Psoriasis is a chronic dermatological disease, the basis of which is unusually fast growth of skin cells for the pathogenesis, which leads to the appearance of the skin surface of compressed areas of different colors.
Nowadays, psoriasis has become the most common, non -infectious dermatological disease.Psoriasis has no gender -specific disposition - both men and women suffer from it with the same often.You can get this pathology at any age, but the first signs of the disease appear more frequently up to 20 years.
Psoriasis is quite bad in therapy, partly due to the fact that etiology and pathogenesis of this pathology have not yet been clear.In addition, there are no means of specific prevention of psoriasis, as it is impossible to determine whether a person has a predisposition to the disease.
The reasons for the development
Scientists can currently the question "Why is developing psoriasis?"Do not answer clearly.Two main factors for the development of the disease are differentiated - this is a genetic predisposition and hyperreactivity of the immunity system.
So far it has been determinedThe disposition for the development of psoriasis is inherited.However, the difficulty lies in the fact that it is extremely difficult to follow how exactly this predisposition is inherited and the influence of which factors can develop psoriasis.
It is believed that the following factors can induce the development of psoriasis:
- Frequent hypothermia of the skin and the effect of the dry climate on it;
- Infectious processes;
- Frequent loads;
- The use of some groups of pharmaceuticals: non -steroid anti -inflammatory medication (especially aspirin), some hypotonic and psychotropic medication;
Pathogenesis
At the moment, the pathogenesis of psoriasis has not been clarified.Two main connections of the pathogenesis can be differentiated:
- Violation of skin ceratization.
- Disorder of the immunity system.
Together, the factors mentioned above mean that the cells of the lower layers of the epidermis begin to share very quickly for an unknown reason.This process leads to a reactive increase in the withered rate of the upper layer of epidermal cells, which manifests itself on the outside by peeling the skin.
Symptoms
The disease always begins acutely without the development of the pathological process.As a rule, the first elements of the rash are located in the place where the skin was damaged.
At the beginning of the symptoms of psoriasis, papules of pink or red colors appear on the skin.This process is accompanied by itching.The size of the elements ranges from a few millimeters to 1.5 centimeters (in some cases the elements also reach large sizes).Then the elements of the rash are covered with slightly separate silver scales.
Sometimes psoriasis damages the nail plates.This pathology is similar to the mushroom damage of the nails and manifests itself by the following symptoms:
- There are many small recesses on the surface of the nail;
- The edge of the nail plate thickens and receives a blunt, yellowish color;
Another characteristic manifestation of psoriasis is psoriasis arthritis (symmetrical damage to the joints and periarticular tissue).Most of the time, the pathological process develops in the interfalized joints of the feet and hands.First of all, the disease manifests itself through pain and swelling, and then the deformation of the affected joint develops, which can even lead to the patient's disability.It should be noted that damage is also possible in rare cases.Sometimes psoriatic arthritis develops in the joints of the spine.
Guy
The following types of psoriasis differ depending on the severity and characteristics of clinical manifestations:
- Plaquaper.This type is most common - it is diagnosed in almost 90% of people with psoriasis.The elements of the rash can theoretically occur on any skin area.However, the most typical locations are the lower back, the scalp and the extensors of the upper and lower extremities (the area of the elbows and knees).It should be noted that with this form of psoriasis pathological elements do not appear on the face, palms and soles remain intact.On the outside, this shape looks like an inflamed plaque with silver with scales.If the plaques of under the scales are displayed, Lymph is released.The plaque begins to bleed with further injury.The plaque form of psoriasis is also characterized by the appearance of the so -called "paraffin lakes" - the confluence of several plaques in one element.
- Reverse psoriasis (psoriasis of flexion areas or interrigonic).This shape is quite rare.The elements of the rash have the shape of red spots without peeling themselves that do not protrude above the surface of the intact skin.Typical localization of this form of psoriasis - skin folds (armpits, groin folds, skin under the chest in women).Due to the features of the localization, a fungal infection often combines the reverse psoriasis.
- Genital psoriasis.This form is most common in girls, mainly in adolescence (up to 16 years).The development of the pathological process is often preceded by streptococcal infection (e.g. angina).The rashes with rocky psoriasis resemble an ordinary allergic rash - small dots that have a color from gray to purple and do not emerge above the skin surface.Such rashes can occur on any area of the skin.The skin on which rashes are located usually has an inflamed appearance.
- Pustula psoriasis.It is a more serious form than the above.With pustular psoriasis, small painful, pus -filled, appear on the patient's body.This form can occur both locally and in general.With pustular psoriasis, the general condition of the patients often worsens, body temperature increases.With the generalized form of pustular psoriasis, hospitalization is required.
- Erytroderma is the hardest form of psoriasis.This damages almost the patient's entire skin.This form is accompanied by chills, an increase in body temperature to high numbers, a sharp worsening of the patient's patient.This disease requires urgent medical interventions in which no fatal result can occur.
Severity
There are many different levels of psoriasis in relation to heaviness.In routine clinical practice, however, the simplest of you is most commonly used, which does not require any special research methods.
So distinguishThree levels of severity of psoriasisDepending on the prevalence of the pathological process:
- Light form.This form is determined in cases in which the patient is affected by a psoriasis of less than 3% of the skin.
- Moderate form.This diagnosis is made with psoriasis damage from 3 to 10% of the patient's skin.
- Heavy shape.This form is shown taking into account the lesion of the skin and clinical manifestations.This shape is thus exhibited with a lesion of more than 10% of the skin or with a significant deterioration of the patient's borehole.It should be noted that psoriasis in the presence of psoriatic arthritis is considered serious, regardless of the degree of the prevalence of the pathological process.
The course of the disease and forecast
Psoriasis is a disease with a wave -like course, ie it has remission periods (if the symptoms practically disappear) and a deterioration.As a rule, the process is exacerbated during the periods outside the season.
The forecast for psoriasis depends on the shape of the disease and severity.As a rule, the prognosis with classic forms of psoriasis is cheap, but disability is possible in severe forms and even death.
Despite the favorable forecast in most forms of psoriasis, they do not forget the social aspect of this disease.In the acute time of the disease, the skin and hairy part of the human head are covered with peeling plaques, which are often perceived by others as manifestation of an infectious disease.For this reason, people around them begin to avoid the patient, which means that he is closed, and often depression.
Diagnosis
The basis for the diagnosis is the clinical manifestations of the diseaseThe characteristics of its current and the data of the objective inspection.There are a number of characteristic symptoms intended for the diagnosis of psoriasis:
- "Psoriatic Film" - if you clean the surface of the papula of the peeling, it will be smooth and shiny.
- "Stearin color" - When the psoriatic elements are displayed, their surface appear whitish and starin films appear.
- "Bloodtau" - if the loops of the elements do not stop after the manifestation of the above symptoms, then their surface is covered with blood droplets (capillary bleeding occurs).
Three symptoms described above are referred to as "psoriasis triad" and are the main method for diagnosing psoriasis.However, there are some other signs that are determined at a certain stage of the disease:
- Pilnov symptoms are caused in the acute stage of psoriasis (Psoria elements are surrounded by a red border) and Kebner (new rashes appear actively in damaged skin areas).
- The regression levels also determine the symptom of Voronov (a brilliant light edge of a small wrinkled skin is determined around the elements).
The following are used by the laboratory and instrumental methods:
- Microscopy of scales and dough with potassium hydroxide (for differential diagnosis with mushroom damage).
- In complex clinical cases, pathological elements with an atypical course take a biopsy.
- In psoriasis arthritis, blood testing indicators are examined (mainly ESR and rheumatoid factor) and an X ray of the affected joints (for differential diagnosis with arthritis of another etiology).
Treatment
Treatment of psoriasis is a long and complex process.Since psoriasis is a chronic disease, the goal of the therapy is unfortunately not the healing of the patient, but the achievement of a longer remission and the prevention of exacerbations.The treatment depends on the shape, shape and severity of psoriasis.It should be noted that a number of medical measures must be prescribed by a dermatologist and only after a thorough examination of the patient and the review of the diagnosis.
Diet.Treatment of psoriasis should begin to correct the patient's daily diet.When we talk about general recommendations, people with psoriasis should reduce the amount of protein in diet and increase the amount of carbohydrates due to the consumption of vegetables and fruit.It is also necessary to exclude the products that can cause deterioration in psoriasis: limit alcohol, chocolate, various spicy spices as well as the use of garlic and onions.It is also worth limiting the consumption of fried meat and fish, smoked meat.
In the compilation of optimal nutrition, the patient's disposition should be excluded to allergies against products and, if possible, if possible.The optimal diet is the use of a large amount of freshness and vegetables as well as lean meat and fish arginium in a cooked form.
Drug treatment.Pharmaceuticals are used to treat psoriasis in various forms of release: ointments, tablets, injections, etc.
In addition to local drugs, system therapy is also used when medication is prescribed in the form of tablets or injections.The following drugs are most frequently prescribed:
- Immunosuppressant.They have an overwhelming influence on the immunity system.It is only prescribed in severe cases that are not accessible to other therapy methods because it has a large number of side effects and is difficult to transmit.
- Cytostatics.Its effect aims to reduce the cell division rate, which leads to a reduction in the development of psoriasis and a decrease in peeling.It is only used in very severe cases with resistance to other therapy methods.
- Various homeopathic drugs.Unfortunately, these drugs are not suitable for all patients and do not always have the necessary effect.
Photochemotherapy.The lighting is one of the main methods of psoriasis therapy.
In summary, it is worth noting that psoriasis is a complex and not fully examined disease.A qualified doctor must be carried out by treatment.Remember that no miraculous methods that have been praised on the Internet help you to get rid of psoriasis yourself.
The same applies to folk medicine - all of its methods will only benefit in combination with basic legal remedies that the doctor present has prescribed.
Therefore, we can come to the conclusion that the patient should only use the methods that he agreed with his lawyer and should observe all of his recommendations.This is the only way to achieve good success in the treatment and an extended remission of psoriasis.