Psoriasis is one of the most common skin diseases, affecting one in every 100 people.
Psoriasis is a disease in the development of which several factors are important at the same time: from hereditary predisposition (from psoriasis of relatives) to disorders of the nervous, endocrine, immune system and other factors.
The reasons
The causes of psoriasis are not fully known.
The principle of the mechanism of the disease is to disrupt the division of skin cells, which triggers an autoimmune reaction (autoimmune reaction - occurs inside the body, does not depend on external threats).
The upper layer of the skin (epidermis) is mainly made up of keratinocytes - cells that produce keratin. Keratin protein, its properties allow it to perform the protective function of the skin. Keratinocytes form in the deep layers of the epidermis and move slowly to their surface, maturing during movement and acquiring new properties.
At the end of their "maturation, " the keratinocytes form a corner layer on the surface of the skin. Keratinized cells are then killed and peeled from the living, ending the life cycle of keratinocytes. This ensures the constant renewal of the skin.
The normal pathway for keratinocytes from the deep layer to the surface takes one month. With psoriasis, their lifespan is reduced to several days, leading to the appearance of scaly, psoriatic foci because the skin does not have time to get rid of the keratinized cells.
When they appear, psoriasis plaques are usually accompanied by itching and redness. This indicates an autoimmune reaction in the deep layers of the skin that results in swelling of the thick layer of skin (dermis). The dermis contains blood and lymphatic vessels.
It is not certain why the process of keratinocyte formation is accelerated, but it is known that the hereditary factor plays a significant role.
Frequent psoriasis can be caused by:
- mental trauma and constant stress states;
- skin damage;
- transmitted infectious disease;
- taking some medications;
- hormonal disorders;
- allergic reactions (typical allergens: citrus fruits, eggs, chocolate);
- alcohol poisoning;
- climate change.
The psoriasis triad is a characteristic symptom of the disease that occurs when the skin is scraped.
Stearin stain(increased peeling after scraping, showing a similarity to the surface of the papules with a crushed drop of stearin).
Thermal film(After complete removal of the balance, a wet, thin, glossy, translucent surface will appear).
Accurate bleeding(appearance of non-melting blood droplets).
What happens to the skin in psoriasis?
In psoriasis, the structure of the skin is disturbed, the epidermis becomes thinner, the keratinization processes in the skin (the accumulation of keratin protein) are interrupted, and some layers of the normal epidermis disappear. In the next stage of the disease, the groups of cells responsible for inflammation are found in the protective superficial stratum corneum of the epidermis and in the parakeratosis zone around the dilated blood vessels of the skin.
Characteristic plaques and scales appear on the surface of the skin.
Psoriasis is not only a common disease, it has many manifestations and even disguises itself as other diseases.
Psoriasis localization sites:
- elbows and knees;
- sacrum and groin;
- scalp (seborrheic psoriasis);
- flexor surfaces and skin folds: the inner surface of the elbow and knee joints, the groin and armpits, the area under the breast (inverse psoriasis);
- palms and foot surfaces (palm-plantar psoriasis);
- psoriasis of the nail plates.
Common symptoms of psoriasis
The main symptoms of psoriasis are:
- psoriatic plaques;
- the tightness of the affected skin surface;
- itchy.
Symptoms by type of psoriasis:
- exudative psoriasis (affected areas of the skin peel off and get wet, a yellow crust forms on the surface of the rash);
- intertriginous psoriasis (more common in children, occurrence foci red, with mild exfoliation, sometimes wet can be confused with diaper rash);
- old psoriasis (characterized by large plaques that do not go away for a long time);
- rupioid psoriasis (another form of chronic psoriasis characterized by a conical plaque);
- guttate psoriasis (loose rash in small papules).
Types of psoriasmr
- Psoriasis normal (vulgar, plaque);
- Generalized psoriasis (common, postural);
- Psoriasis is teardrop-shaped (according to the type of rash);
- Arthropathic psoriasis (with joint damage);
- Other types of psoriasis (seborrheic and others).
Vulgaris psoriasis is the most common form of the disease.
Psoriasis begins with the appearance of rashes, often in few, typical places: the elbow and knee. The characteristic localization of the rash is also the scalp and the trunk area. There is usually a clear correlation between the onset of rash and the effect of the provoking factor.
The provocative factors for psoriasis can be stress, skin trauma, recent infectious disease, and regular alcohol consumption.
Usually, the exacerbation of the disease occurs during the cold season - this is winter-type psoriasis. The summer type is rarer. Mixed forms of psoriasis are now noted. Over time, the number of rashes increases. They form characteristic psoriasis plaques. The Kebner phenomenon can be observed - the appearance of new plaques on skin traumas. As a general rule, patients have plaques that remain on the skin even without aggravation.
The disease is cyclical:
- Progressive stage (increase in the number of rashes);
- Inpatient phase (no new rashes);
- Regressive stage (regression of rash, appearance of pigmented skin surfaces in place).
Psoriasis vulgaris, photo
Diagnostics
When diagnosing psoriasis, a detailed examination of the skin is needed first and foremost.
Thin skin, occasional bleeding, loose plaques are signs of psoriasis. In the presence of these symptoms, the physician performs a number of diagnostic measures to rule out the presence of other events with similar manifestations. Blood tests, smears, and skin biopsies are performed as needed for a final diagnosis. If the joints are affected, magnetic resonance imaging (MRI) is prescribed and an x-ray is taken to identify the lesions.
Psoriasis vulgaris, treatment
Psoriasis is a disease associated with systemic skin diseases and requires complex treatment: both topical and systemic therapy. The disease is chronic, the goal of treatment is to reduce the number and severity of exacerbations and to achieve a skin disease that is acceptable to the patient.
In the progressive stage of psoriasis, all aggressive procedures are eliminated: ultraviolet radiation, baths. It is important that patients with psoriasis treat their skin carefully and carefully so as not to damage it in order to avoid aggravation and the appearance of new plaques.
Diet for psoriasis
Psoriasis is often associated with liver disease, so it is important to avoid alcohol, fatty, fried, smoked foods. Equally important is moderate carbohydrate intake, as this changes the pH of the skin and increases the risk of rash infection.
Prophylaxis
Preventing psoriasis is about maintaining a healthy lifestyle. This helps prevent other diseases from occurring, as the body’s immune system is protected from stress and resistant to external threats.
Measures to prevent psoriasis include:
- proper skin care;
- relaxing massage to improve blood circulation;
- in the interests of proper nutrition, it is advisable to avoid allergenic foods and to exclude (limit) the intake of spicy, fatty, pickled, smoked, salty foods and citrus fruits;
- milk and vegetable diet;
- sufficient moisture in the body;
- elimination of alcohol, smoking and other bad habits;
- increased physical activity;
- walks outdoors;
- avoiding stressful situations;
- taking vitamins of groups A, B, C, D, E;
- choosing loose clothing made of natural materials that does not wear and irritate.
Devices for the treatment of psoriasis
Systemic therapy for psoriasis aims to reduce skin epithelial proliferation and stabilize keratinization of skin cells and cell membranes. For this purpose, preparations based on vitamin A (retinoids) and cytostatics are used. Among the most modern treatments, so-called biological substances are used, which neutralize the substances that cause inflammation.
UFOs have been used for many years - treatment with group B ultraviolet rays (in solariums, group A rays), which reduce inflammation and contribute to the destruction of altered cells. PUVA therapy is the simultaneous application of ultraviolet radiation and a special substance that increases your sensitivity to the skin.
An effective cure for psoriasis
Topical treatment is no less important than systemic treatment. Helps reduce skin inflammation. Medications are prescribed depending on the stage of psoriasis.
Progressive stage
- exfoliating ointments and body lotions;
- anti-inflammatory hormonal ointments with calcitriol;
- emollients to relieve itching and dry skin.
Stationary stage
- UVB therapy;
- concentrated exfoliating ointments;
- emollients to restore skin and reduce dryness.
Regressive section
- concentrated exfoliating ointments;
- emollients to restore skin and reduce dryness.
Psoriasis cream
Psoriasis creams and ointments have different purposes and are used in different stages of the disease. Hormonal anti-inflammatory ointments and creams are used to stop the inflammatory processes in the skin. There are several classes of hormonal drugs. They have different absorption capacities and different activities. In children, they try to avoid applying hormonal drugs to the area of the face and neck, the area of skin folds - places where the skin is thinner. Topical preparations based on calcipotriolone (a derivative of vitamin D) have an anti-inflammatory effect. This is the later generation of drugs. It is not currently used during pregnancy and lactation.
Salicylic acid ointment and salicylic acid cream are used to remove peeling skin flakes. Salicylic acid not only has an exfoliating effect but also increases the effectiveness of topical hormonal drugs. In the stationary and regressive stages, when inflammation is less active, salicylic acid-based agents are used in higher concentrations.
Devices to restore the structure of the skin and eliminate dryness are used throughout the treatment and in combination with ultraviolet radiation to reduce itching of the skin. Once the flares are relieved, these products help maintain the skin’s protective properties and reduce the risk of new outbreaks.
Effective cream for psoriasis
The modern approach to caring for and helping dry skin is based on the saturation of the epidermis with moisture and is called corneotherapy ("corneo" - the horny layer of the epidermis).
The goal of corneotherapy is to restore the stratum corneum and protective functions of the epidermis, which allows to improve the condition of the skin as a whole. The work of Albert Kligman, the founder of corneotherapy, made it possible to create special devices - emollients.
How do emollients work?
Within 1 hour after application of emollients: - the condition of the skin improves due to the fact that emollients "block" moisture.
6 hours after the application of emollients: - the structure of the skin is restored due to the content of special restorative natural lipids (ceramides and other useful fats).
24 hours after application of emollients: - clinical improvement of the skin condition by penetration of moisturizing components into the deep layers of the epidermis and restoration of the surface layers of the skin (up to 24 hours from the start of application).