases, which increases their sensitivity.
- In fat metabolism, an increase in the content of lipids and cholesterol in the blood is observed.
- Reducing calories and eating plant foods can reduce psoriatic inflammatory activity.
- Disorders almost always occur in carbohydrate metabolism.
- Vitamin and mineral metabolism is also affected, which is shown 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 causes
This theory was widespread in the last century. It is believed that psoriasis can be caused by certain bacteria (streptococci), fungi and viruses, but this hypothesis has not been scientifically confirmed. However, dermatologists point out that any acute infectious process or chronic infection can cause psoriasis to recur. Particular attention is paid to the theory of viruses. Recent research shows that RNA viruses, such as HIV and other retroviruses, can affect the genetic apparatus and cause the appearance of genes that are prone to the development of psoriasis.
Genetic predisposition
Inherited predisposition to autoimmune reactions is a risk factor for psoriasis. If a close relative of a person suffers from this disease, then the possibility of developing it increases. Several genes may be associated with psoriasis, including the PSORS1-PSORS9 complex, with PSORS1 thought to be highly 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, the presence of this gene does not mean that a person will necessarily develop psoriasis. The development of this disease may be caused by other factors.
Neurogenic causes
Excessive stress on the nervous system, prolonged stress and imbalances in the autonomic nervous system, which provides protection to blood vessels and internal organs, may 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 cause psoriasis.
Endocrine
Endocrine disorders that occur with psoriasis are common and can have a significant impact on the progression of the disease. However, the relationship between them and psoriasis is not entirely clear and has not been proven. Experts believe that psoriasis patients often experience dysfunction of the thyroid gland, pituitary gland and adrenal gland. Women may experience problems with the 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 usually begins in childhood or adolescence and is associated with hormonal disorders, vegetative-vascular dystonia and stress.
The first signs aretirednessAndmood swings. The main symptoms are small pink bumps on the skin called papules, covered with whitish scales. The papule is surrounded by a brighter rim.
Over time, the elements of the rash can merge into a large and unusually shaped plaque. The basis of each papule isinflammatory infiltrate. The following types of rash are distinguished:
- accurate (no more than 1 mm in diameter);
- teardrop-shaped – (teardrop papules up to 2 mm in size);
- coin-shaped – (round-coin papules up to 5 mm in size).
The rash also has its own characteristics:
- stearic stain - if you scrape the surface of the papule;
- terminal film - after cleaning the papule from scale, you can see a transparent film;
- bloody dew (Auspitz phenomenon) - if the integrity of the film is damaged, small bloody drops may appear.
Is psoriasis contagious?
Many people believe that psoriasis is contagious, which is why they try to avoid contact with people who have it. This can cause patients to want to withdraw from others and lead to serious psychological problems. However, studies have shown that psoriasis is not contagious through contact with patients. If all family members suffer from this disease, this only indicates the presence of genetic factors in the development of the pathology.
Classification and stages of psoriasis development
Currently, there are three main stages in the development of psoriasis:
- The progressive stage, which is characterized by the continuous formation of new skin rashes, which is accompanied by severe itching.
- Stationary stage, where new formations stop appearing, and existing ones begin to heal.
- A regressive stage in which a rim appears around the rash, and the skin affected by the rash becomes darker in color due to increased pigmentation.
In addition, there are several levels of pathology severity:
- Mild level, when no more than 3% of the skin surface is affected.
- Moderate degree, which is characterized by 3-10% damage to the skin.
- Severe level, where the disease affects more than 10%.
Types of psoriasis
Psoriasisis a chronic skin disease that can manifest itself in many ways. The rash, location and damage to other systems and organs may vary. Depending on these characteristics, various forms of psoriasis are distinguished.
Easy (abrasive, plaque)
Plaque psoriasis is the most common form of the disease. 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 on the elbow is the presence of one or more permanent "task" plaques on the extensor side of the elbow joint. If these elements are exposed to trauma, deterioration occurs.
Guttate Psoriasis
Associated with bacterial (most often 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, tear-shaped papules on the skin of the limbs, body, or face. Papules have a scaly surface and can develop into erosions and ulcers, increasing the risk of infection.
The condition can develop rapidly or gradually become chronic, followed by periods of exacerbation and reduction of symptoms. In rare cases, psoriasis can get worse.
Palmoplantar psoriasis
This type of psoriasis often develops in people involved in manual labor and is often accompanied by severe itching and can lead to complications in the nails. Some of the subtypes of this type of psoriasis include:
- Fan-shaped plaques: 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.
- Circular: ring-shaped scaly elements on the palmar and plantar surfaces.
- Callosal: rough epithelial growth with callus formation.
- Pustular: This is a distinct subtype of psoriasis on the palms and soles of Barber. In the area located below the big toe, blisters and pustules containing pus appear, which cause severe itching. Ulcers coalesce, then dry and form crusts. The characteristic elements of psoriasis also appear in other parts of the body.
Psoriasis on the legs can be associated with varicose veins and manifests itself mainly on the lower part of the legs.
nail psoriasis
It can occur as a separate disease or as a complication of other types of psoriasis. The main symptom is small dimples on the nail plate, which have different depths. These dimples are usually more noticeable and painful when pressed than other types of dermatitis. In addition, symptoms include spontaneous nail separation, subungual bleeding (especially when wearing tight shoes), changes in nail color and surface, such as trachyonychia and koilonychia.
Scalp psoriasis
It can manifest itself as an independent disease or as part of a general pathological process. One of the characteristic features is weeping and the formation of crusts on part or the entire surface of the head. In this case, hair growth is not affected, because the function of the hair root is not affected. However, wetting creates a threat of infection, which can cause damage to hair follicles.
Seborrheic psoriasis
It occurs as a result of disruption of the skin glands, which produce viscous sebum, causing skin irritation and promoting inflammation - dermatitis. This condition quickly spreads to the entire head, covering it in the form of a hat and is accompanied by severe itching. In the area behind the ear, crying sometimes develops and infection may develop. A scalp covered with dandruff and crusting may look like a psoriatic crown.
Psoriasis on the face
It usually appears in the area of the nasolabial triangle, eyelids, above the eyebrows and in the area behind the ears. The rash can coalesce, forming a large area of redness and swelling. If the function of the sebaceous glands is affected, the process may be accompanied by weeping, the formation of crusts and an increased risk of infection.
Genital psoriasis
Psoriasis affecting the genitals is a concomitant process that is usually accompanied by the characteristic rash of psoriasis all over the body, which makes it easier to diagnose.
Psoriatic rash on the penis in men, labia majora in women and the surrounding skin area is oval shaped and slightly raised above the surface of the skin. They are pink and flaky. Practically not accompanied by itching. Sometimes the lesion process spreads to the mucous membrane and can take the form of vulvovaginitis in women and balanoposthitis in men.
In obese people, an atypical psoriatic rash can be observed in folds located near the genitals (inguinal, intergluteal). In this area, a dark red area appears, which has a mirror-like surface and does not peel off due to continuous wetting.
Why is psoriasis dangerous?
Psoriasis can be very serious when the rash covers more than 10% of the skin. The condition is difficult and prone to recurrence, and the rash may become moist, wet, and prone to infection. Only timely and effective treatment of psoriasis can prevent the spread of the disease.
In some cases, psoriasis can be complicated by joint inflammation and the development of psoriatic polyarthritis, which can cause 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.
Ignoring the timely treatment of psoriasis can lead to complications, such as psoriatic erythroderma, which can occur due to improper treatment of psoriasis or due to exposure to various factors that irritate the skin. With psoriatic erythroderma, the skin becomes deep pink with a clear difference 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 for psoriasis can harm important organs and systems of the body, such as joints, heart, kidneys and nervous system. This can lead to disability or even death.
Diagnostics
Usually, the diagnosis of psoriasis is made based on the typical symptoms of the skin lesions and their location. In some complicated cases, additional tests may be needed to rule out other skin diseases.
Laboratory tests may include:
- A complete blood count, which can detect leukocytosis and anemia in psoriasis.
- Rheumatoid factor (RF) is a protein whose levels may be elevated in systemic inflammatory diseases involving joint damage, but in psoriasis the levels are usually normal.
- The erythrocyte sedimentation rate (ESR) is also usually normal, except for pustular psoriasis and psoriatic erythroderma.
- Uric acid levels may be elevated in psoriasis, which can cause confusion with gout.
- Antibodies to the human immunodeficiency virus (HIV) can be detected by the sudden onset of psoriasis.
Other tests, such as joint x-rays and skin biopsies, can be used in more complex cases to assess the severity of joint damage and differentiate psoriasis from other skin diseases.
Treatment
Psoriasis treatment requires a comprehensive approach, including local treatment of skin lesions, medications, 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 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, vitamin D preparations and others);
- physiotherapeutic procedures;
- Bathing daily with bath oil, oatmeal infusions 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 showering;
- light therapy, which involves exposing the skin to ultraviolet light, may also help (avoid burns);
- photochemotherapy using intermediate 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, general health and the effect of external factors are taken into account. Sometimes, to cure it, it is enough to change your lifestyle, and in other cases, several courses of treatment are prescribed.
In addition to traditional methods, psoriasis treatment may include the use of modern laser technology. Laser therapy can reduce pathological symptoms, achieve long-term remission and relieve patients from unpleasant rashes and related problems. A special feature of laser therapy is that the special excimer laser acts only on the affected skin area, without affecting the healthy one, which ensures rapid recovery without side effects. Laser therapy is safe and painless, requires no preparation and can be used regularly so that patients can live without restriction.
The effectiveness of treatment depends on many factors, including hereditary predisposition, provoking factors, the stage of the disease and the specific nature of the lesion, so it is recommended first of all to consult a specialist and set treatment measures based on clinical recommendations.
Prevention
Psoriasis is a disease that can be treated successfully if you consult a doctor in time and receive qualified help. In the simple form of psoriasis, the patient can work without any restrictions, except for working in a chemical plant, where being at work can be dangerous.
However, psoriasis can cause complications, such as psoriatic arthritis, which can limit work performance and lead to disability.
Psoriasis prevention is an important part of treatment. After recovery, patients should reconsider 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 play sports.
Diet for psoriasis
Diet for psoriasis is not strict, but proper nutrition plays an important role in complex treatment. When making nutritional recommendations, patients are advised to:
- Avoid food that the body is hypersensitive to and avoid it from the diet.
- Prefer fresh fruits, vegetables, berries, grilled or boiled lean meat and drink more.
- Avoid the following foods: onions, garlic, radishes, strong tea, coffee, alcohol, sweets, salty and sour foods, as well as foods that can cause allergic reactions such as oranges, honey, nuts, cocoa and eggs.
- Avoid fatty foods of animal origin.