Psoriasis is a chronic inflammatory disease of the body, accompanied by primary skin lesions with the formation of erythematous spots and plaques that have clear boundaries and silvery scales on the surface.
The course of the disease is characterized by periods of exacerbation and remission (decrease in the manifestation of symptoms). Unfortunately, medicine has not yet identified the exact and reliable cause of psoriasis, but hereditary factors have been clearly observed, which, in combination with triggering factors, contribute to the triggering moment of the appearance of this disease. The relationship between the occurrence of psoriasis and HLA system antigens has been revealed.
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 manifest itself at any age, but the period of 20-30 years and 50-60 years is considered critical.
Important!Psoriasis is not contagious to others, but it causes discomfort to the patient himself, because the rash that appears during the disease is not only a cosmetic defect, but is also accompanied by unpleasant itching. In addition, the manifestation of psoriatic arthritis is possible, which significantly worsens the patient's quality of life.
Most often, the rash is localized on the scalp, on the surface of the elbows and knees, in the area of skin folds and genitals. 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 talk about autoimmune causes. The second theory that explains the occurrence of the disease is a disruption in the normal maturation and division of skin cells. Heredity and stress are also thought to be causes.
Genetic predisposition to psoriasis, allergies and frequent disorders of the skin's barrier function (strong friction, chemical exposure, influence of alcohol-containing products) can trigger an exacerbation of the disease.
- Koebner's phenomenon is the appearance of a fresh rash 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, which causes guttate psoriasis;
- The 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;
- Disorders in the digestive system.
The main cause of the development of this 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 located in the lower layer of the epidermis begin to grow rapidly and put pressure on the cells located above. This process is accompanied by significant peeling of the skin and is called parakeratosis. It is believed that excessive stimulation by the immune system is the main link in the occurrence of this mechanism.
Symptoms and signs of psoriasis
The rash associated with psoriasis is asymptomatic or accompanied by itching. Most often it is localized on the scalp, extensor surfaces of the knees and elbows, sacrum and buttocks (especially in the gluteal folds), and in the genital area. Fingers and toenails, skin on the eyebrows, armpits and navel may be affected. The rash may coalesce with the lesions and cover large anatomical areas and areas of skin in between. Depending on the type of psoriasis, the rash may have different external manifestations.
As a rule, the rash is located discretely and is represented by erythematous papules or plaques, which are covered with dense, silvery, shiny scales. The rash appears gradually. Remission and exacerbation occur spontaneously or after exposure to provoking factors.
5-30% of patients develop
Important!Psoriasis does not threaten the patient's life, but it disturbs the patient's self-image. In addition to the fact that the patient's appearance changes, a large amount of time is also required to treat skin rashes and to maintain cleanliness of clothes and bedding, which greatly reduces the patient's quality of life.
Types of psoriasis
abusive (regular or chronic plaque) psoriasis, where the rash has the appearance of individual plaques covered with silvery scaling. Plaques can coalesce as the disease progresses. Among all subtypes, this type of psoriasis is the most common and accounts for approximately 90%.inverse psoriasis accompanied by a rash that appears in the area of natural folds and can form cracks.guttate psoriasis characterized by various skin rashes with a diameter of 0. 5-1. 5 cm Often formed after streptococcal pharyngitis.palmoplantar psoriasis manifests itself as plaques on the palms and soles, which can coalesce.nail psoriasis affecting the nail plate in the form of precise depressions and grooves with discoloration and thickening of the nail. Nail changes with psoriasis often resemble changes with fungal infections.pustular psoriasis accompanied by the formation of pustules on the palms, soles, or perhaps damage to one of the fingers. There may also be general forms.erythrodermic psoriasis manifests itself as a sudden or gradual appearance of redness in patients with psoriatic plaques, when the plaque itself is mild or absent. Usually appears due to improper treatment of psoriasis.
Methods for diagnosing psoriasis
When symptoms of psoriasis appear, the patient should consult a dermatologist. He will conduct an external examination of the affected skin area and collect a complete medical history.
Psoriasis has a general similarity with other dermatological diseases, especially in the first stage of manifestation. It is important to exclude the presence of fungal infections on the hands and nails. The seborrheic type of psoriasis requires a special differential diagnosis to exclude seborrheic eczema, pityriasis rosea and papular syphilis.
In case of active disease and large lesions in the epidermal area, visual analysis of scraping is used. In the process of scraping, exfoliation is intensified. In place of the removed scale, a smooth thin film appears, which peels off under mechanical action and reveals a surface moistened with drops of blood.
Diagnosing psoriasis in most cases is not difficult; enough to just examine the patient's skin. Doctors must rule out errors in diagnosis and determine the presence of other diseases and other pathologies that occur against the background of psoriasis.
In rare cases, diagnosis requires a biopsy. If there are non-classic clinical signs, the need for it should be considered. There are mild, moderate and severe disease severity based on the area of skin affected. Damage to less than 10% of the skin corresponds to mild severity. There are more sophisticated methods to assess the severity of the disease, but these are used in clinical trials.
Treatment of psoriasis
There are a large number of factors on which the development of the disease and its various manifestations depend. Therefore, many treatments for psoriasis have been developed. Often these methods are combined, including drug and non-drug interventions.
A treatment plan is prepared depending on the severity of the disease, the affected skin area and the severity of 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 may limit the choice of treatment methods.
Treatment of psoriasis should lead to reduction of clinical manifestations (rash and other symptoms), improvement in the patient's general condition and restoration of his ability to work.
When treating psoriasis, it is necessary to follow a diet and take care of the skin properly, because 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, leaving alcohol, sweets (simple sugar) and starchy foods. The emphasis in the diet should be on protein: lean meat, fish, dairy products, vegetables and fruits. Be sure to pay attention to allergic reactions or intolerances 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 very effective in treating psoriasis on the face and hands.Drug therapy used as an additional effective method of psoriasis treatment when ointments do not help. The drug reduces the inflammatory process, eliminates swelling and itching, and suppresses the increase in the 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 therapeutic shampoo : antifungal, tar, contains corticosteroids. Shampoo eliminates pathological inflammatory pathogens, removes scales, relieves itching and burning. Therapeutic antihistamine injections prevents severe itching, biological drugs have a beneficial effect on the immune system.
Unfortunately, today there is no possibility for a complete cure for psoriasis. Any treatment for psoriasis aims to eliminate the signs of the disease for a long time and prolong remission. But the treatment of psoriasis is necessary, even if it is a slow chronic disease, because the prolonged absence of therapy can lead to the patient's disability.