Psoriasis is one of the most common skin diseases, with one in every hundred people.
Psoriasis is a progressive disease in which there are several important factors at the same time: from genetic factors (psoriasis in a relative) to dysfunction of the nervous system, the endocrine system, the immune system. translation and other factors.
The reasons
The causes of psoriasis are not fully understood.
The principle of the mechanism of the disease is to disrupt the division of skin cells, thereby causing an autoimmune response (an autoimmune response - which occurs inside the body, regardless of external threats). .
The top layer of the skin (epidermis) is composed mainly of keratinocytes - the cells that make the keratin. Keratin is a protein whose properties enable it to carry out the protective functions of the skin. The keratinocytes are formed in the deep layers of the epidermis and slowly move up to its surface, and during migration they mature and acquire new properties.
At the end of the "maturation" process, keratinocytes form a layer of keratin on the surface of the skin. Then the keratinocytes die and peel off the living cell, so the keratinocyte's path of life ceases. This ensures a continuous skin renewal process.
The normal pathway of the keratinocytes from the deep layer to the surface takes a month. With psoriasis, their lifespan is reduced to a few days, which leads to the appearance of scaly psoriasis, since the skin does not have time to remove keratinized cells.
When they appear, psoriatic plaques are often accompanied by itching and redness. This shows an autoimmune response in the deep layers of the skin, leading to swelling of the thick layer of skin (dermis). The dermis contains blood and lymphatic vessels.
It is not clear why the keratinocyte is accelerated, but it is known that genetic predisposition plays an important role.
The development of common psoriasis can begin due to:
- trauma and constant stress;
- skin damage;
- transferable infectious diseases;
- are taking some medications;
- Hormonal disorder;
- allergic reactions (typical allergens: citrus fruits, eggs, chocolate);
- drunk;
- the change of the climate.
Triangular psoriasis is a characteristic symptom of the disease that occurs when the skin is scratched.
Stearin stains(increased flaking after scraping, making the surface of the papules resemble a drop of crushed stearin).
Thermal film(appears after the complete removal of the scale of the wet, thin, shiny, matte surface).
Bleeding determined(blood droplets do not mix together).
What happens to the skin during psoriasis?
In psoriasis, the structure of the skin is disturbed, the epidermis becomes thinner, the keratinization process (accumulation of the protein keratin) is disrupted, and some layers of the normal epidermis disappear. At the next stage of the disease, inflamed clusters of cells are found in the stratum corneum that protects the surface of the epidermis and in the parakeratosis, around the skin's dilating vessels.
Typical patches and scales appear on the skin's surface.
Psoriasis is not just an ordinary disease, it has many manifestations, it can even disguise itself as other illnesses.
Localized sites of psoriasis:
- elbows and knees;
- sacrum and lobe;
- scalp (seborrheic psoriasis);
- fold and fold surfaces of the skin: inner surfaces of elbow and knee joints, groin and armpits, under breasts (inverted psoriasis);
- the palms and surfaces of the feet (palm-plantar psoriasis);
- psoriasis of the nail plates.
Common symptoms of psoriasis
The main symptoms of psoriasis are:
- psoriatic plaques;
- affected skin tightness;
- itching.
Symptoms according to the type of psoriasis:
- exudative psoriasis (affected skin flakes off and wet, a yellow scaly layer forms on the surface of the rash);
- alternating psoriasis (more common in children, erythematous, mild peeling, sometimes wet, diaper rash can be mistaken for diaper rash);
- old psoriasis (it is characterized by large plaques that do not go away for a long time);
- ruptured psoriasis (another form of chronic psoriasis, characterized by a conical plaque);
- guttate psoriasis (a rash of many small papules).
Types of psoriasis
- Common psoriasis (profanity, plaque);
- Whole (widespread, posterior) psoriasis;
- Droplet-shaped psoriasis (in the form of a rash);
- Psoriasis (with joint damage);
- Other types of psoriasis (seborrhea and others).
Psoriasis vulgaris is the most common form of the disease.
Psoriasis begins with the appearance of rashes, usually of a small number, in typical locations: in the elbows and knees. In addition, the characteristic localization of the rash is the scalp and trunk area. Usually there is a clear relationship between the appearance of the rash and the action of the provoking factor.
Triggers for psoriasis can be stress, skin trauma, recent infectious diseases and frequent alcohol use.
Usually, the exacerbation of the disease occurs in the cold season - this is the winter psoriasis. The rarer summer type. Mixed forms of psoriasis have now been reported. Over time, the number of rashes increases. They form characteristic psoriatic plaques. The Kebner phenomenon is observed - the appearance of new plaques in places where the skin is injured. As a rule, the patient has plaques that remain on the skin even in the absence of an exacerbation.
The disease progresses in cycles:
- Progressive stage (increase in the number of rashes);
- Static stage (new rash does not appear);
- Degradation stage (regression of a rash, the appearance in the place of areas of skin that are not pigmented)
Psoriasis vulgaris, photo
Diagnose
When diagnosing psoriasis, it is necessary first of all, a detailed examination of the skin.
Thin skin, bleeding in many places, loose patches are signs of psoriasis. In the presence of these symptoms, the doctor conducts some diagnostic measures to rule out the presence of other events with similar manifestations. For final diagnosis, blood tests, smear and skin biopsy are performed as needed. If joints are affected, magnetic resonance imaging (MRI) is ordered and X-rays are taken to identify the lesions.
Psoriasis vulgaris, treatment
Psoriasis is a systemic disease with skin manifestations, requiring complex treatment: local and systemic therapy. The disease is chronic and the treatment is aimed at reducing the number and severity of exacerbations and achieving a tolerable skin condition.
During the progressive stage of psoriasis, all active processes are canceled: ultraviolet irradiation, bathing.
Diet for psoriasis
Psoriasis is often associated with liver disease, so stay away from alcohol, fatty foods, fried foods, and smoked products. It is equally important to eat a moderate amount of carbohydrates, as this alters the pH of the skin and increases the risk of a rash infection.
Preventive
Prevention of psoriasis is maintaining a healthy lifestyle. This helps to prevent the occurrence of other diseases, as the body's immune system is protected from stress and can resist external threats.
Measures to prevent psoriasis include:
- proper skin care;
- Relaxing massage to improve blood circulation;
- proper nutrition, hypoallergenic foods should be avoided and foods that are spicy, fatty, pickled, smoked or salty should be avoided (restricted), as well as citrus fruits;
- a dairy-vegetable diet;
- adequate amount of moisture in the body;
- eliminating alcohol and tobacco and other bad habits;
- increase physical activity;
- walking outdoors;
- avoid stressful situations;
- taking vitamins of groups A, B, C, D, E;
- Choose loose clothing made of natural materials that won't stain and irritate.
Means for the treatment of psoriasis
Systemic therapy for psoriasis aims to reduce the proliferation of the skin epithelium, stabilize the keratinization of skin cells and cell membranes. For this, preparations based on vitamin A (retinoids), cytostatics are used. Among the most modern treatments, the so-called biology is used to neutralize inflammatory substances.
For many years, UFOs have been used - treatment with group B ultraviolet rays (in the tanning beds, group A rays), to reduce inflammation and contribute to the death of altered cells. PUVA therapy is the simultaneous use of ultraviolet radiation and a special substance that increases the skin's sensitivity to it.
An effective remedy for psoriasis
Local treatment is no less important than systemic treatment. It helps to reduce skin inflammation. The drugs are prescribed depending on the stage of psoriasis.
Progressive stage
- exfoliating ointments and creams;
- anti-inflammatory hormonal ointment with calcitriol;
- emollients to relieve itching and dryness of the skin.
Stationary stage
- UVB therapy;
- a concentrated exfoliating ointment;
- emollients to restore skin and reduce dryness.
Depression period
- a concentrated exfoliating ointment;
- emollients to restore skin and reduce dryness.
Psoriasis cream
Creams and ointments for psoriasis have different purposes and are used at different stages of the disease. Hormonal anti-inflammatory ointments and creams are used to prevent inflammatory processes on the skin. There are several hormonal drugs. They have different absorption capacity and act differently. When using it on children, they try to avoid applying hormonal drugs on the face and neck, the areas where the skin folds - where the skin is thinner. Topical preparations based on calcipotriol (a vitamin D derivative) also have an anti-inflammatory effect. This is a later generation of drugs. They are not currently used during pregnancy and lactation.
Salicylic ointments and lotions containing salicylic acid are designed to remove severe flaky skin flakes. Salicylic acid not only exfoliates but also increases the effectiveness of topical endocrine drugs. In the sedentary and regressive phase, when the inflammation becomes less active, agents based on salicylic acid are used at higher concentrations.
Methods of restoring the skin's structure and eliminating dryness are used throughout the entire treatment period, as well as in combination with ultraviolet irradiation to reduce itchiness. When flare-ups subside, these products help maintain skin's protective properties and reduce the risk of new blemishes.
An effective cream for psoriasis
Modern approach to the care and support of dry skin is based on the moisture saturation of the epidermis and is called corneal therapy (derived from "coro" - the horny layer, or horny layer of the epidermis. ).
Corneal therapy aims to restore the horny layer of the epidermis and its protective functions, helping to improve the general condition of the skin.
How does emollient work?
within 1 hour of applying emollients: - the condition of the skin improves, due to the fact that the emollient "locks" in moisture in it.
6 hours after the application of emollients: - the skin's structure is restored due to its special regenerating natural fat content (ceramides and other useful fats).
24 hours after the application of emollients: - a clinical improvement of the skin condition occurs due to the penetration of moisturizing ingredients into the deep layers of the epidermis and restoration of the superficial layers of the skin (upup to 24 hours from the start of use).