psoriasis

Psoriasis is a chronic, non-infectious autoimmune skin disease of unknown cause.The most common symptoms are peeling of the skin (including the scalp) and the appearance of rashes.Psoriasis can cause pathological changes in other organs: the nails, spine, joints and kidneys are most commonly affected.

The disease causes severe psychological discomfort in the patient;Due to defects in appearance, it becomes difficult for the person to adapt to the team and communicate with people.Severe forms of psoriasis can lead to disability.It is impossible to completely cure the pathology.However, with proper treatment, you can achieve stable remission and restore your previous quality of life.

What is Psoriasis?

The main symptom of the disease is the presence of psoriatic plaques - scaly pink spots of various sizes, accompanied by itching.Most often they are found on the scalp (they can also be present along the hairline, behind the ears), elbows and knees, and can also appear on the genitals, buttocks, lower back and other parts of the body.Sometimes plaques appear on old scars.The pink color of the rash is due to the vessels dilating in the affected areas.

Psoriasis occurs due to a malfunction of the immune system.In each layer of the epidermis (there are 5 in total - basal, spiny, granular, shiny and horny) there are keratinocytes (about 90% of them in the entire epidermis).Depending on which layer they are in, keratinocytes perform different functions (regeneration, synthesis of keratin or other proteins, prevention of skin drying, protection of the lower layers of the skin).

Keratinocytes are constantly renewed.Their synthesis occurs in the basal layer.Then they move higher, each time fulfilling a new function.Once they reach the stratum corneum, they lose their nucleus and transform into corneocytes (peculiar sacs containing keratin).Now their function is barrier.After they have outlived their lives, corneocytes detach from the surface of the skin.Keratinocytes live for about 2-4 weeks and are then replaced by new ones.

In psoriasis, under the influence of a malfunction of the immune system, keratinocytes begin to divide much faster and their lifespan is shortened.Peeling occurs, accompanied by inflammation of the epidermis and dermis.

Psoriasis can occur in people of all ages (around 4% of the world's population suffers from it).However, the disease most commonly occurs in people under 20 and over 55 years of age.Fair-skinned people often suffer from psoriasis;In representatives of the Negroid race, pathology is detected much less often.

Causes of Psoriasis

The exact causes of psoriasis are not yet clear.However, most often there are two theories about the origin of this disease:

1. Hereditary disease – the tendency to develop psoriasis is thought to be inherited genetically.
2. A result of immune disorders caused by infections, poor lifestyle, climatic conditions and bad habits.

Reference!In 40% of patients suffering from this pathology, relatives also suffered from psoriasis.Close relatives of the patients also often developed a latent form of psoriasis, which manifested itself through changes in the structure of the capillaries.

Most often, emotional overload (in 50% of cases), focal infections, metabolic disorders, diabetes mellitus, liver diseases and taking certain medications (most often glucocorticosteroids, beta-blockers, lithium salts) are the “impetus” to the development of psoriasis.

There are other factors that “trigger” the disease or provoke its exacerbation:

• Injuries, fractures.
• Frostbite.
• Sunburn.
• Tobacco smoking.
• Alcohol abuse.
• Obesity.
• Chemical damage to the skin.
• Food allergies.
• Parasitic infestation.
• Pregnancy and birth.
• Other skin diseases - eczema, dermatitis.

Reference!It is absolutely known that psoriasis is not contagious.The development of pathology in people whose close relatives suffer from this disease is explained by a genetic predisposition.Psoriasis is not transmitted from person to person.

Types and stages of psoriasis

There are many forms of psoriasis, but some are the most common:

1. Common psoriasisdevelops most often.It is characterized by itchy plaques with a scaly surface on the skin.In addition, with this form, discoloration of the nails and the appearance of small white spots on them are often observed.In some cases (in advanced stages) the nails detach from the nail bed.
2. Guttate psoriasismanifests itself as a small rash localized mainly on the chest and back.The rash is accompanied by itching on the affected skin areas.Usually the symptoms of the disease disappear after 4-6 months and do not recur.However, the patient may later develop another form of psoriasis.This happens about half of the time.Guttate psoriasis usually occurs in children and adolescents.It often occurs as a result of an infection, most commonly a bacterial infection of the throat.
3. Reversible psoriasisIf a patient responds well to treatment, it is sometimes possible to achieve stable remission without relapses.Red, weeping plaques only appear in some parts of the body, in the folds, and do not spread further.Typically, rashes appear in the groin or under the mammary glands, including in the armpits.Reversible psoriasis most often develops in older patients.
4. Pustular psoriasisis a severe and dangerous form.In some cases it develops quickly and suddenly.It is characterized by the appearance of blisters with purulent contents on the soles of the feet and palms, then the affected skin thickens and begins to actively peel off.The rash later spreads over a large area.In advanced cases, the skin of the entire body can be affected.Pustular psoriasis can be life-threatening for the patient.Mainly affects adults.

Psoriasis develops in 3 stages:

1. Progressive.
2. Stationary.
3. Regressive.

Progressive phasecharacterized by the appearance of multiple nodular rashes and their spread to new areas of the body.The plaques gradually increase in size.

In the stationary stagethe appearance of skin rashes stops.The existing plaques no longer increase, but active peeling begins on the entire affected surface.

In a declining phasePlaques become denser, their elements dissolve, peeling decreases.Then pigmentless spots remain at the site of the rash.

Reference! Psoriasis can also be classified according to seasonality: there are summer and winter forms, according to the development of exacerbations.Most often, relapses still occur more often in the autumn-winter period than in the spring-summer period.

Symptoms of psoriasis

Symptoms of psoriasis are:

• Pink rashes or white patches covered in scales.
• Itching in the affected areas.
• Vascular changes.
• Signs of inflammation in the affected tissue.
• Deterioration in the appearance and condition of nails.

Reference!About 1 in 10 patients develop arthritis as a result of psoriasis.Therefore, it is necessary to start treatment as early as possible to prevent the development of complications.

diagnosis

Psoriasis has a very characteristic clinical picture, so diagnosis is usually not difficult.When scraping the papules (plaques), 3 main phenomena are observed:

1. Stearin spot - with light scratching, the peeling increases and the rash resembles a crushed drop of stearin.
2. Terminal film – when you remove the scales from the surface of the plaque, it has a shiny, moist surface.
3. Bloody dew – if you scratch the terminal foil, dot-shaped drops of blood form on it.

In some cases, a piece of dead skin is removed for analysis for differential diagnosis.

Treatment of psoriasis

The main goal of medical measures is not to cure the patient (since this is impossible), but to achieve stable remission.Comprehensive treatment is carried out, the plan of which is developed in accordance with the course of the disease of a particular person.It includes:

• Local drug therapy – ointments, creams, shampoos, aerosols, lotions.
• General drug therapy – injections of antihistamines, sedatives, vitamins, treatment with immunosuppressants, cytostatics, retinoids, corticosteroid hormones.
• Maintenance therapy – the patient is prescribed UV irradiation along with taking a dermatotropic agent.
• The use of detoxification methods – the appointment of immunomodulators, blood purification procedures.
• In some cases, taking non-steroidal anti-inflammatory drugs.

If comorbidities are diagnosed, these are also treated.

Lifestyle with psoriasis

The patient must expect that the treatment of the disease will last a lifetime.The duration of remission depends on this in many ways.It is important to give up bad habits (smoking, drinking alcohol).It is also necessary to follow a diet.Exclude from the diet citrus fruits, whole milk, chocolate, honey, eggs, foods with red dye (strawberries, watermelon) and other foods that can cause allergic reactions.It is also advisable to avoid spicy, fatty, fried, smoked foods, as well as rich meat and fish broths.Condiments are excluded: ketchup, mayonnaise, mustard, etc. You should limit your intake of sugar and salt.You should pay attention to products that contain fiber, omega acids, vitamins A, E, C, group B, as well as zinc and calcium.

The following simple measures will help alleviate the condition:

• Refusal to stay in the water for a long time – you should swim and bathe less often, it is recommended to take short showers.
• Hard washcloths should be replaced with a soft sponge or cotton cloth and regular soap with a pH-neutral product.
• After showering, you should not wipe your skin, but dab it with a towel - this will avoid damaging the plaques and increasing itching.
• After water treatments, the skin must be moisturized with cream.
• It is necessary to give preference to roomy, light clothing made from soft natural fabrics, as the pressure of clothing on the skin can provoke the appearance of new rashes.
• The itching often forces the patient to scratch, which can lead to injury to the skin - to avoid new damage, it is better to cut the nails short.
• Drying out the skin should be avoided, so avoiding air conditioning is just as beneficial as humidifying the air in the room.
• Although sunbathing can be helpful for psoriasis, excessive exposure to ultraviolet light can worsen the disease - you should consult your doctor about your sunbathing.
• Any risk of skin irritation should be avoided.
• Cuts and wounds can lead to new rashes, so you need to protect yourself from them.
• Stress is a common trigger for exacerbation of the disease, so it is necessary to avoid traumatic situations if possible.
• It is necessary to avoid physical inactivity (inactivity) - moderate physical activity benefits the condition of the entire organism.

If you feel worse, you should see a doctor immediately to prevent the disease from progressing to a more serious stage or complications from occurring.