Psoriasis is a chronic inflammatory disease of the body, accompanied by damage mainly to the skin with the formation of erythematous spots and plaques with clear boundaries and silvery scales on the surface.
The course of this disease is characterized by periods of exacerbation and remission (reduction of symptomatic manifestations). Unfortunately, medical science has not yet determined the exact and reliable cause of psoriasis, but genetic factors have been well documented, which combined with triggering factors contribute to the onset of psoriasis. appearance of this disease. The link between the occurrence of psoriasis and the antigens of the HLA system has been revealed.
Between 1 and 5% of the world's population suffers from this very unpleasant disease, and people with fair skin are at a higher risk of developing psoriasis than black people.
The disease can manifest at any age, but the stages 20-30 years old and 50-60 years old are considered critical.
Important!Psoriasis is not contagious to others, but it is inconvenient for the patient, because the rashes that appear during the illness are not only cosmetic defects but are also accompanied by an unpleasant itchy feeling. . In addition, psoriatic arthritis may appear, which significantly worsens the patient's quality of life.
Most rashes are localized on the scalp, on the surfaces of the elbows and knees, in skin folds, and on the genitals. The fingernails, buttocks and the area around the eyebrows can often be affected. The nature and appearance of the rash depends on the type of psoriasis.
Causes of psoriasis
The nature of the appearance of psoriasis has not yet been revealed by medicine, some doctors talk about autoimmune causes. The second hypothesis explaining the occurrence of the disease is a disturbance in the normal process of maturation and division of skin cells. Genetics and stress are also considered causes.
Genetic predisposition to psoriasis, allergies and frequent disruption of the skin barrier function (strong friction, exposure to chemicals, effects of alcohol-containing products) can causethe disease becomes more serious.
For known causative agentsPsoriasis, relate to:
- Koebner phenomenon is the appearance of bright red rashes at the site of skin irritation during the acute phase of some dermatological diseases;
- Sunburn or other types of burns;
- HIV infection;
- Beta-hemolytic streptococcal infection, causing guttate psoriasis;
- Use of medications (especially beta blockers, lithium, angiotensin-converting enzyme inhibitors);
- Severe emotional stress;
- Alcohol consumption;
- Smoke;
- Fat;
- Hormonal imbalance, especially in women during menopause and pregnancy;
- Disorders in the digestive system.
The main cause of the development of the disease is skin cells growing and dividing too quickly and excessively combined with inflammation in the dermis. In other words, skin cells located in the lower layer of the epidermis begin to grow rapidly and put pressure on the cells located above. This process is accompanied by significant skin shedding and is called parakeratosis. It is believed that overstimulation of the immune system is the main cause of the appearance of this mechanism.
Symptoms and signs of psoriasis
Psoriasis-related rashes are asymptomatic or accompanied by itching. Typically, they are localized on the scalp, the extensor surfaces of the knees and elbows, the sacrum and buttocks (especially in the gluteal folds), and in the genital area. Fingernails and toenails, skin in the eyebrows, armpits and navel may be affected. The rashes can merge with the lesions and cover large anatomical areas and the skin areas between them. Depending on the type of psoriasis, the rash can have different external manifestations.
As a rule, the rashes are discrete and are represented by erythematous papules or plaques, covered with dense, silvery, shiny scales. The rash appears gradually. Remissions and exacerbations occur spontaneously or after exposure to provoking factors.
5-30% of patients developpsoriatic arthritis, can cause disability for the patient. This process can lead to joint destruction.
Important!Psoriasis does not threaten the patient's life, but it affects the patient's self-image. In addition to changing the patient's appearance, treating skin rashes and maintaining the cleanliness of clothes and bed sheets also require a large amount of time, which significantly reduces the patient's quality of life. core.
Types of psoriasis
- impolite(common or chronic plaque) psoriasis, in which the rash has the appearance of individual plaques covered with a silvery, flaky layer. Plaques can coalesce as the disease progresses. Among all types of psoriasis, this type of psoriasis is the most common and accounts for about 90%.
- Inverse psoriasisaccompanied by a rash that appears in the area of natural folds and may form cracks.
- Guttate psoriasisCharacterized by multiple skin rashes 0. 5-1. 5 cm in diameter, often forming after strep throat.
- palm psoriasismanifests as plaques on the palms and soles, which may coalesce.
- nail psoriasisaffects the nail plates in the form of sharp dents and grooves with discoloration and thickening of the nail. Nail changes caused by psoriasis often resemble changes caused by fungal infections.
- pustular psoriasisaccompanied by the formation of pustules on the palms of the hands, soles of the feet or may cause damage to one of the fingers. There can also be a general form.
- erythematous psoriasismanifested by the sudden or gradual appearance of red spots in patients with psoriasis plaques, when these plaques are mild or absent. Often appears due to improper treatment of vulgar psoriasis.
Methods of diagnosing psoriasis
When symptoms of psoriasis appear, patients should consult a dermatologist. He will perform an external examination of the affected skin areas and take a complete medical history.
Psoriasis has common characteristics similar to other dermatological diseases, especially in the first stages of manifestation. It is important to rule out the presence of fungal infections in the hands and nails. This type of seborrheic psoriasis requires special differential diagnosis to rule out seborrheic eczema, pityriasis rosea, and papular syphilis.
In case of active disease and large lesions in epidermal areas, visual analysis of scratches is used. During shaving, peeling intensifies. In place of the removed scales, a thin smooth film can be seen, which peels off under mechanical influence and reveals a surface wet with drops of blood.
Diagnosing psoriasis in most cases is not difficult, it is enough to examine the patient's skin. The doctor must exclude diagnostic errors and determine the presence of other diseases and other pathologies occurring against the background of psoriasis.
In rare cases, diagnosis requires a biopsy. If there are non-classical clinical signs, its necessity should be considered. The disease has mild, moderate and severe levels depending on the affected skin area. Damage to less than 10% of the skin corresponds to mild severity. There are more complex methods for assessing disease severity, but they are used in clinical trials.
Psoriasis treatment
There are a large number of factors that depend on the development of the disease and its various manifestations. Therefore, many psoriasis treatments have been developed. Often these approaches are combined, including both pharmacological and non-pharmacological interventions.
The treatment plan is outlined depending on the severity of the disease, the area of skin affected, and the severity of symptoms such as redness, itching, and peeling. Age and gender, stage of disease and general condition of the patient, presence of comorbidities are also taken into account because they can limit the choice of treatment.
Treatment of psoriasis should reduce clinical manifestations (rash and other symptoms), improve the patient's general condition and restore the ability to work.
When treating psoriasis, it is necessary to follow a proper diet and skin care regimen because there is a risk of liver damage. In such cases, it is recommended to reduce the amount of fatty foods in the patient's diet, give up alcohol, sweets (simple sugars) and starchy foods. In the diet, the emphasis should be on proteins: lean meat, fish, dairy products, vegetables and fruits. Be sure to pay attention to allergic reactions or intolerance to certain products.
To improve the patient's quality of life and get rid of this disease, it is necessary to use a comprehensive approach:
- Local treatment–Ointments and creams work well for peeling and itching in small areas where the disease is localized. Hormonal ointments, salicylic acid, retinoids, and moisturizers are especially effective in treating psoriasis on the face and hands.
- Treatment with medicationused as a complementary method to effectively treat psoriasis when ointments do not help. The drug reduces the inflammatory process, eliminates swelling and itching, and also prevents increased activity of skin cells. But it is worth noting that the drug has many side effects (increased fatigue, loss of appetite, high blood pressure). Therefore, it is very important to follow all the doctor's recommendations regarding the dosage of the drug.
- When psoriasis is localized on the head and neck, usetherapeutic shampoo: antifungal, tar, contains corticosteroids. Shampoo helps eliminate pathogens of pathological infections, removes scales, reduces itching and burning.
- Antihistamine injection treatmentPreventing severe itching, biological drugs have a good effect on the immune system.
Unfortunately, today there is no possibility of completely curing psoriasis. Any treatment for psoriasis is aimed at eliminating the signs of the disease in the long term and prolonging the period of remission. But treatment of psoriasis is necessary, even though the disease has a slow, chronic course, because prolonged lack of treatment can lead to the patient's disability.