Psoriasis

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

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

What is psoriasis?

The main symptom of this disease is the presence of psoriatic plaques - scaly pink spots of different sizes, which are accompanied by itching.Most often they are located on the scalp (they can also be present along the hairline, behind the ears), elbows, knees, and can also occur on the genitals, buttocks, lower back 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 area expand.

Psoriasis develops as a result of damage to the immune system.In each layer of the epidermis (there are 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 skin dehydration, protection of the lower layers of the skin).

Keratinocytes are constantly renewed.Their synthesis occurs in the basal layer.Then they move higher, where each time they perform a new function.After reaching the stratum corneum, they lose their nucleus and turn into corneocytes (special sacs containing keratin).Now their function is a barrier.After living longer, corneocytes peel off the surface of the skin.Keratinocytes live for about 2-4 weeks, then are replaced by new ones.

With psoriasis, under the influence of damage to the immune system, keratinocytes begin to divide more quickly, and their lifespan decreases.Exfoliation occurs, accompanied by inflammation of the epidermis and dermis.

Psoriasis can develop in a person of any age (overall, about 4% of the world's population suffers from it).However, this disease most often occurs in people under the age of 20 and over 55 years.Fair-skinned people experience psoriasis quite often;among representatives of the Negroid race, pathology is detected less often.

Causes of psoriasis

The exact cause of psoriasis has not yet been identified.However, the most common are 2 theories of the origin of the disease:

1. Hereditary disease - the tendency to develop psoriasis is believed to be genetically inherited.
2. As a result of immune disorders caused by infections, bad lifestyle, climatic conditions and bad habits.

Reference!In 40% of patients suffering from this pathology, relatives also suffer from psoriasis.Also, the patient's close relatives often have a latent form of psoriasis, which is indicated by changes in the capillary structure.

Often, the "push" to initiate the development of psoriasis is emotional stress (in 50% of cases), focal infections, metabolic disorders, diabetes mellitus, liver disease, and the use of certain medications (most often glucocorticosteroids, beta-blockers, lithium salts).

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

• Injuries, broken bones.
• frostbite.
• Sunburn.
• Smoking tobacco.
• Alcohol abuse.
• Obesity.
• Damage to the skin by chemicals.
• Food allergies.
• Parasite infestation.
• Pregnancy and childbirth.
• Other skin diseases - eczema, dermatitis.

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

Types and stages of psoriasis

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

1. Common psoriasisgrow most often.It is characterized by the presence of itchy plaques with a scaly surface on the skin.Also, with this form, changes in the color of the nails and the appearance of small white spots on them are often observed.In some cases (in advanced stages), the nail moves away from the nail bed.
2. Guttate Psoriasisappears as a small rash, localized mainly on the chest and back.The rash is accompanied by itching in the area where the skin is affected.Usually the symptoms of the disease disappear after 4-6 months and do not appear again.However, patients may develop other forms of psoriasis.This happens about half the time.Guttate psoriasis is usually seen in children and adolescents.It often develops as a result of an infection, often after a bacterial infection of the throat.
3. Psoriasis is reversiblerespond well to treatment, it is sometimes possible to achieve a stable remission without relapse.Red, weeping plaques appear only in some parts of the body, in the folds, and do not spread further.Usually, the rash appears in the groin area or under the mammary gland, also in the armpit.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 soles of the feet and palms, then the affected skin thickens and begins to actively peel.Then, the rash spreads over a wide area.In advanced cases, the skin of the entire body may be affected.Pustular psoriasis can be life-threatening.Affects mainly 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.The plaque gradually increases in size.

At the stationary stagethe appearance of the rash stopped.Existing plaques stop growing in size, but active exfoliation begins over the entire affected surface.

In the backward stageplaque becomes more dense, its elements dissolve, peeling decreases.Then, at the site of the rash, spots without pigment remain.

Reference! Psoriasis can also be classified by season: there are summer and winter forms, according to the progression of exacerbations.Often, relapses still occur more often in the autumn-winter period than in the spring-summer period.

Symptoms of psoriasis

Symptoms of psoriasis are:

• A pink rash or white patches covered with scales.
• Itching in the affected area.
• Vascular changes.
• Signs of inflammation in the affected tissue.
• Deterioration in the appearance and condition of nails.

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

Diagnostics

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

1. Stearin stain - with a little scraping, the exfoliation intensifies, and the rash becomes similar to crushed drops of stearin.
2. Terminal film - if you remove the scales from the surface of the plaque, it has a shiny and moist surface.
3. Bloody dew - if you scratch the terminal film, the exact drop of blood appears 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 (because this is impossible), but to achieve a stable remission.Comprehensive treatment is carried out, a plan developed according to the course of the disease in a particular person.It includes:

• Local drug therapy - ointments, creams, shampoos, aerosols, lotions.
• General drug therapy - injections of antihistamines, sedatives, vitamins, treatment with immunosuppressants, cytostatics, retinoids, corticosteroid hormones.
• Maintenance therapy - patients are prescribed ultraviolet irradiation along with taking dermatotropic agents.
• The use of detoxification methods - the appointment of immunomodulators, procedures that cleanse the blood.
• In some cases, take non-steroidal anti-inflammatory drugs.

If concomitant diseases are diagnosed, they are also treated.

Lifestyle with psoriasis

The patient must take into account that the treatment for the disease will last for the rest of his life.In many ways, the duration of remission depends on it.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 pigments (strawberries, watermelon) and other foods that can trigger the development of allergic reactions.It is also advised to avoid spicy, fatty, fried, smoked, rich meat and fish soups.Condiments excluded: ketchup, mayonnaise, mustard, etc.You should limit your intake of sugar and salt.You should pay attention to products that contain fiber, Omega acids, vitamins A, E, C, group B, as well as zinc and calcium.

The following simple steps will help alleviate the situation:

• Reluctance to stay in the water for a long time - you should swim and shower less often, it is recommended to take a short shower.
• Hard cloths should be replaced with soft sponges or cotton cloths, and regular soap with pH neutral products.
• After the shower, you should not wipe, but pat your skin with a towel - this will prevent plaque damage and increase itching.
• After the water procedure, the skin must be moisturized with cream.
• It is necessary to give preference to loose and light clothes made of soft natural fabrics, because the pressure of clothing items on the skin can trigger the development of new rashes.
• Itching often forces the patient to scratch, which can cause injury to the skin - to avoid new damage, it is better to cut your nails short.
• Drying out the skin should be avoided, so avoiding air conditioning will be beneficial, as will humidifying the indoor air.
• Although sunbathing can be beneficial for psoriasis, excessive exposure to ultraviolet light can make the disease worse - you should consult your doctor about your sun exposure regimen.
• Any risk of skin irritation should be avoided.
• Cuts and cuts can cause new rashes to appear, so you need to protect yourself from them.
• Stress is a common trigger for disease exacerbation, so it is necessary to avoid traumatic situations whenever possible.
• It is necessary to avoid physical inactivity (inactivity) - moderate physical activity will benefit the overall condition of the organism.

If you feel worse, you should immediately see a doctor to prevent the disease from progressing to a worse stage or the occurrence of complications.