Psoriasis

Psoriasis (scaly lichen) is a chronic non-infectious autoimmune skin disease of unknown origin.Its most common manifestations are peeling of the skin (including the scalp) and the appearance of a rash.Psoriasis can cause pathological changes in other organs: nails, spine, joints and kidneys are most often affected.

The disease causes severe psychological discomfort for the patient;Due to defects in appearance, people have difficulty adapting to groups and communicating with people.Severe forms of psoriasis can lead to disability.The disease cannot be completely cured.However, appropriate treatment allows you to 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 - peeling pink spots of various sizes, accompanied by itching.Usually they are located on the scalp (they can also appear along the hairline, behind the ears), elbows, knees and can also appear on the genitals, buttocks, lower back and other parts of the body.Sometimes plaque appears on old scars.The pink color of the rash is due to dilated blood vessels in the affected area.

Psoriasis develops due to malfunction of the immune system.In each layer of the epidermis (there are a total of 5 layers - basal, spinous, granular, lucid and horny) there are keratinocytes (about 90% of them are in the entire epidermis).Depending on which layer they are located, keratinocytes perform different functions (regeneration, synthesis of keratin or other proteins, preventing skin dehydration, protecting the lower layers of the skin).

Keratinocytes are constantly renewed.Their synthesis occurs in the basic layer.Then they move higher, where each time they perform a new function.When they reach the stratum corneum, they lose their nucleus and turn into keratinocytes (special sacs containing keratin).Now their function is as barrier.Having lived longer, keratin cells will peel off the surface of the skin.Keratinocytes live for about 2-4 weeks, then are replaced by new cells.

With psoriasis, under the influence of a malfunction of the immune system, keratinocytes begin to divide much faster and their lifespan is reduced.Skin peeling occurs, accompanied by inflammation of the epidermis and dermis.

Psoriasis can develop in people of any age (in total, about 4% of the world's population has the disease).However, the disease most often occurs in people under 20 years old and over 55 years old.People with fair skin often suffer from psoriasis;Among representatives of the Negroid race, pathology is detected less often.

Causes of psoriasis

The exact cause of psoriasis remains unknown.However, the most popular are 2 hypotheses about the origin of this disease:

1. Genetic disease – the tendency to develop psoriasis is thought to be genetic.
2. Consequences of immune disorders caused by infections, poor lifestyle, climatic conditions and bad habits.

Authority to resolve!In 40% of patients with this disease, relatives also have psoriasis.In addition, relatives of the patient often experience an underlying form of psoriasis, manifested by changes in the structure of capillaries.

Most often, the "trigger" for the beginning of the development of psoriasis is emotional overload (in 50% of cases), localized infections, metabolic disorders, diabetes mellitus, liver disease and the use of certain drugs (usually glucocorticosteroids, beta blockers, lithium salts).

There are other factors that “trigger” the disease or make it worse:

• Injuries, broken bones.
• Numb.
• Sunburn.
• Smoking.
• Alcohol abuse.
• Obesity.
• Skin damage caused by chemicals.
• Food allergies.
• Parasitic infection.
• Pregnancy and childbirth.
• Other skin diseases - eczema, dermatitis.

Authority to resolve!It is well known that psoriasis is not contagious.The development of pathology in people who have relatives with 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 of the most common:

1. psoriasis commondevelop most frequently.It is characterized by the presence of itchy patches 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 nail moves away from the nail bed.
2. Guttate psoriasismanifests itself in the form of a small rash, localized mainly on the chest and back.The rash is accompanied by itching in the affected skin areas.Usually the symptoms of the disease will disappear after 4-6 months and will no longer appear.However, the patient may later develop another form of psoriasis.This happens about half the time.Guttate psoriasis is commonly seen in children and adolescents.It usually develops as a result of infection, most commonly following a bacterial throat infection.
3. Psoriasis is reversibleresponds well to treatment, sometimes stable remission can be achieved without relapse.The red, oozing patches only appear on some parts of the body, in the folds, and do not spread further.Most often, the rash appears in the groin area or under the mammary glands, as well as in the armpits.Reversible psoriasis 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 purulent blisters on the soles of the feet and palms, after which the affected skin thickens and begins to actively peel.The rash then spreads over a large area.In severe cases, the entire body's skin can be affected.Pustular psoriasis can threaten the patient's life.Affects mainly adults.

Psoriasis develops through 3 stages:

1. Progress.
2. Stationery.
3. Regress.

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

In stationary phaseThe appearance of the rash stopped.Existing plaques stop increasing in size but active peeling begins over the entire affected surface.

Currently in declinePlaques become denser, their components dissolve, peeling decreases.Then, at the site of the rash, spots without pigment remain.

Authority to resolve! Psoriasis can also be classified by season: there are summer and winter forms, depending on the development of exacerbations.Usually, relapses still occur more often in the fall-winter period than in the spring-summer period.

Symptoms of psoriasis

Symptoms of psoriasis are:

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

Authority to resolve!About 1 in 10 patients has arthritis caused by psoriasis.Therefore, it is necessary to start treatment as early as possible to prevent the development of complications.

Diagnose

Psoriasis has a very characteristic clinical picture, so diagnosis is usually not difficult.If you scrape off the papules (plaques), you will see 3 main phenomena:

1. Stearin stains - with a light scraping, the peeling increases and the rash becomes like a crushed drop of stearin.
2. Terminal film - if you remove scales from the surface of the plaque, it will have a shiny and wet surface.
3. Bloody dew - if you scratch the end film, small drops of blood will appear on it.

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

Psoriasis treatment

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

• Treatment is with topical medications - ointments, creams, shampoos, sprays, lotions.
• Conventional drug treatment - injections of antihistamines, sedatives, vitamins, treatment with immunosuppressants, cytostatics, retinoids, corticosteroid hormones.
• Maintenance treatment - the patient is prescribed ultraviolet radiation along with the use of skin-directed medications.
• The use of detoxification methods - appointment of immunomodulators, blood cleansing procedures.
• In some cases, nonsteroidal anti-inflammatory drugs are used.

If concurrent diseases are diagnosed, they are also treated.

Lifestyle with psoriasis

Patients must take into account that treatment for this disease will last a lifetime.In many ways, the duration of remission depends on it.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 containing red pigment (strawberries, watermelon) and other foods that can cause allergic reactions.Also avoid spicy, fatty, fried, smoked foods, rich meat and fish broths.Does not include spices: ketchup, mayonnaise, mustard, etc. You should limit your intake of sugar and salt.You should pay attention to products containing fiber, Omega acids, vitamins A, E, C, group B, as well as zinc and calcium.

The following simple measures will help alleviate this condition:

• Refuse to stay in water for a long time - you should swim and shower less often, showering should be short.
• Hard washcloths should be replaced with soft sponges or cotton cloths, and regular soaps should be replaced with pH-neutral products.
• After bathing, you should not wipe, but gently pat the skin with a towel - this will avoid damaging the plaques and increasing itching.
• After the water procedure, the skin must be moisturized with cream.
• Preference should be given to loose, light clothing made from soft natural fabrics, as the pressure of clothing on the skin can stimulate the development of new rashes.
• Itching often forces the patient to scratch, which can cause damage to the skin - to avoid new damage, it is better to keep your nails short.
• Dry skin should be avoided, so avoiding the use of air conditioning will be beneficial, as will humidifying the air in the home.
• While sunbathing can be beneficial for psoriasis, too much UV exposure can make it worse - you should consult your doctor about your sun exposure regimen.
• Any risk of skin irritation should be avoided.
• Cuts and wounds can cause new rashes to appear, so you need to protect yourself from them.
• Stress is a common aggravator, so traumatic situations should be avoided whenever possible.
• Physical inactivity (inactivity) should be avoided - moderate physical activity will benefit the condition of the entire body.

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