All About Psoriasis - How To Treat, Causes & Symptoms, Types

For more than two thousand years, mankind has tried to solve all the riddles of this severe dermatosis, but much is still unknown. According to statistics, this disease affects 4 to 7% of the population, women and men are equally susceptible to it. The first signs of psoriasis usually appear during puberty and will stay with a person for the rest of their life. Then they subside and disappear completely and then intensify.

Can Psoriasis Be Cured?Modern medicine has achieved a great deal in the treatment of this chronic dermatosis and can provide the patient with a decent quality of life.

Causes of Psoriasis

Psoriasis is a chronic inflammatory skin process that modern medicine calls autoimmune (associated with an allergy to one's own tissue). There are many causes of psoriasis and factors predisposing to the development of this dermatosis, related to which a number of theories have been put forward about its origin.

Autoimmune

This is the main theory as it is known that the immune system actively responds to certain types of skin exposure. The skin of people with psoriasis is very sensitive to mechanical, physical and chemical influences. Not only epithelial cells react to such influences, but the entire immune system.

Cellular immunity is impaired: the relationship between the individual subtypes of lymphocytes that are responsible for the formation of a normal immune response. In psoriasis, the number of T lymphocytes from helpers - helpers that regulate immunity - increases, while the number of T lymphocytes from suppressors that suppress an excessively strong immune response decreases. Lymphocytes and some other cells produce cytokines - agents that stimulate the immune response. Humoral immunity also suffers, there is an imbalance in the antibodies (immunoglobulins) in the blood serum, antibodies against the tissue of the patient's body appear.

Inflammation begins against the background of the activation of T lymphocytes, but why they are activated is not clear. The research process also raises the question of how the autoimmune reaction can be suppressed without harming the patient.

exchange

A metabolic imbalance has a significant impact on the skin and immunity. In patients with psoriasis, there is an acceleration in metabolism, the appearance of a large amount of toxic free radicals and other toxins that aid the inflammatory response. The metabolism is disturbed:

• containing protein- the CDSN predisposition gene stimulates the synthesis of the protein corneodesmosin, which sensitizes the body (allergenic); the content of albumin proteins in the blood decreases, and the content of globulins increases; This condition is known as dysproteinemia and it further increases sensitization.
• greasy- the level of lipids and cholesterol in the blood increases; Using mostly plant-based foods and generally reducing the calorie content of the daily diet can reduce the activity of psoriatic inflammation.
• carbohydrate- almost always injured;
• Exchange of vitamins and minerals- The content of vitamin C in the skin increases, the content of vitamins C, A, B6, B12, iron, copper and zinc in the blood decreases.

Contagious

This theory was relevant at the beginning and middle of the last century. Certain bacteria (streptococci), fungi and viruses have been thought to cause psoriasis. These theories have not been confirmed. However, dermatologists note that any acute process of infection or the presence of a permanent source of infection can provoke relapses. The virus theory occupies a special place. Recent studies have shown the effect of retroviruses (viruses containing RNA - HIV, etc. ) on the genetic apparatus to produce genes for psoriatic predisposition.

Genetically

The predisposition to autoimmune reactions is inherited. If a person's loved ones have psoriasis, the likelihood of developing the disease increases many times. There are genes for susceptibility to psoriasis (local complexes PSORS1 - PSORS9, PSORS1 is particularly active, it contains the genes HLA-C, HLA-Cw6, CCHCR1 and CDSN, which are responsible for the development of the disease). Genes influence metabolism, immunity and the development of autoimmune processes. However, the presence of such genes in no way guarantees the development of the disease. The influence of provoking factors is of great importance.

Neurogenic

Prolonged stress, high neuropsychological stress, disorders of the autonomic nervous system (innervation of the walls of blood vessels and internal organs) can lead to the development of psoriasis, which can lead to an imbalance in the endocrine system, impaired metabolism and immunological processes.

Endocrine

Endocrine disorders in psoriasis are common and mainly play the role of a provoking factor. A clear connection between the two has not been established. Dermatologists note that patients often have thyroid, adrenal, and pituitary dysfunction. There are menstrual irregularities in women and sexual functions in men.

Psoriasis symptoms

The main symptoms of psoriasis are rashes. But there are other signs as well. The very first manifestations usually appear in adolescence or childhood on the background of hormonal disorders, vegetative-vascular dystonia and persistent stress.

The disease begins with a feeling of constant fatigue and mood disorders. Characterized by small, pink-colored formations (papules) that protrude above the surface and are powdered with whitish peeling from above. They are surrounded by a lighter, towering border.

Elements of the rash grow and combine into large plaques of bizarre shapes. The base of the papule is an inflammatory infiltrate. Due to the nature of the rash, psoriasis is divided into:

• Point- elements with a diameter of not more than 1 mm;
• tear- papule droplets up to 2 mm;
• coin-shaped- round papule coins up to 5 mm in size.

Characteristic features of the rash:

• Stearin stain- if you scratch, the surface of the papules;
• Connecting foil- If you thoroughly clean the surface of the papules from the scales, you will see a transparent film.
• Blood dew (Auspitz phenomenon)- After we scraped off the film and violated its integrity, small bloody droplets will stick out on the surface.

Stages of psoriasis

There are three stages of the disease:

1. progressive- The first elements of the rash appear, their number increases, all new areas are captured. Skin rashes also occur when scratching the itchy skin or when exposed to external irritant factors (Kebner phenomenon); In the early stages of psoriasis, the papules begin to merge into large plaques.
2. stationary- There are no new elements, and those that appeared earlier do not regress.
3. regressive- the rash becomes pale, its base becomes less dense; the rash gradually regresses, the process often begins in the central part, so the plaques can be in the form of rings; When plaques in psoriasis dissolve from the periphery to the center, they just gradually decrease and a white ring is formed around them - Voronov's pseudo-atrophic edge; where there was a rash, white, pigmented areas remain - psoriatic leukoderma.

Occasionally, papules are present on the skin at all three stages of development at the same time. There are also summer and winter forms, with a predominance of exacerbations in summer or winter.

Is Psoriasis Contagious?

Numerous studies have confirmed that this is not a contagious disease. If infectious pathogens are involved in its development, it is only through a general effect on metabolism, immunity and the genetic apparatus.

Patients often ask:

• How does psoriasis spread?

  Psoriasis is not transmitted from person to person.

• Is psoriasis inherited?

  The answer is again negative, but there is a hereditary predisposition in the form of metabolic characteristics and immune system function that is passed on to close relatives.

Types of psoriasis

The type of rash, its location, the damage to other organs and systems in this chronic dermatosis can vary. According to these signs, different types of diseases are distinguished.

Simple (vulgar, badge)

The most common. Its symptoms are papules of a characteristic light pink color, covered with white scales. Downstream plaque psoriasis is divided into the following forms:

• easy- if the lesion does not cover more than 3% of the skin; in the progressive phase the papules increase, but then quickly develop the reverse development;
• moderate- the rash lasts from 3 to 10%; Papules are large, merge into plaques;
• heavy- The defeat covers more than 10%. Rashes are numerous, merging, and forming a myriad of shapes.

Vulgar psoriasis takes the form of relapses alternating with remissions, but there is also a continuous course.

Elbow psoriasis

This is one of the manifestations of a mild form of plaque inflammation. A characteristic feature of psoriasis on the elbows is the constant presence of one or more "mandatory" plaques on the extensor side of the elbow joints. When these elements are violated, an exacerbation begins.

Guttate psoriasis

In the development of good psoriasis, bacterial (mostly streptococci) and viral infections are of great importance. Occurs in childhood. Inflammation begins after infection. Streptococci secrete toxins (antigens - substances that are foreign to the human body) that bind to tissue proteins. Antibodies are produced against them and autoimmune inflammation develops.

The beginning is acute. Small red papular cracks with a scaly surface appear on the skin of the extremities (less often on the body and face). Injuries in the area of the rash cause small erosions and wounds, and the risk of infection increases.

Psoriasis quickly takes on a subacute and chronic course. Relapses are replaced by remissions, independent recovery or a transition to the adult form of the disease is possible.

Palmar-plantar psoriasis

It develops in people who do physical labor, is accompanied by severe itching, and almost always leads to complications on the nails. There are subspecies:

• Plaque fan-shaped- with large elements on the palmar and plantar surface, covered with white scales, merging into fan-shaped plaques; Such psoriasis on the hands is more common.
• circular- annular scaly elements on the palmar and plantar surface;
• hot- characterized by the growth of coarse epithelium with the formation of grains;

A separate subspecies is Barber's pustular psoriasis on the palms and soles of the feet. Areas under the thumbs of the extremities are covered with vesicles and pustules (with purulent contents), severe itching occurs. The abscesses fuse, then dry up and form crusts. Characteristic psoriatic elements develop in other parts of the body. The disease often spreads to the nails.

Psoriasis on the legs is maintained and exacerbated by varicose veins. In this case, the rash appears mainly in the lower leg area.

Nail psoriasis

Damage to the nails can either be independent or a complication. Typical symptoms:

• small dimples of different depths appear on the nail plate; Similar nail lesions are found in other dermatitis, but in psoriatic lesions they are deeper and slightly painful when pressed;
• spontaneous slow painless separation of the nail (onycholysis);
• subungual bleeding on the toenails, especially if the patient wears tight shoes;
• Trachyonychia - cloudiness and irregularities on the nail plate; In the middle of the nail a depression forms, which acts like a spoon (koilonychia).

Sometimes the periungual roll is affected by the transition of the inflammation to other tissues (psoriatic paronychia).

Psoriasis on the scalp

Here the disease proceeds independently or as part of a general pathological process. Characterized by wetting, the formation of crusts on parts or on the entire surface of the head. Hair growth is not affected at the same time: psoriasis on the head does not affect the function of the hair roots. However, oozing carries the risk of infection with subsequent damage to the hair follicles.

It flows in waves, then subsides with the disappearance of the crusts, then worsens again and is accompanied by severe itching, which often leads to neurosis.

Seborrheic psoriasis

Seborrhea is a condition caused by a malfunction of the skin glands that produce sebum. The result is a viscous oil that irritates the skin and contributes to the development of inflammatory dermatitis.

Seborrheic psoriasis quickly spreads to the entire head, covering it in the form of a cap and is accompanied by severe itching. Crying sometimes develops in the areas behind the ear and an infection occurs. The head, covered with scales and firm crusts, sometimes looks like a psoriasis crown.

Psoriasis on the face

Usually psoriasis is localized on the face in the area of the nasolabial triangle, the eyelids above the eyebrows in the areas behind the ear. The fused elements of the rash form large areas of redness and swelling. If there is a dysfunction of the sebum glands, the process is often accompanied by crying, crusting and an increased risk of infection.

Psoriasis on the genitals

This is not an isolated process. Simultaneously with the defeat of the genitals, characteristic psoriasis rashes appear all over the body, so it is not difficult to identify the disease.

Psoriasis on the penis in men and on the labia in women, as well as on the adjacent skin areas, manifests itself in the form of oval, pink scaly papules that rise slightly above the skin. There is practically no itching. Sometimes the process spreads to the mucous membranes and looks like vulvovaginitis in women and like balanoposthitis in men.

Atypical psoriatic rashes can be observed in overweight people in folds next to the genitals (groin, intergluteal). Areas of intense red color with a mirror-like surface are formed here with no signs of peeling due to constant wetting.

What is the danger of psoriasis and whether it needs treatment

The danger is that psoriasis can take a widespread severe form. Rashes make up more than 10% of the integument. This stage of the disease is difficult, relapses, the elements of the rash are injured and wet, infection is common. Treatment of psoriasis can only stop the spreading process in time.

Sometimes the disease is complicated by inflammation in the joints with the formation of psoriatic arthritis, against which the function of the joints can be significantly impaired.

Against the background of a systemic autoimmune process that has a significant impact on the patient's condition, other autoimmune diseases (rheumatoid arthritis, some types of osteoarthritis, Crohn's disease, etc. ), as well as severe cardiovascular pathologies, diseases of the digestive system, neurological reactions, often develop.

If you do not start treatment for psoriasis in a timely manner, the patient's condition worsens dramatically and leads to disability.

There is also such a complication as psoriatic erythroderma, which develops with improper or inadequate treatment of psoriasis, as well as exposure to various irritating factors of the inflamed skin. The skin takes on a light pink color with a clear demarcation of the affected areas from healthy, small and large lamellar shells. Such a patient needs emergency medical care.

Is Psoriasis Treated?

Yes, and quite successfully, but a full recovery cannot be guaranteed.

Treatment methods

Autoimmune inflammation requires individually selected complex therapy, lifestyle changes, diet and the elimination of all bad habits. Modern medicine has suggested three basic principles for the successful treatment of psoriasis:

• strict adherence to the algorithms for the prescribed therapy;
• regular monitoring of the effectiveness of therapy;
• timely correction of the prescribed therapy with insufficient effectiveness.

Diet in psoriasis

There is no specific diet for psoriasis, but diet is very important. Therefore, when prescribing complex treatment, dietary recommendations are necessarily given:

• notice an increased sensitivity of the body to certain foods and exclude them from the diet;
• give preference to fresh vegetables, non-sour fruits and berries, boiled and baked lean meat, drink more;
• what not to eat with psoriasis:
  1. Products that contain essential oils - onions, garlic, radishes;
  2. beverages containing caffeine (concentrated tea, coffee), alcohol;
  3. everything is salty, sour and sweet, rich;
  4. Products that promote sensitization (allergization) of the body - orange fruits, honey, nuts, cocoa, eggs;
  5. Do not eat fatty animal products.

Pegano diet for psoriasis

This diet was developed by the American doctor John Pegano, but has not received official medical approval. The principle of the structure of the Pegano diet against psoriasis is related to alkalizing the body by choosing the right diet. According to this principle, all products are divided into:

• alkali-forming (two-thirds of the daily diet) - non-acidic fruit and berry mixes and juices, vegetables (except those that cause increased gas formation);
• acidifying (one third of the diet) - meat, fish, dairy products, beans, peas, potatoes, cereals, sweets and pastries.

Patients are advised to drink mineral water without gas, drinking water up to 1. 5 liters per day, as well as other liquids that they drink (compotes, juices, etc. ).

Drug therapy

Mild psoriasis is treated with topical medications. Severe and rapidly progressing forms of the disease are mainly treated in a hospital with the prescription of drugs with general (systemic) effects.

External psoriasis treatment

The drug is selected by a dermatologist. For psoriasis vulgaris with dry constricting plaques, ointments are suitable. If oozing (with seborrheic) develops, creams and medicinal solutions are used. In order to avoid a resistance (resistance) of the organism to a certain drug, this is changed over time.

In the acute (progressive) stage, the following external therapy is carried out:

• Means that have an emollient effect - Borse Vaseline, 2% salicylic ointment;
• effective non-hormonal ointments for psoriasis containing activated zinc pyrithionate; They suppress the infection and have a cytostatic effect (suppress the proliferation of tissue).
• external agents that contain glucocorticosteroid (GCS) hormones;
• a combined agent with calcipotriol (an analog of vitamin D3) and corticosteroids betamethasone; perfectly suppresses the inflammatory process.

External treatment of psoriasis in the stationary stage:

• Ointments that dissolve dandruff (keratolytic) and have anti-inflammatory effects - 5% naphthalane, boron-naphthalane, tar-naphthalane;
• Corticosteroid drugs.

External treatment of psoriasis in the dissolution stage:

• the same keratolytic ointments, but in a higher concentration: 10% tar naphthalene ointments;
• Ointments based on vitamin D3 analogues - within 6 - 8 weeks; suppresses the inflammatory process and the peeling of the rash.

For the treatment of nail psoriasis, special varnishes are used, which suppress the development of the pathological process. It is recommended to treat periungual phalanges with moisturizing gels.

Systemic treatment of psoriasis

• Drugs that relieve inflammation and poisoning - calcium chloride, sodium thiosulfate, Unitiol in the form of injections;
• Tablets for psoriasis that suppress the processes of proliferation (multiplication of epithelial cells) - cytostatic drugs that suppress the activity of the immune system, analogs of vitamin A, corticosteroid hormones;
• biological agents that contain human IgG class monoclonal antibodies that act on certain inflammatory compounds by suppressing the synthesis of cytokines; It is a very powerful modern drug that is given by injection.
• Vitamins for psoriasis help restore metabolism and cornification of epithelial cells; Doctors prescribe vitamins A, E, D3, group B.

Folk remedies for psoriasis

Treatment of psoriasis, even with the use of folk remedies, can only be prescribed by a doctor. Self-treatment can lead to the opposite effect: the spread of the disease.

As part of a complex therapy, the following methods can be used:

• fat- Product of processing industrial oils; To prepare the ointment, you need to buy a medicinal solid oil from a pharmacy. Recipe: in 0. 5 kg of solid oil, add 50 g of honey and half a pack of baby cream. Procedures are carried out daily; In the pharmacy you can buy ready-made preparations based on solidol.
• Baking soda- a folk remedy for psoriasis, which helps cleanse crusts, relieves itching; Recipe for soda applications: take 60 g of soda, dissolve in 0, 5 liters of water, soak a cheesecloth in the solution, fold in several layers and apply the lesion for 20 minutes; After the procedure, dab the skin and apply an emollient ointment to it. Treatment of psoriasis with soda is carried out once a day.
• mummy- has a pronounced anti-inflammatory effect, relieves itching well; can be taken orally at 0. 2 g once a day for two weeks; External therapy is carried out with a mummy solution. it is applied to dry itchy plaques twice a day; Treatment of psoriasis on the head is carried out by rinsing the scalp with a mummy solution after washing.
• sea-salt- relieves inflammation and itches well; Baths with sea salt: take 1 kg of salt, dilute in two liters of water and add to the bath; Take a bath for 15 minutes, then rinse the solution off under a warm shower, blot the body with a towel and apply an emollient ointment. Treat psoriasis with baths no more than twice a week;
• Clay- has a pronounced cleaning effect, adsorbing toxins on its surface, which are caused by inflammation and improper metabolism; helps to dry, get rid of crusts and itching; You can take any clay, but it is better to buy blue clay in a pharmacy; Pieces of clay need to be dried well, broken with a hammer, diluted with water and left for several hours; Put the resulting plate-like clay on a napkin (up to 3 cm thick) and apply it to the foci of inflammation for three hours. Treat psoriasis with clay every other day.

Important: home treatment of psoriasis with folk remedies should be carried out with caution and strictly according to the doctor's prescription. Such treatment will help one patient while it may cause the inflammation to worsen and spread rapidly in another. Therefore, if the patient's condition has worsened against the background of therapy, then it must be immediately canceled and consulted a doctor.

Treatment of psoriasis at home

When treating psoriasis at home, it is important to follow dietary recommendations, lead a healthy lifestyle, rule out bad habits, and closely follow all prescriptions of a dermatologist.

How To Cure Psoriasis At Home? Some patients try to rid themselves of toxins and toxins using all sorts of unconventional methods (enemas, etc. ). This can do just the opposite: the work of the digestive tract is disrupted and an exacerbation begins. Modern medicine recognizes the cleansing of the body in the form of proper nutrition and the elimination of bad habits.

It is important to follow all medical prescriptions and pay attention to how the prescribed therapy is working. If it is not effective enough, the doctor will substitute treatment for the maximum therapeutic effect.