For centuries, humanity has tried to uncover all the secrets of this mysterious skin disease, but much remains unknown. According to statistics, psoriasis affects 4 to 7 percent of the population, and both men and women are equally susceptible to the disease. Usually, the first signs of psoriasis appear during puberty and can accompany a person throughout life, sometimes gradually decreasing and disappearing, sometimes gaining strength.
Causes and risk factors for psoriasis
Psoriasisis a long-term inflammatory process of the skin, considered an autoimmune disease (involving an allergic reaction to its tissues). This is a chronic skin disease that affects the cells in the outer layer of the epidermis. This condition often appears as red, silvery scaly skin on the feet, knees, back, chest, etc. v. In most cases, psoriasis starts in small patches of skin, which can then spread to large areas of the body. There are many causes and risk factors that can contribute to the development of this disease and there are several hypotheses that explain its occurrence.
Autoimmune causes
Some studies show that psoriasis may be caused by a combination of genetic and environmental factors such as infection, trauma, stress, and certain medications. These factors can trigger a response from the immune system, which begins to fight against the body's tissues, including the skin.
However, the underlying processes of psoriasis are still not fully understood. It is important to note that psoriasis is a diverse disease that presents differently in each patient. Research into psoriasis mechanisms can help develop more effective treatments, reduce the risk of complications, and improve patients' quality of life.
Effects of metabolism
Metabolic disorders significantly affect skin condition and immunity in psoriasis patients. Increased metabolism leads to the formation of toxins and free radicals, which contribute to the inflammatory response. There are imbalances in various metabolic processes.
- With disorders of protein metabolism in psoriasis patients, the albumin content in the blood decreases and the globulin content increases, increasing their sensitivity.
- During fat metabolism, an increase in lipid and cholesterol content in the blood is observed.
- Reducing calories and eating plant foods may reduce psoriasis activity.
- Disorders almost always occur in carbohydrate metabolism.
- The metabolism of vitamins and minerals is also impaired, manifested by a decrease in the content of vitamins C, A, B6, B12, iron, copper and zinc in the blood but an increase in vitamin C content.
Infectious causes
This theory was widely popularized in the last century. It is believed that psoriasis may be caused by certain bacteria (streptococci), fungi and viruses, but these hypotheses have not been scientifically confirmed. However, dermatologists point out that any acute or chronic infectious process can cause psoriasis to recur. Special attention was paid to the virus theory. Recent research shows that RNA viruses, such as HIV and other retroviruses, can affect the genetic machinery and cause the appearance of genes that predispose to the development of psoriasis.
Genetic predisposition
Inherited predisposition to autoimmune reactions is a risk factor for psoriasis. If a person's relatives have this disease, the likelihood of developing the disease increases. Several genes may be involved in psoriasis, including the PSORS1-PSORS9 complex, in which PSORS1 is thought to be specifically active. It contains the genes HLA-C, HLA-Cw6, CCHCR1 and CDSN, which may contribute to the development of the disease. Genes influence metabolism, immunity, and the development of autoimmune processes. However, the presence of these genes does not mean that a person will necessarily develop psoriasis. The development of the disease can be caused by other factors.
Neurological causes
Excessive stress on the nervous system, prolonged stress and imbalance in the autonomic nervous system, the system that supplies nerves to blood vessels and internal organs, may be risk factors for developingdevelop psoriasis. These factors can cause imbalances in the endocrine system, changes in metabolism and immune response disorders, increased irritability or depression, constant fatigue, drowsiness and lethargy. Oh, that can lead to psoriasis.
Endocrine
Endocrine disorders that occur with psoriasis are quite common and can have a significant impact on the development of the disease. However, the link between them and psoriasis is not completely clear and has not been proven. Experts believe that psoriasis patients often suffer from thyroid, pituitary and adrenal dysfunction. Women may have problems with their menstrual cycles and men may have problems with sexual function.
Symptoms and characteristics of psoriasis
Psoriasis not only manifests itself in skin rashes but also in other symptoms. It often begins in childhood or adolescence and is associated with hormonal disorders, vegetative dystonia, and stress.
The first signs areTiredAndmood changes. The main symptom is small pink bumps on the skin called papules, covered with white scales. The papules are surrounded by a brighter rim.
Over time, elements of the rash can combine into large, irregularly shaped patches. The base of each papule isinflammatory infiltrate. The following types of rashes are distinguished:
- determined (diameter not more than 1 mm);
- teardrop shape – (droplet papules up to 2 mm in size);
- coin-shaped – (round papular coin up to 5 mm in size).
The rash also has its own characteristics:
- stearic stains - if you scrape the surface of the papule;
- terminal membrane - after cleaning the papules from the scales, you can see a transparent membrane;
- bloody dew (Auspitz phenomenon) – if the integrity of the membrane is damaged, small drops of blood may appear.
Is psoriasis contagious?
Many people believe that psoriasis is contagious, which is why they try to avoid contact with people who have the disease. This can make the patient want to stay away from others and lead to serious psychological problems. However, studies have shown that psoriasis is not transmitted through contact with patients. If all family members suffer from this disease, this only indicates the presence of a genetic factor in the development of pathology.
Classification and stages of development of psoriasis
Currently, there are three main stages in the development of psoriasis:
- A progressive stage, characterized by the continuous formation of new skin rashes, accompanied by intense itching.
- Stationary phase, at which new formations stop appearing and existing formations begin to heal.
- A regressive phase in which borders appear around the rash and the affected skin becomes darker as pigmentation increases.
In addition, there are several degrees of severity of pathology:
- Mild severity, when no more than 3% of the skin surface is affected.
- Moderate severity, characterized by 3-10% skin damage.
- Severity, in which the disease affects more than 10%.
Types of psoriasis
Psoriasisis a chronic skin disease that can manifest in many different ways. The rashes, their location, and their damage to other systems and organs may vary. Depending on these characteristics, different forms of psoriasis are distinguished.
Simple (vulgar, plaque)
Plaque psoriasis is the most common form of the disease. Its symptoms include the appearance of bright pink papules covered with white scales.
Elbow psoriasis
This is a typical manifestation of mild plaque psoriasis. A characteristic feature of elbow psoriasis is the presence of one or more permanent "duty" plaques on the extensor surface of the elbow joint. If these elements come into contact with trauma, exacerbation will occur.
Guttate psoriasis
Associated with bacterial (most commonly streptococcal) and viral infections, this type of psoriasis can cause inflammation. This condition usually occurs in children and begins with the appearance of small, red, teardrop-shaped papules on the skin of the limbs, body or face. The papules have a scaly surface and can develop into erosions and ulcers, increasing the risk of infection.
The condition may develop rapidly or gradually become chronic, followed by periods of exacerbation and gradual decrease in symptoms. In rare cases, psoriasis can become more severe.
palm psoriasis
This type of psoriasis often develops in manual workers and is often accompanied by intense itching and can lead to complications on the nails. Some subtypes of this type of psoriasis include:
- Fan-shaped plaques: large white scaly lesions on the palmar and soleal surfaces that merge into fan-shaped plaques. This subtype is often found on the hands.
- Circular: ring-shaped scaly sections on the surface of the palms and soles of the feet.
- Callosal: growth of rough epithelium with callus formation.
- Pustules: This is a specific form of Barber's psoriasis on the palms and soles of the feet. In the areas below the big toe, blisters and pustules appear, causing intense itching. The ulcers fuse, then dry and form a crust. Elements characteristic of psoriasis also appear in other parts of the body.
Leg psoriasis can be associated with varicose veins and manifests primarily on the lower legs.
Nail psoriasis
It can occur as a separate disease or as a complication of another type of psoriasis. The main symptom is small indentations on the nail plate, of varying depth. These dimples are often more noticeable and painful when pressed than other types of dermatitis. Additionally, symptoms include nails falling off on their own, bleeding under the nails (especially when wearing tight shoes), and changes in the color and surface of the nails, such as trachyonychia and koilonychia.
Scalp psoriasis
It can manifest itself as an independent disease or as part of a general pathological process. One of the characteristic features is weeping and the formation of scales on part or all of the head surface. In this case, hair growth is not impaired because the function of the hair roots is not impaired. However, wetting creates a risk of infection, which can lead to damage to hair follicles.
Seborrheic psoriasis
It occurs due to disruption of skin glands that secrete viscous sebum, which irritates the skin and promotes inflammation – dermatitis. This condition quickly spreads to the entire head, covering it in the form of a cap and is accompanied by severe itching. In the areas behind the ears, there is sometimes weeping and infection can develop. The scalp is covered with dandruff and scales that can look like psoriasis.
Psoriasis on the face
Usually appears in the nose triangle, eyelids, above the eyebrows and behind the ears. The rashes can coalesce, forming large areas of redness and swelling. If the function of the sebaceous glands is impaired, this process can be accompanied by lacrimation, crust formation and increased risk of infection.
Psoriasis in the genitals
Psoriasis affecting the genitals is a concurrent process, often accompanied by characteristic psoriatic rashes all over the body, making diagnosis easier.
Psoriasis on the penis in men, labia majora in women and surrounding skin areas are oval shaped, slightly raised above the skin surface. They are pink and peeling. It is practically not accompanied by itching. Sometimes the damaging process spreads to the mucous membrane and can take the form of vulvitis in women and balanoposthitis in men.
In obese people, atypical psoriatic rashes can be observed in folds located near the genitals (groin, interstitial). In these areas, dark red areas appear, have a mirror-like surface and do not peel off due to constant wetting.
Why is psoriasis dangerous?
Psoriasis can become very severe when the rash covers more than 10% of the skin. This condition is difficult to treat and easily recurs. The rash can become wet and susceptible to infection. Only timely and effective psoriasis treatment can prevent the spread of the disease.
In some cases, psoriasis can be complicated by arthritis and the development of psoriatic polyarthritis, which can lead to joint dysfunction. In addition, the systemic autoimmune process caused by psoriasis can lead to the development of other autoimmune diseases, serious cardiovascular and gastrointestinal pathologies, and neurological reactions.
Ignoring timely psoriasis treatment can lead to complications, such as erythrodermic psoriasis, which can occur due to improper psoriasis treatment or exposure to irritants. different on the skin. With psoriatic rosacea, the skin becomes dark pink with a clear distinction between the affected and healthy areas, as well as small and large peeling. This condition requires urgent medical attention.
Complications of psoriasis
Failure to promptly and adequately treat psoriasis can seriously damage the body's vital organs and systems, such as the joints, heart, kidneys, and nervous system. These consequences can lead to disability or even death.
Diagnose
Usually, the diagnosis of psoriasis is made based on the typical symptoms of skin lesions and their location. In some complicated cases, additional tests may be required to rule out other skin diseases.
Lab tests may include:
- Complete blood count, which can detect leukocytosis and anemia in psoriasis.
- Rheumatoid factor (RF) is a protein whose levels may be elevated in systemic inflammatory diseases involving joint damage, but in psoriasis its levels are usually normal.
- The erythrocyte sedimentation rate (ESR) is also usually normal, except in pustular psoriasis and psoriasis erythema.
- Uric acid levels can be elevated in psoriasis, which can lead to confusion with gout.
- Antibodies against the human immunodeficiency virus (HIV) can be detected when psoriasis has a sudden onset.
Other tests, such as joint X-rays and skin biopsies, may be used in more complex cases to assess the severity of joint damage and distinguish psoriasis from other diseases. other skin.
Treatment
Treating psoriasis requires a comprehensive approach, including topical treatment of skin lesions, medications, light therapy, and preventing exposure to aggravating factors. The choice of treatment depends on the type and severity of psoriasis. Treatment may include:
- external preparations (external ointments, kerosene, paraffin, vegetable oils and creams with anti-inflammatory effect, the amount depends on the nature of the lesion and is used daily);
- lotions and shampoos based on salicylic acid, as well as photosensitizers;
- oral medications (retinoids, vitamin D preparations and others);
- physiotherapy procedures;
- Bathing daily with bath oils, oatmeal or sea salt can help soften the skin and reduce inflammation that occurs with psoriasis. It's important to avoid hot water and scrubs, and use moisturizer after showering;
- light therapy, which involves exposing the skin to ultraviolet light, may also be helpful (avoiding burns);
- photochemotherapy with midwave radiation;
- compliance with special diets and general regimes.
When developing a treatment program, the patient's gender and age, the presence of comorbidities, general health and the impact of external factors are taken into account. Sometimes, to cure it, it is enough to change your lifestyle, and in other cases, several courses of treatment are prescribed.
In addition to traditional methods, psoriasis treatment may include the use of modern laser technologies. Laser therapy can reduce symptoms of the condition, achieve long-term remission, and relieve patients from bothersome rashes and related problems. The special feature of laser therapy is that a special excimer laser only affects the affected skin area without affecting healthy skin areas, ensuring quick recovery without side effects. Laser therapy is safe and painless, requires no preparation and can be used regularly so patients can live without restrictions.
Treatment effectiveness depends on many factors, including genetic factors, provoking factors, disease stage and specific nature of the lesion, so you should first consult a specialist and prescribePrescribe treatment options based on clinical recommendations.
Prevent
Psoriasis is a disease that can be successfully treated if you consult a doctor in time and receive qualified help. In the simple form of psoriasis, the patient can work without any restrictions, except for work in chemical plants, where workplace accommodation can be dangerous.
However, psoriasis can cause complications, such as psoriatic arthritis, which can limit work performance and lead to disability.
Psoriasis prevention is an important part of treatment. After recovery, patients need to review their lifestyle, quit bad habits, take care and treat other chronic diseases, monitor their diet and increase physical activity, and spend more time outdoors. and play sports.
Nutrition for psoriasis
Diet for psoriasis is not strict, but proper nutrition plays an important role in the complex treatment process. When making nutritional recommendations, patients should:
- Avoid foods that your body is hypersensitive to and eliminate them from your diet.
- Prefer fresh fruits, vegetables, berries, grilled or boiled lean meat and drink more.
- Avoid the following foods: onions, garlic, radishes, strong tea, coffee, alcohol, sweets, salty and sour foods, as well as foods that can cause allergies such as orange fruits, honey, nuts, cocoa and eggs.
- Avoid fatty foods of animal origin.