Psoriasis: symptoms, treatment, and prevention

18 April 2021

psoriasis- one of the most common diseases, the incidence of which in the population is steadily increasing every year. And if we consider that absolutely all age categories are prone to this pathology, and its simple form changes quickly enough into a more complex one, then the question of the right therapy and prevention is really very acute.

According to statistics, approximately every 30th inhabitant of the planet suffers from this disease to one degree or another. What to do with psoriasisWhat drugs and folk remedies can be treated? How do you properly organize your meals? Let's finally set all the points.

Psoriasis and its causes

Psoriasis is an autoimmune disease with a rather vague etiology - the exact cause is still unknown despite numerous studies in this area. It is believed that this pathology is a consequence of genetic changes in the immune system, due to which chronic inflammation of the skin develops. However, their multifactorial character is not excluded either - in other words, involvement, heredity and the influence of the external environment.

It is noteworthy that, according to scientists, the predisposing factors are very different for different age groups: for example, if different types of bacterial infections, including strep infections in particular, are considered triggers in children, then for adults stress stimuli and nicotine abuse are of paramount importance. Alcohol, obesity, and the use of certain medications (such as adrenaline receptor blockers).

It is impossible to completely cure psoriasis, but modern medicine is quite capable of significantly alleviating the course of the disease and maintaining long-term remission in the patient.

There are several theories to explain the onset of psoriasis:

contagious and parasitic;
neurogenic;
endocrine;
Metabolism;
immunological;
hereditary;
Molecular Mimicry Theory.

As with many other diseases, the cause of skin problems should lie in the intestines. Its length is 4 to 6 meters and the inner surface is covered with villi, the total area of which is comparable to the size of a tennis court - so the absorption processes can take place much more efficiently. Interestingly, the cells of the small intestinal mucosa are completely renewed every 3-5 days. Up to 70% of human immunocytes are also concentrated here. One of the most common causes of psoriasis is leaky gut syndrome (LEPS).

Deviations from the normal function of the intestinal mucosa are fraught with malabsorption, that is, a violation of the assimilation of basic nutrients (proteins, fats, carbohydrates, vitamins, minerals). In addition, the negative effects of toxins and allergens on the body increase: in such conditions, it is much easier for them to get into the bloodstream. The direct link between psoriasis and inflammatory bowel disease has been demonstrated in numerous studies.

Other work by scientists confirms that a special microflora forms on the skin of a patient with psoriasis, which is significantly different from the microbiome of healthy skin.

In the area of psoriasis lesions, a mass of various bacteria is concentrated, the stability of which is significantly less than that of normal skin - in particular, colonization by Staphylococcus aureus is observed, which has an extremely negative effect on the course of the inflammatory process.

Types of psoriasis

Plaque psoriasis. . . In 90% of cases, dermatologists are faced with this particular form of the disease, which is also known as simple or common. Initially, separate small areas appear on the skin that are raised above the level of the healthy dermis. These inflamed areas are known as psoriatic plaques. Gradually they grow and merge with neighboring spots into a whole.
Reverse psoriasis.This diagnosis is made in patients who develop smooth red spots in the folds of the skin and in the folds - in the groin, on the inner thighs, under the chest. In contrast to simple psoriasis, the foci of inflammation are practically not covered with scales, but due to their location and constant friction, they cause serious discomfort to the patient. In addition, there is a risk of re-infection with streptococci or fungi, since ideal conditions for the reproduction of microorganisms are created in places where spots are localized due to the high humidity and temperature.
Guttate psoriasis.This type of disease got its name from the shape of the formations. The lesions are in the shape of a drop that is raised above the level of healthy skin. A common trigger for this form of psoriasis is a previous strep infection, as mentioned earlier. The thing is that the patient's immunity, affected during the fight against the infection, is seriously weakened - its resources are not unlimited and, like all living things, it takes time to recover - and against this background lies an autoimmune diseasebefore activated.
Pustular psoriasis.It is considered to be the most severe form, accompanied by the formation of bubbles filled with a clear liquid. Inflammation of the skin begins around the foci, swelling and thickening appear. With a secondary exacerbation, the probability of which is quite high, the blisters fill with pus. Localized foci of pustular psoriasis on the arms and legs. In difficult cases, there is an ubiquitous location of blisters on the body, their rapid growth and the risk of infection of the entire surface of the skin.

Psoriasis on nails.This type of disease changes the appearance and structure of the nail plates on the hands and feet. Nails thicken, lose their natural color, give off an unpleasant odor. The skin around the nail bed is coarsened and thick ridges are formed. In more advanced cases, the nails can disappear without subsequent regrowth.
Psoriatic arthritis. In this case, the disease affects the joints and connective tissues. Most often, inflammation affects the distal phalanges of the extremities. There is psoriatic dactylitis - swelling of the fingers. The hip and knee joints are also exposed to the devastating effects of the ongoing illness. There are common cases of disability with loss of the ability to move independently.
Psoriatic erythroderma.Scaly patches appear on the skin while peeling of the affected layer is observed. Patients experience extreme discomfort due to constant itching and swelling. Most commonly, this diagnosis is made in patients who have already been treated for simple psoriasis but have not yet completed therapy or changed their medication.

Symptoms of the disease

The first manifestation of psoriasis is a small rash. Papules grow quickly and grow into spots 4 to 8 cm in diameter, they keep increasing in size, and dry scales form on the surface. In more advanced cases, individual spots fuse together and the lesion affects large areas of the body. Psoriasis papules differ from other skin diseases in their round shape with clear borders, red or light pink in color and silver-white scales. They first appear on those areas of the skin the integrity of which is compromised by abrasions, wounds, frostbite and constant friction. There are three characteristic signs that confirm the onset of the development of psoriasis:

Stearin spot phenomenon- Dry particles are easily separated from the affected surface and reveal an area that looks like a drop of wax or sterol.
Psoriasis phenomenon(Terminal) film. If you keep cleaning the papules from the scales, you will see a transparent and moist film, the skin of which is inflamed.
Auspitz phenomenon. . . Removal of the final film results in the appearance of the smallest drops of blood on the surface of the stain.

This triad of psoriasis is unique - its presence allows the correct diagnosis to be made unmistakably. Still, different parts of the body have their own characteristics for the manifestation of the disease.

Psoriasis on the body.The back, neck, abdomen, thighs, and lower legs are most commonly affected by guttated psoriasis. Small papules, which are similar in shape to drops, gradually grow and rise above the surface of the skin. This form of the disease is often diagnosed in people who have had a staph infection.

Psoriasis on the hands.The most common sites for psoriatic papules to appear on the hands are the elbows and interdigital spaces - a form of plaque is usually observed where individual small fragments fuse into a single area of the lesion covered with dry scales. The forearms are much less affected.
Psoriasis on the legs.The disease begins with individual rashes in the knee area. Inflamed areas, bothers patients with severe peeling and itching, quickly increase in size and merge with neighboring ones.
On the palms and feet.In most cases, the simultaneous defeat of both the palms and feet is recorded, but in some patients the disease affects the stratum corneum of the purely upper or lower extremities. As a result of the growth of psoriasis papules, the skin becomes thickened and coarsened with further cracks.
Scalp psoriasis.First, rashes appear on the forehead, the back of the head and also behind the ears. First, patients perceive individual scaly formations that grow, fuse with those nearby, and over time can affect the entire scalp. Papules are very itchy, causing a constant urge to scratch the skin - the resulting wounds and cracks are likely to become the gateway to infection. Dry particles are separated from the harmful formations - first small, somewhat flake-like, and then larger flakes.

In the face, ears, neck.The localization of psoriatic papules on the face is rather an exception in the usual clinical picture. In rare cases, the disease affects the areas around the eyes and eyelids, as well as the cheeks and tongue. Formations on the neck quickly spread further - on the back or the head. The ears are the site of the development of seborrheic psoriasis. Papules can appear both inside and outside the cartilage shell. When making a diagnosis, it is important not to confuse the disease with seborrheic eczema, which has similar symptoms.
On nails.There are three options for the initial manifestation of psoriasis on the nail plates. The first is the appearance of small punctiform depressions. The second is a thickening of the nails, a change in their natural color to gray or yellow. With the advancement of nail psoriasis, the plate flakes off, the upper particles are easy to separate off. And finally, the third is deformation of the nail, accompanied by a loss of smoothness due to the plate and the appearance of depressed areas.

Symptoms of psoriasis in children.At an early age, the disease takes a different course: the main localization of red scaly rashes are folds of the skin: groin folds in the elbow and folds of the hollow of the knee on the neck. Papules itch a lot, children experience constant agony, become irritable and restless. In general, all clinical variants observed in children are similar to those in adults. The differences concern pure manifestations, the location of the pathological process and the course of the disease itself.

4 stages of psoriasis

Clinical dermatology, based on differences in symptoms, degree of skin lesions, and duration, distinguishes three stages in the course of psoriasis. However, it is believed that the initial stage must be recognized as another full-fledged stage in the development of the disease.

Initial phase.The first sign of psoriatic lesions is small rashes. The places of their occurrence can be different and depend on the nature of the disease. Primary papules are no larger than 3 mm and have a pale pink color, which is replaced by a gray bloom after 3-4 days - dead dermis particles form on the site. This process is accompanied by itching and burning, and general health deteriorates. In general, at the initial stage, the formation of plaques lasts up to three weeks, and at this point a person has the opportunity to slow down the development of the pathology.
Progressive.At this stage, the disease affects significant areas of the skin: for example, with normal psoriasis, plaques are formed, with other forms, papules that are characteristic of them. In the course of the development of the disease, individual spots merge with each other, covered with shades of gray. The symptom used to determine the progressive stage is the Koebner phenomenon (isomorphic reaction). Any damage to the skin after a while is accompanied by the appearance of a psoriasis rash at this point. Another confirmation that the disease is actively developing is the appearance of drops of blood, similar to dew, after the plaque is removed. The duration of this stage depends on the type of lesion. On average, it takes two weeks to two months.
Stationary stage.During this time, a thick gray-white or gray crust forms. The pink rims disappear. The skin becomes rough, dry particles are constantly peeled off from it. The itching and burning sensation will be less bothersome, but neither will it go away completely. New papules are not formed. This phase can be very long.
Regressive phase.The last stage of the development of the disease, when plaques are gradually reduced and reabsorbed. Itching is no longer a problem. A clear sign of regression is Voronov's symptom when papules are surrounded by white rings. Bleaching of spots occurs from the center to the periphery, creating bizarre patterns on the skin. At the end of the regressive stage, only areas of the skin that differ slightly from healthy areas in the shade are reminiscent of psoriasis. There is no need to talk about a full recovery with psoriasis. The end of the regressive stage indicates that the cycle of the disease is complete, which can return at any time. In order to prolong remission, it is necessary to take care of health: avoid provoking factors, follow a diet and let yourself be observed by a dermatologist.

Exam plan for psoriasis

General clinical analysis of blood.
Research on the content of vitamins D, B12 and folic acid in the blood.
Blood test for ALT (alanine aminotransferase), AST (aspartate aminotransferase), direct bilirubin, alkaline phosphatase, gamma-glutamyltransferase, cholesterol with lipid profile, creatinine, glucose, insulin, total protein.
Blood for rheumatoid factor, c-reactive protein, uric acid, ASLO.
Ferritin, transferrin and serum iron are indicators of anemia (especially chronic diseases).
Thyroid panel: TSH, T4 sv, TK sv.
Coprogram.
KhMS to Osipov.
Ultrasound of the abdominal organs.

Traditional treatments for psoriasis

Early therapy.

The sooner a person, who discovered the first signs of skin lesions, visits a doctor, the greater the chances of taking timely measures that will prevent the rapid development of the disease and its transition to a chronic form - and therefore significantly improve the diseaseOverall standard of living.

Prescription of treatment for psoriasis by a doctor

One of the most commonly prescribed drugs at the onset of the disease is salicylic ointment. It has anti-inflammatory and antimicrobial effects, has a keratolytic effect, due to which plaques are freed from keratinized particles. A naphthalene ointment is also used to relieve itching.

Therapy in a progressive stage.

This phase requires an integrated approach to treatment that only an experienced specialist can provide. Treatment aims to relieve symptoms and rid the body of toxins. To normalize metabolic processes, intramuscular injections of calcium gluconate are often prescribed. Sodium thiosulfate relieves inflammation and eliminates the manifestations of intoxication.

Special emulsions and salicylic ointment are used to moisturize the inflamed skin. Means containing tar are contraindicated at a progressive stage: they have an irritating effect and increase the patient's suffering.

When the intensity of the inflammation decreases, physiotherapy procedures can be linked. Patients with psoriasis are shown UV radiation, PUVA therapy, and paraffin applications. Corticosteroids and cytostatics are not used unnecessarily; these effective drugs are only needed in difficult and advanced cases.

To reduce allergic manifestations, antihistamines and sedatives are prescribed to reduce nervousness. Diuretics reduce the swelling of inflamed skin and remove toxins from the body.

Inpatient therapy.

At this stage, the inflammation disappears, the plaques are covered with a dry crust, so funds are needed to relieve the discomfort from the appearance of dandruff. These are tar shampoos, oil-based emulsions.

UV radiation and PUVA technology have a positive effect on many patients. If there is no improvement, doctors prescribe cytotoxic drugs.

Therapy in a regressive stage.

At the last stage of the disease cycle, depending on the current condition of the patient, constant correction of methods of treatment is required. Prevention replaces active therapeutic measures.

The patient is given recommendations on diet and lifestyle changes in general. In order to avoid the return of the skin lesion, it is necessary to avoid stressful situations that trigger the formation of psoriatic plaques.

Doctors typically give patients the following advice: :

Rethink lifestyle: Make adjustments to your diet, get enough sleep, exercise more;
Maintain normal vitamin levelsD, iron, B vitamins, protein in the body;
normalize the digestive tract: Exclude hypoacid, impaired outflow of bile, SIBO and CIGR (syndromes of excessive bacterial and, accordingly, fungal growth);
get rid of chronic foci of infection: Disinfect the oral cavity and have an ENT specialist treat you.
deal with the accompanying somatic pathology: Hypothyroidism, insulin resistance, metabolic syndrome, etc.

Traditional Methods to Get Rid of Psoriasis

Initial phase.At the first sign of skin lesions, juniper and lavender oils are effective. They soothe irritated areas of the dermis, promote healing of minor injuries, and relieve the feeling of tightness. A few drops of oil are added to a cream that has a neutral composition, for example, for children, and applied to the rash that appears. Another popular way to treat the first manifestations of psoriasis is to use 3 percent hydrogen peroxide. All measures, even the most harmless at first glance, can be carried out after consulting a dermatologist. Diet changes, avoiding unhealthy foods, and alcohol are also common recommendations made by traditional healers.

Progressive phase.At the stage of rapid development of the disease, an infusion of celandine is added to the medicinal oils and hydrogen peroxide. For preparation you need fresh or dried plant stems and salt water. Alcoholic tinctures are contraindicated, they can worsen the condition of the affected skin. It is necessary to insist on celandine for at least a few hours, and before applying the healing solution to the plaques, treat them with birch tar.
Stationary stage.At the stage of the termination of the formation of new papules, you can use proven folk methods that definitely do not harm the patient. This includes the use of sulfur ointment, salicylic solution.
Regressive phase.Hirudotherapy (leech therapy) is often used in the end stages of the disease. Although this method is not officially recognized by traditional medicine, many experts do not rule out its effectiveness. The interventions are carried out within 3 to 10 days, depending on the patient's state of health.

Prevention of psoriasis: how to prevent the development of the disease

Skin care.In order to minimize the likelihood of psoriasis damage in the presence of a genetic predisposition, simple methods help to maintain skin health: water and hardening procedures (bathing in the sea, baths with herbal extracts and salts, contrast showers, pouring cold water over the air, etc. ); Use soft sponges and avoid hard washcloths, which can damage the skin. the use of natural detergents without any aggressive chemical components.
Ultraviolet radiation.Several studies have shown the beneficial effects of sun exposure on the skin, which is prone to psoriatic plaque formation. Moderate doses of ultraviolet light accelerate tissue regeneration and reduce inflammation. You should not abuse sunbathing: an excess of rays can provoke an exacerbation of the disease.

Dress.Synthetic fabrics, tight-fitting styles, an abundance of belts and fasteners - all this is contraindicated for patients with psoriasis even in remission. Clothing should be natural, hypoallergenic, loose and not cause discomfort that can lead to the return of pronounced symptoms. Dark tones should be avoided for aesthetic reasons, silvery-white scales are less noticeable on light-colored clothing.
Injuries.In patients with psoriasis, any small sore, scratch, or abrasion can cause the progressive stage to return and secondary skin infection. You should be extremely careful to avoid injury.
Cosmetic and household products.Not all means are suitable for maintaining the cleanliness of people with such diagnoses. When choosing shower gels, soaps and shampoos, it is important to pay attention to their composition and give preference to those that contain natural ingredients. It is better to buy therapeutic series of care products that are sold in pharmacies. Solid particle scrubs are absolutely contraindicated: they can restart the disease process due to the slightest damage to the skin. Household chemicals should also be chosen for health safety reasons. Do not use aggressive cleaning powders based on chlorine and lye. Gloves should be worn when cleaning to avoid negative effects on the skin of the hands.
Vitamin therapy.Maintaining the vitamin balance is indicated for everyone, especially those with chronic dermatitis. Complex preparations keep the body in good condition, help it withstand viruses and prevent metabolic disorders.

psoriasis- This is not a death sentence, but a very grave reason to reconsider the rules by which you previously lived. Your allies on the path to taming the disease should be competent professionals - dermatologists, nutritionists, therapists. With their help, as well as a conscious approach to treatment, you can learn to live comfortably despite your diagnosis.