Psoriasis is an inflammatory chronic disease of the body, which is accompanied by a predominant skin lesion with the formation of erythematous spots and plaques with clear boundaries and silvery scales on the surface.
The course of the disease is characterized by periods of exacerbation and remission (reduced symptomatic manifestations). Unfortunately, medicine has not yet identified the exact and reliable cause of psoriasis, but a hereditary factor has been clearly identified, which, in combination with trigger factors, contributes to the provoking moment of the appearance of this disease. A connection has been established between the occurrence of psoriasis and the antigens of the HLA system.
Between 1 and 5% of the world's population suffer from this very unpleasant disease, and people with fair skin are at a higher risk of developing psoriasis than black people.
The disease can manifest itself at any age, but the periods 20-30 years and 50-60 years are considered critical.
Important!Psoriasis is not contagious to others, but it causes inconvenience to the patient himself, since the rashes that appear during the disease are not only a cosmetic defect, but are 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 rashes are localized on the scalp, on the surface of the elbows and knees, as well as in the area of skin folds and genitals. The nails, buttocks and the area around the eyebrows are often affected. The type and appearance of the rash depends on the type of psoriasis.
Causes of Psoriasis
The way in which psoriasis occurs has not yet been clarified by medicine; some doctors speak of autoimmune causes. The second theory that explains the occurrence of the disease is a disruption in the normal maturation and division process of skin cells. Heredity and stress are also considered causes.
A genetic predisposition to psoriasis, allergies and frequent disorders of the skin barrier function (strong friction, chemical exposure, influence of alcohol-containing products) can cause the disease to worsen.
Leading to the known triggerspsoriasis, regarding:
- Koebner's phenomenon is the appearance of fresh rashes 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 causing guttate psoriasis;
- taking medications (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;
- Disturbances in the digestive system.
The main cause of the development of the disease is excessive, accelerated growth and division of skin cells in combination with the inflammatory process in the dermis. In other words, skin cells that lie in the lower layer of the epidermis begin to grow rapidly and put pressure on the cells above. This process is accompanied by severe peeling of the skin and is called parakeratosis. Excessive stimulation of the immune system is believed to be the main reason for the emergence of this mechanism.
Symptoms and signs of psoriasis
Rashes associated with psoriasis are asymptomatic or accompanied by itching. Most often they are localized on the scalp, the extensor surfaces of the knees and elbows, the sacrum and buttocks (especially in the buttock fold), as well as in the genital area. Fingernails and toenails, skin in the eyebrows, armpits and navel can be affected. The rashes may merge with the lesions and cover large anatomical areas and areas of skin in between. Depending on the type of psoriasis, the rash can have different external appearances.
As a rule, the rashes are discretely localized and are represented by erythematous papules or plaques covered with dense, silvery, shiny scales. The rash appears gradually. Remissions and exacerbations occur spontaneously or after exposure to provoking factors.
5-30% of patients developPsoriatic arthritis, which can lead to disability of the patient. This process can lead to joint destruction.
Important!Psoriasis does not pose a threat to the patient's life, but does affect the patient's self-image. In addition to the fact that the patient's appearance changes, a lot of time is also needed to treat rashes and keep clothes and bedding clean, which significantly affects the patient's quality of life.
Types of psoriasis
- vulgar(normal or chronic plaque) Psoriasis, in which the rashes look like individual plaques covered with silvery flakes. As the disease progresses, the plaques may fuse. Among all subtypes, this form of psoriasis is the most common, accounting for about 90%.
- inverse psoriasisaccompanied by skin rashes that appear in the area of natural wrinkles and can form cracks.
- Guttate psoriasischaracterized by multiple skin rashes with a diameter of 0. 5–1. 5 cm, which often arise after streptococcal pharyngitis.
- palmoplantar psoriasismanifests itself as plaques on the palms of the hands and soles of the feet, which can fuse together.
- Nail psoriasisAffects the nail plates in the form of pinpoint depressions and grooves with discoloration and thickening of the nail. Nail changes in psoriasis are often similar to changes in a fungal infection.
- pustular psoriasisaccompanied by the formation of pustules on the palms, soles or possibly damage to a finger. There may also be a generalized form.
- erythrodermic psoriasismanifests itself as a sudden or gradual appearance of redness in patients with psoriatic plaques, when the plaques themselves are mild or absent. Usually occurs due to improper treatment of vulgar psoriasis.
Methods for diagnosing psoriasis
If symptoms of psoriasis appear, the patient should consult a dermatologist. He carries out an external examination of the affected skin areas and takes a complete anamnesis.
Psoriasis has fundamental similarities with other dermatological diseases, especially in the early stages of manifestation. It is important to rule out the presence of fungal infections on the hands and nails. The seborrheic type of psoriasis requires a specific differential diagnosis to exclude seborrheic eczema, pityriasis rosea and papular syphilis.
In case of active disease and large lesions of the epidermal areas, a visual analysis of the abrasions is carried out. When you scrape, the peeling increases. In place of the removed scales, a smooth, thin film is visible, which peels off under mechanical influence, revealing a moistened surface with drops of blood.
Diagnosing psoriasis is not difficult in most cases; it is enough just to examine the patient's skin. The doctor must exclude diagnostic errors and establish the presence of other diseases and other pathologies that arise against the background of psoriasis.
In rare cases, the diagnosis requires a biopsy. If non-classic clinical symptoms are present, the need should be considered. Depending on the area of skin affected, there is a mild, moderate and severe severity of the disease. Damage to less than 10% of the skin represents mild severity. There are more sophisticated methods of assessing disease severity, but these are used in clinical trials.
Treatment of psoriasis
There are a variety 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 and include both drug and non-drug interventions.
The treatment plan is drawn up depending on the severity of the disease, the area of skin affected and the severity of symptoms such as redness, itching, flaking. The patient's age and gender, stage of the disease and general condition, as well as the presence of concomitant diseases are also taken into account, as these may limit the choice of treatment methods.
Treatment of psoriasis should lead to a reduction in clinical manifestations (rashes and other symptoms), an improvement in the patient's general condition and a restoration of his ability to work.
When treating psoriasis, it is necessary to follow a diet and properly care for the skin, as there is a risk of liver damage. In such cases, it is recommended to reduce the proportion of fatty foods in the patient's diet and avoid alcohol, sweets (simple sugars) and starchy foods. The emphasis of the diet should be on proteins: lean meat, fish, dairy products, vegetables and fruits. Be sure to watch out for allergic reactions or intolerance to certain products.
To improve the patient's quality of life and get rid of the disease, an integrated approach is required:
- Local treatment–Ointments and creams relieve flaking and itching well in small areas where the disease is localized. Hormonal ointments, salicylic acid, retinoids, and moisturizers are particularly effective in treating psoriasis of the face and hands.
- Drug therapyUsed as an additional method of effective treatment of psoriasis when ointments do not help. Drugs reduce the inflammatory process, relieve swelling and itching, and block the increased activity of skin cells. However, it should be borne in mind that the tablets have many side effects (increased fatigue, loss of appetite, high blood pressure). Therefore, it is very important to follow all the doctor's recommendations regarding the dosage of the drug.
- If psoriasis is localized on the head and neck, use itmedicated therapeutic shampoos: Antifungal, tar, contains corticosteroids. The shampoo eliminates pathogens of pathological inflammation, removes dandruff, relieves itching and burning.
- Therapeutic antihistamine injectionsBlock severe itching, biological drugs have a positive effect on the immune system.
Unfortunately, today there are no options for a complete cure for psoriasis. Any treatment for psoriasis is aimed at eliminating the signs of the disease for a long time and prolonging remission. Despite the slow, chronic progression of the disease, treatment of psoriasis is necessary, as prolonged absence of treatment can lead to disability for the patient.