All about psoriasis - treatment, causes and symptoms, types

For more than two thousand years, mankind has been trying to solve all the questions of this serious dermatological disease, but much remains unknown. According to statistics, this disease affects between 4 and 7% of the population, women and men are equally susceptible. The first signs of psoriasis usually appear at puberty and accompany the patient for the rest of his life, then gradually decrease and disappear completely, then gradually increase.

Can psoriasis be cured?Modern medicine has achieved a lot in the treatment of this chronic dermatological disease and can give patients a decent quality of life.

Causes of Psoriasis

Psoriasis is a chronic inflammatory skin disease, which modern medicine calls an autoimmune disease (involving an allergy to one's own tissues). There are many causes of psoriasis and the factors that lead to the development of this dermatological disease, related to which several theories about its origin have been put forward.

Autoimmunity

This is the main theory, since the immune system responds positively to certain types of skin contact. The skin of people with psoriasis is very sensitive to mechanical, physical, and chemical influences. Not only do epithelial cells respond to such influences, but the entire immune system.

Impaired cellular immunity: the ratio between the distinct lymphocyte subtypes responsible for the formation of a normal immune response. So, in psoriasis, the number of helper T lymphocytes increases - those that help regulate immunity, while the number of human T lymphocytes suppresses, suppressing the immune response. too strong, reduced. Lymphocytes and some other cells produce cytokines - substances that stimulate an immune response. Humoral immunity is also affected, an imbalance of antibodies (immunoglobulins) in the serum develops, antibodies to the patient's tissues appear.

Inflammation is initiated against the background of T-lymphocyte activation, but the reason why they are activated remains undetermined. In the course of the study was also the question of how to suppress the autoimmune response without harming the patient.

Change

The imbalance in metabolism has a significant effect on the skin and immunity. In patients with psoriasis, there is an acceleration of metabolism, the appearance of a large amount of toxic free radicals and other toxins that support an inflammatory response. Disordered metabolism:

• rich in protein- the CDSN gene has a tendency to stimulate the synthesis of the protein corodesmosin, a sensitizer (allergen) to the body; the level of albumin proteins in the blood decreases and the content of globulins increases; this condition is called dysproteinemia and increases sensitivity;
• fat- the content of lipids and cholesterol in the blood increases; the use of mainly plant foods and reducing the calorie content of the daily diet can reduce the activity of psoriasis;
• carbohydrates- almost always violated;
• vitamin and mineral exchange- The content of vitamin C in the skin increases, the content of vitamins C, A, B6, B12, iron, copper and zinc in the blood decreases.

Infectious

This theory was relevant at the beginning and middle of the last century. Certain bacteria (streptococcal), fungi, and viruses are considered to be causative agents of psoriasis. These theories have not been confirmed. But dermatologists note that any acute infectious process or the presence of frequent foci of infection can cause recurrence. Virus theory occupies a special place. Recent studies have revealed the influence of retroviruses (RNA-containing viruses - HIV, etc. ) on the genetic machinery on the formation of psoriasis genes.

Genetic

The predisposition to autoimmune reactions is genetic. If a close relative of a person has psoriasis, the chance of developing the disease increases many times over. There are psoriasis susceptibility genes (the local complex PSORS1 - PSORS9, PSORS1 is particularly active, it contains the genes HLA-C, HLA-Cw6, CCHCR1 and CDSN, which are responsible for the development of the disease. ). Genes influence metabolism, immunity and the development of autoimmune processes. But the presence of such genes does not at all guarantee the development of the disease. The influence of provoking factors is of great importance.

Nerve

Prolonged stress, high nervous tension, disorders of the autonomic nervous system (formation of blood vessels and internal organs) can cause psoriasis, cause endocrine imbalance, impairedmetabolism and immunity.

Endocrine

Endocrine disturbances in psoriasis are common and mainly play the role of a trigger factor. A clear link between the two has yet to be proven. Dermatologists note, patients often have dysfunction of the thyroid gland, adrenal gland, and pituitary gland. There are menstrual abnormalities in women and sexual function in men.

Symptoms of Psoriasis

The main symptom of psoriasis is a rash on the skin. But there are other signs as well. The first manifestations usually appear in adolescence or early childhood against the background of hormonal disturbances, vegetative vascular dystonia, and prolonged stress.

The disease begins with a feeling of constant fatigue, unstable mood. Characterized by small, pink formations (papules) towering over the surface, powdery top-down with a white crust. They are surrounded by a brighter, towering rim.

The rash elements grow and combine into large patches of bizarre shape. The basis of the papule is an inflammatory infiltrate. According to the nature of the rash, psoriasis is divided into:

• point- elements with a diameter not exceeding 1 mm;
• tear- papules-droplets up to 2 mm;
• coin shape- round-coin papules up to 5 mm in size.

Characteristic features of the rash:

• stearin stain- if you scrape, the surface of the papules;
• terminal movie- Thoroughly clean the surface of papules from scabs, we will see a transparent film;
• blood mist (Auspitz phenomenon)- When scraping the membrane and violating its integrity, we will see small drops of blood protruding on the surface.

Stages of Psoriasis

There are three stages of the disease:

1. progressive- the first elements of the rash appear, their number increases, all new areas are captured; rash also occurs when scratching the itchy skin or coming into contact with some external irritant (Kebner phenomenon); in the initial stages of psoriasis, papules begin to coalesce into large patches;
2. freeze- there are no new elements and those that have appeared before do not regress;
3. recession- the rash turns pale, its base becomes less dense; initially regressive, usually starting in the central part, so the plaques can be ring-shaped; if the plaques in psoriasis dissolve from the periphery to the center, then they simply gradually decrease in size and form a white ring around them - Voronov's pseudo-rim; where the rash remains, areas of white, pigmented skin - psoriatic leukemia.

Sometimes papules appear on the skin at all three stages of development. There are also summer and winter forms with exacerbations predominating in summer or winter.

Is psoriasis contagious?

Many studies have confirmed this is not an infectious disease. If an infectious pathogen participates in its development, it is only through a common effect on metabolism, immunity and the genetic apparatus.

Patients often ask:

• How is psoriasis spread?

  Psoriasis is not contagious from person to person.

• Is psoriasis hereditary?

  The answer is negative again, but there is a genetic predisposition in the form of metabolic traits and immune system activity, which are passed on to close relatives.

Types of Psoriasis

The nature of the rashes, their location, and damage to other organs and systems in this chronic dermatosis can vary. According to these signs, several types of diseases are distinguished.

Simple (vulgar, plaque)

Most popular. Its symptoms are characteristic bright pink papules covered with white scales. Downstream, plaque psoriasis is divided into the following forms:

• easily- if the lesion covers no more than 3% of the skin; in the advanced stage, papules increase, but then they rapidly undergo an opposite growth;
• medium- rash accounts for 3 to 10%; large papules, coalescing into plaques;
• heavy- failure accounts for more than 10%; the rash is numerous, merging, forming many shapes.

Pustular psoriasis develops as recurrent episodes alternating with periods of remission but also intermittent episodes.

Psoriasis on the elbows

This is one of the symptoms of mild periodontitis. A distinctive feature of psoriasis on the elbow is the constant presence of one or more "duty" plaques on the extensor side of the elbow joint. If these elements are injured, an exacerbation begins.

Intestinal psoriasis

In the development of guttate psoriasis, bacterial (usually streptococcal) and viral infections are of great importance. Occurs during childhood. Inflammation begins after an infection. Streptococci secrete toxins (antigens - substances foreign to the human body) that bind to tissue proteins. Antibodies are made to them and autoimmune inflammation develops.

The beginning is acute. On the skin of the extremities (less often on the body and face), small red papules with a flaky surface appear. With wounds in the rash area, small erosions and sores formed, the risk of infection increases.

Psoriasis rapidly progresses into subacute and chronic phases. Relapse episodes are replaced by episodes of remission, which can either recover independently or progress to an adult form of disease.

Palmar-plantar psoriasis

It develops in manual workers, is accompanied by intense itching and almost always complicates the nails. There are subspecies:

• fan picture- with large particles on palm and woodland surfaces, covered with white scales, coalescing into fan-shaped patches; psoriasis on such hands is more common;
• round shape- circular flake particles on palm and plantation surfaces;
• horned- is characterized by the growth of the rough epithelium with the formation of cornices;

A separate subspecies is Barber's pustular psoriasis of the palms and soles. The area under the thumb has many blisters, pustules (with pus inside), appears intense itching. The abscesses coalesce, then dry, and crust over. Elsewhere on the body, characteristic psoriatic factors develop. The disease usually spreads down to the fingernails.

Psoriasis of the legs is sustained and aggravated by varicose veins, in which case the rash will be predominantly on the lower legs.

Nail psoriasis

Nail damage can be independent or a complication. Typical symptoms:

• small indentations of different depths appear on the nail plate; Similar nail lesions are also found in other inflammatory skin diseases, but in psoriatic lesions they are deeper and slightly painful when pressed;
• painful spontaneous slow nail separation (onychomycosis);
• bleeding under the toenail, especially if the patient wears tight shoes;
• trachyonychia - lumps and irregularities on the nail plate; a depression is formed in the middle of the nail and the nail becomes like a spoon (koilonychia).

Sometimes the perioral roller is affected with the transition of the inflammation to other tissues (psoriatic paronychia).

Scalp psoriasis

Here, the disease progresses independently or as part of a general pathological process. Characterized by oozing, the formation of crusts on parts or over the entire surface of the head. Hair growth is not simultaneously affected: psoriasis on the head does not impair the function of the hair roots. But the oozing poses a threat of infection with further damage to the hair follicles.

It flows in waves, then subsides with the disappearance of the scabs, then becomes more severe and is accompanied by intense itching, often causing the patient to become neurotic.

Seborrheic Psoriasis

Seborrhea is a condition caused by a malfunction of the sebum-producing glands in the skin. Oil is produced, which irritates the skin and contributes to the development of dermatitis.

Seborrheic psoriasis quickly spreads to the entire head, covers in the form of a cap and is accompanied by intense itching. In the areas behind the ears, sometimes crying and infection. The head is covered with dandruff and the solid scales sometimes look like a crown of psoriasis.

Psoriasis on the face

Most often, psoriasis on the face is localized in the area of the triangle of the nose, eyelids, on the eyebrows, in the area behind the ears. The fused elements of the rash form large areas of redness and swelling. If there is dysfunction of the sebaceous glands, this process is often accompanied by crying, crusting and an increased risk of infection.

Psoriasis on the genitals

This is not an isolated process. Simultaneously with the defeat of the genitals are characteristic itchy rashes all over the body, so it is not difficult to recognize the disease.

Psoriasis on the penis in men and on the labia in women, as well as on the adjacent skin, manifests as oval papules, with pink scales slightly raised above the skin. There is practically no itch. Sometimes the process spreads to the mucous membranes and looks like vulvovaginitis in women and pouchitis in men.

An atypical psoriatic rash can be observed in obese people in the folds located next to the genitals (inguinal, interstitial). Here, areas of deep red with a mirror-like finish are formed with no signs of peeling due to constant wetting.

What is the danger of psoriasis and does it need to be treated?

The danger is that psoriasis can take place in a severe, widespread form, the rash will cover more than 10% of the area. This is a difficult, recurrent disease, the elements of the rash are injured and wet, and the infection is often combined. Only in the prescribed time psoriasis treatment can stop the process of its spread.

Sometimes the disease is complicated by inflammation in the joints with the formation of psoriatic arthritis, as a result of which joint function can be significantly impaired.

Against the background of a systemic autoimmune process, which significantly affects the patient's condition, other autoimmune diseases often develop (rheumatoid arthritis, certain types of joint diseases, Crohn's disease, etc. ), as well as severe cardiovascular disease, diseases of the digestive system, nervous reactions.

If psoriasis is not treated in time, the patient's condition will become worse and lead to disability.

There is also a complication such as rosacea psoriasis, which develops when the treatment of psoriasis is improper or insufficient, as well as when various irritants come into contact with inflamed areas of the skin. The skin acquires a bright pink color with clear demarcation of the affected areas from the healthy areas, peeling in large and small patches. Such a patient needs urgent medical attention.

Can psoriasis be treated?

Yes, and quite successfully, but full recovery cannot be guaranteed.

Treatments

Autoimmune inflammation requires individually selected complex therapy, lifestyle changes, nutrition and elimination of all bad habits. Modern medicine has suggested three basic principles for the successful treatment of psoriasis:

• strict adherence to the algorithms for the indicated therapy;
• regular monitoring of the effectiveness of therapy;
• timely adjustment of therapies indicated but not effective enough.

Nutrition for Psoriasis

There is no special diet for people with psoriasis, but nutrition is extremely important. Therefore, when prescribing a complex treatment, it is imperative to make nutritional recommendations:

• determine the increased sensitivity of the body to certain foods and exclude them from the diet;
• give preference to fresh vegetables, non-sour fruits and berries, boiled and grilled lean meat, drink more;
• what not to eat with psoriasis:
  1. products containing essential oils - onions, garlic, radish;
  2. caffeinated beverages (concentrated tea, coffee), alcohol;
  3. everything is more salty, sour and sweet, full of flavor;
  4. products that promote sensitization (allergies) of the body - orange fruit, honey, nuts, cocoa, eggs;
  5. Do not eat fatty animal products.

Pegano Diet for Psoriasis

This diet was developed by American physician John Pegano, but has not yet been officially recognized by medical professionals. The principle of formulating the Pegano diet for psoriasis is related to alkalizing the body by making the right dietary choices. According to this principle, all products are divided into:

• alkaline forming (two-thirds of the daily diet) - a mixture of fruits and berries without acidity and juices, vegetables (excluding substances that increase gas formation);
• acid-forming (one third of the diet) - meat, fish, dairy products, beans, peas, potatoes, cereals, sweets and cakes.

Patients are advised to drink mineral water without gas, drinking water up to 1. 5 liters per day, plus other liquids when intoxicated (juices, juices, etc. )

Drug treatment

Mild psoriasis is treated with topical medications. Severe and rapidly progressive forms of the disease are mainly treated in the hospital with the prescription of systemic (systemic) drugs.

External psoriasis treatment

The drug is selected by a dermatologist. For psoriatic psoriasis with dry spasmodic patches, ointments are suitable, if discharge develops (with seborrhea), then creams and medicinal solutions are used. To avoid an organism's resistance (resistance) to a certain drug, it is changed over time.

In the acute (advanced) stage, the following external therapy is performed:

• emollient agents - boric mineral oil, salicylic ointment 2%;
• effective non-hormonal ointments for psoriasis containing activated zinc pyrithionet; they prevent infection and have a cytostatic effect (prevent tissue proliferation);
• external agents containing the hormone glucocorticosteroids (GCS);
• a combined agent with calcipotriol (an analogue of vitamin D3) and the corticosteroid betamethasone; perfectly suppresses the inflammatory process.

External treatment of psoriasis in the stationary stage:

• ointment that dissolves scales (keratolytic) and has an anti-inflammatory effect - 5% naphthalan, boron-naphthalan, tar-naphthalan;
• corticosteroid drugs.

External treatment of psoriasis in the stage of resolution:

• the same keratolytic ointment, but in a higher concentration: 10% tar-naphthalan ointment;
• ointments based on analogues of vitamin D3 - within 6-8 weeks; suppresses the inflammatory and peeling process of the rash.

For the treatment of nail psoriasis, special varnishes are used to prevent the development of the pathological process. You should treat perioral dermatitis with a moisturizing gel.

Systemic treatment of psoriasis

• drugs that reduce inflammation and intoxication - calcium chloride, sodium thiosulfate, unitiol in the form of injections;
• tablets for psoriasis, blocking proliferative processes (replication of epithelial cells) - cytostatics that block the activity of the immune system, analogues of vitamin A, corticosteroid hormones;
• biologic agent containing a human monoclonal antibody of the class IgG, which acts on a number of inflammatory links by blocking the synthesis of cytokines; it is a very effective modern drug that is administered by injection;
• vitamins for psoriasis help restore the metabolism and keratinization of epithelial cells; Doctors prescribe vitamins A, E, D3, group B.

Folk remedies for psoriasis

Any treatment for psoriasis, including the use of folk remedies, can only be prescribed by a doctor. Self-treatment can lead to the opposite effect: the disease spreads.

As part of complex therapy, the following methods can be used:

• grease- industrial oil processing products; To prepare the ointment, you need to buy medical snake oil at the pharmacy; recipe: in 0. 5 kg of snake oil, add 50 g of honey and half a pack of baby cream; the procedures are carried out daily; in the pharmacy you can buy ready-made preparations based on solidol.
• baking salt- a folk remedy for psoriasis, helps to clear psoriasis, relieve itching; recipe for applying soda: take 60 g of soda, dissolve it in 0. 5 liters of water, soak a gauze cloth in the solution, fold several layers and apply to the lesion for 20 minutes; after the procedure, pat the skin dry and apply any emollient ointment on it; psoriasis treatment with soda is carried out once a day;
• Mummies- has a pronounced anti-inflammatory effect, reduces itching well, can be taken once a day, 0. 2 g for two weeks; external therapy is carried out with a solution of the mummy; it is applied to dry itchy patches twice a day; treatment of psoriasis on the head is carried out by rinsing the scalp with a solution of mummy after washing;
• sea salt- Reduce inflammation, reduce itching well; bath with sea salt: take 1 kg of salt, dilute it in two liters of water and put in the bath; take a shower for 15 minutes, then rinse the solution under a warm shower, blot with a towel and apply an emollient ointment; treat psoriasis with a bath no more than twice a week;
• clay- has a pronounced cleansing effect, absorbs toxins on its surface that are formed by inflammation and improper metabolism; helps to dry, remove scales and itching; you can take any clay, but it is better to buy green clay at the pharmacy; the piece of clay must be thoroughly dried, broken with a hammer, diluted with water and left to stand for several hours; put the resulting sheet clay on a napkin (up to 3 cm thick) and apply it to the inflamed nodules for three hours; to treat psoriasis with clay every day.

It is important: the treatment of psoriasis at home with folk remedies should be done carefully and strictly according to the doctor's prescription. Such treatment will help one patient, while in another it can cause exacerbations and rapid spread of inflammation. Therefore, if, against the background of therapy, the patient's condition worsens, it is necessary to stop immediately and consult a doctor.

Home treatment for psoriasis

When treating psoriasis at home, it's important to follow the recommendations of a healthy diet and lifestyle, rule out bad habits, and strictly follow all your skin doctor's prescriptions. willow.

How to cure psoriasis at home? Some patients try to cleanse themselves of toxins and poisons using all sorts of unconventional methods (enemas, etc. ). This can have the exact opposite result: the work of the gastrointestinal tract will be disrupted and a flare-up will begin. Modern medicine acknowledges cleansing the body in the form of proper nutrition and the elimination of bad habits.

It's important to follow all of your doctor's prescriptions and pay attention to how the prescribed therapy works. If it is not effective enough, the doctor will replace the treatment method, achieving the maximum treatment effect.