For many centuries, humanity has been trying to uncover all the secrets of this mysterious skin disease, but much is still unknown. According to statistics, psoriasis affects 4 to 7 percent of the population, with men and women 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 becoming more severe.
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. The disease usually manifests itself as red, silvery scaly skin on the feet, knees, back, chest, etc. In most cases, psoriasis begins 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 that explain its occurrence.
Autoimmune cause
Some studies suggest that psoriasis may occur due to a combination of genetic and environmental factors such as infections, trauma, stress, and certain medications. These factors can trigger an immune system response that begins to attack the body's tissues, including the skin.
However, the underlying processes of psoriasis are not yet fully understood. It is important to note that psoriasis is a multiple disease that manifests itself differently in each patient. Studying the mechanisms underlying psoriasis may help develop more effective treatments, reduce the risk of complications, and improve patients' quality of life.
Influence of metabolism
Metabolic disorders significantly affect the skin condition and immunity in patients with psoriasis. The increased metabolism leads to the formation of toxins and free radicals, which contribute to inflammatory reactions. There is an imbalance in various metabolic processes.
- With disorders of protein metabolism in patients with psoriasis, the albumin content in the blood decreases and the content of globulins increases, which increases their sensitization.
- During lipid metabolism, an increase in the content of lipids and cholesterol in the blood is observed.
- Reducing calorie intake and consuming plant-based foods can reduce the activity of psoriatic inflammation.
- Disturbances in carbohydrate metabolism almost always occur.
- The metabolism of vitamins and minerals is also impaired, which is manifested by a decrease in the content of vitamin C, A, B6, B12, iron, copper and zinc in the blood, but an increase in the content of vitamin C.
Infectious cause
This theory was widespread in the last century. It has been thought that psoriasis could be caused by certain bacteria (streptococci), fungi and viruses, but these hypotheses have not been scientifically confirmed. However, dermatologists point out that any acute infectious process or chronic infection can lead to the recurrence of psoriasis. Particular attention is paid to the virus theory. Recent research shows that RNA viruses such as HIV and other retroviruses can affect the genetic apparatus and cause the appearance of genes that predispose to the development of psoriasis.
Genetic predisposition
The inherited predisposition to autoimmune reactions is a risk factor for psoriasis. If close relatives of a person suffer from this disease, the likelihood of developing it increases. Several genes may be associated with psoriasis, including the PSORS1-PSORS9 complexes, with PSORS1 being particularly 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 these genes does not mean that a person will necessarily develop psoriasis. The development of the disease can be caused by other factors.
Neurogenic cause
Excessive stress on the nervous system, prolonged stress and imbalance in the autonomic nervous system, which provides the innervation of blood vessels and internal organs, can be risk factors for the development of psoriasis. These factors can lead to an imbalance in the endocrine system, changes in metabolic processes and disorders of the immunological response, increased irritability or depression, constant fatigue, sleepiness and apathy, which in turn can lead to psoriasis.
Endocrine
Endocrine disorders occurring in psoriasis are quite common and can have a significant impact on the development of the disease. However, the connection between them and psoriasis is not entirely clear and has not been proven. Experts believe that patients with psoriasis often suffer from dysfunction of the thyroid, pituitary and adrenal glands. Women may experience problems with the menstrual cycle and men may experience problems with sexual function.
Symptoms and characteristics of psoriasis
Psoriasis is manifested not only by skin rashes, but also by other symptoms. It often begins in childhood or adolescence and is associated with hormonal disorders, vegetative-vascular dystonia and stress.
The first signs arefatigueAndMood change. The main symptom is small pink bumps on the skin called papules that are covered in whitish scales. Papules are surrounded by a lighter border.
Over time, elements of the rash can combine to form large, unusually shaped plaques. The base of each papule isinflammatory infiltrate. The following types of rash are distinguished:
- precise (no more than 1 mm in diameter);
- teardrop-shaped – (droplet papules up to 2 mm in size);
- Coin-shaped – (round papule coins up to 5 mm in size).
The rash also has its own characteristics:
- Stearic acid stain – when you scrape the surface of the papule;
- Final film – after clearing the papules of scales, you can see a transparent film;
- bloody dew (Auspitz phenomenon) – if the integrity of the film is damaged, small bloody droplets may be produced.
Is psoriasis contagious?
Many people believe that psoriasis is contagious, which is why they try to avoid contact with people who suffer from it. This can lead to the patient's desire to withdraw from others and to serious psychological problems. However, studies have shown that psoriasis is not transmitted through contact with the patient. If all family members suffer from this disease, this simply indicates the presence of a genetic factor in the development of the pathology.
Classification and stages of development of psoriasis
Currently there are three main stages in the development of psoriasis:
- A progressive stage characterized by the constant emergence of new rashes accompanied by severe itching.
- The stationary stage, in which new formations stop appearing and existing ones begin to heal.
- A regressive stage in which borders appear around the rash and the skin affected by the rash becomes darker in color due to increased pigmentation.
In addition, there are several degrees of severity of pathology:
- Mild degree, when no more than 3% of the skin surface is affected.
- Moderate grade 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 a variety of ways. The rashes, their location and damage to other systems and organs can be different. Depending on these characteristics, different forms of psoriasis are distinguished.
Simple (vulgar, badge)
Plaque psoriasis is the most common form of this disease. Symptoms include the appearance of light pink papules covered with white scales.
Elbow psoriasis
This is a typical manifestation of mild plaque psoriasis. A characteristic feature of psoriasis of the elbows is the presence of one or more permanent "duty" plaques on the extensor side of the elbow joints. When these elements are exposed to trauma, aggravation occurs.
Guttate psoriasis
When associated with bacterial (most commonly streptococcal) and viral infections, this type of psoriasis can cause inflammation. This condition is common 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.
This condition can develop rapidly or gradually become chronic, followed by periods of exacerbation and weakening of symptoms. In rare cases, psoriasis can become more severe.
Palmoplantar psoriasis
This form of psoriasis often occurs in people who do physical work, is often accompanied by severe itching and can lead to complications on the nails. The different subtypes of this type of psoriasis include:
- Plaque-fan-shaped: Large elements on the soles of the hands and feet with white scales that merge into fan-shaped plaques. This subtype is most commonly found on the hands.
- Circular: ring-shaped scale elements on the soles of the hands and feet.
- Callosal: Growth of rough epithelium to form calluses.
- Pustule: This is a special subtype of psoriasis on the palms and soles of Barber's feet. Blisters and pus pustules form in the area below the big toes, causing severe itching. The ulcers merge, then dry out and form crusts. Characteristic features of psoriasis also occur in other parts of the body.
Psoriasis on the legs can be accompanied by varicose veins and is particularly evident on the lower legs.
Nail psoriasis
It can occur as a standalone disease or as a complication of another form of psoriasis. The main symptom is small pits on the nail plate that vary in depth. These dimples tend to be more noticeable and painful when pressed than other types of dermatitis. Symptoms also include spontaneous detachment of the nail, subungual bleeding (especially when wearing tight shoes), and changes in the color and surface of the nail such as trachyonychia and koilonychia.
Psoriasis of the scalp
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 roots is not affected. However, wetting poses a risk of infection, which can lead to damage to the hair follicles.
Seborrheic psoriasis
It is caused by a disorder of the skin glands that produce thick sebum, which leads to skin irritation and inflammation - dermatitis. This condition quickly spreads to the entire head, covering it in the form of a cap and is accompanied by severe itching. The areas behind the ears sometimes experience tearing and infection can occur. A scalp covered in scales and crusts can look like a crown of psoriasis.
Psoriasis on the face
Most often occurs in the area of the nasolabial triangle, the eyelids, above the eyebrows and in the area behind the ears. The rashes can coalesce and form widespread redness and swelling. If the function of the sebaceous glands is impaired, tearing, crust formation and an increased risk of infection can occur.
Psoriasis of the genitals
Psoriasis affecting the genitals is a concomitant process that is usually accompanied by characteristic psoriatic rashes all over the body, which makes the diagnosis easier.
Psoriasis rashes on the penis in men, on the labia majora in women, and surrounding skin areas are oval and slightly raised above the surface of the skin. They are pink and scaly. Virtually no itching. Sometimes the lesion process spreads to the mucous membranes and can take the form of vulvovaginitis in women and balanoposthitis in men.
In overweight people, atypical psoriatic rashes can be observed in the folds near the genitals (inguinal, intergluteal). These areas create areas with an intense red color that have a reflective surface and do not come off due to constant wetting.
Why is psoriasis dangerous?
Psoriasis can become very serious if the rash covers more than 10% of the skin. This condition is difficult and prone to reoccurrence, and the rash may become moist and wet and susceptible to infection. Only timely and effective treatment of psoriasis can prevent the disease from spreading.
In some cases, psoriasis can be complicated by inflammation of the joints and the development of psoriatic polyarthritis, which can lead to joint dysfunction. In addition, the systemic autoimmune process caused by psoriasis can lead to the development of other autoimmune diseases, serious cardiovascular and digestive diseases, and neurological reactions.
Ignoring timely treatment of psoriasis can lead to complications such as psoriatic erythroderma, which can occur due to improper treatment of psoriasis or as a result of exposure to various irritating factors on the skin. In psoriatic erythroderma, the skin turns a deep pink color with a clear distinction between affected and healthy areas and small and large peelings. This condition requires urgent medical attention.
Complications of psoriasis
Lack of timely and appropriate treatment for psoriasis can cause serious damage to vital organs and systems of the body such as joints, heart, kidneys and nervous system. These consequences can lead to disability or even death.
diagnosis
Typically, the diagnosis of psoriasis is made based on the typical symptoms of skin lesions and their location. In some complex cases, additional testing may be necessary to rule out other skin conditions.
Laboratory tests may include:
- Complete blood count that can detect leukocytosis and anemia in psoriasis.
- Rheumatoid factor (RF) is a protein whose levels may be elevated in systemic inflammatory diseases with joint damage but are usually normal in psoriasis.
- The erythrocyte sedimentation rate (ESR) is also usually normal, with the exception of pustular psoriasis and psoriatic erythroderma.
- In psoriasis, uric acid levels may be elevated, which can lead to confusion with gout.
- If psoriasis suddenly occurs, antibodies against the human immunodeficiency virus (HIV) can be detected.
In more complex cases, other tests such as joint x-rays and skin biopsies may be used to assess the severity of joint damage and to differentiate psoriasis from other skin diseases.
Treatment
Treatment of psoriasis requires a comprehensive approach that includes local treatment of skin lesions, medication, light therapy and avoidance of 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 of which depends on the type of lesion and is used daily);
- Lotions and shampoos based on salicylic acid and photosensitizers;
- Drugs for oral administration (retinoids, vitamin D preparations and others);
- physiotherapeutic procedures;
- Daily baths with bath oil, oatmeal infusion, or sea salt can help soften skin and reduce the inflammation that occurs with psoriasis. It is important to avoid hot water and scrubs and to use a moisturizer after bathing.
- Light therapy, which involves exposing the skin to ultraviolet light, may also be helpful (avoiding burns).
- photochemotherapy with medium-wave radiation;
- Compliance with a special diet and a general regime.
When developing a treatment program, the patient's gender and age, the presence of concomitant diseases, general health status and the impact of external factors are taken into account. Sometimes for healing it is enough to change lifestyle, in other cases several courses of treatment are prescribed.
In addition to traditional methods, the treatment of psoriasis may include the use of modern laser technologies. Laser therapy can relieve the symptoms of pathology, achieve long-term remission and relieve the patient of unpleasant rashes and related problems. A distinctive feature of laser therapy is that a special excimer laser acts only on the affected areas of the skin without affecting healthy areas of the skin, which ensures rapid recovery without side effects. Laser therapy is safe and painless, requires no preparation and can be used regularly, allowing the patient to live a life without restrictions.
The effectiveness of treatment depends on many factors, including hereditary predisposition, provoking factors, stage of the disease and the specific type of lesion. Therefore, it is recommended to first consult a specialist and prescribe treatment measures based on clinical recommendations.
prevention
Psoriasis is a disease that can be successfully treated if you consult a doctor in a timely manner and receive qualified help. With the simple form of psoriasis, the patient can work without restrictions, with the exception of working in chemical factories, where the workplace can be dangerous.
However, psoriasis can cause complications such as psoriatic arthritis, which can limit work performance and lead to disability.
Prevention of psoriasis is an important part of treatment. After recovery, patients need to reconsider their lifestyle, get rid of bad habits, take care of the treatment of other chronic diseases, monitor their diet and increase physical activity by spending more time outdoors and playing sports.
Nutrition for psoriasis
The diet for psoriasis is not strict, but proper nutrition plays an important role in the complex treatment. When making nutritional recommendations, patients are advised to:
- Avoid foods to which the body is hypersensitive and exclude them from the diet.
- Give preference to fresh fruits, vegetables, berries, lean baked or boiled meats and drink more.
- Avoid the following foods: onions, garlic, radishes, concentrated tea, coffee, alcohol, sweets, salty and acidic foods, and foods that can cause allergic reactions such as orange fruits, honey, nuts, cocoa and eggs.
- Avoid fatty foods of animal origin.