Humanity has been trying to uncover all the secrets of this mysterious skin disease for centuries, but there is still much that is unknown. According to statistics, psoriasis affects 4-7 percent of the population, and men and women are equally susceptible to it. The first signs of psoriasis usually appear during puberty and can accompany a person throughout his life, sometimes they decrease and disappear, sometimes they increase in intensity.
Causes and risk factors of psoriasis
Psoriasisa long-term inflammatory process of the skin, which is considered an autoimmune disease (associated with an allergic reaction to tissues). It is a chronic skin disease that affects the cells of the outer layer of the epidermis. The condition usually appears as red, silvery scaly skin on the legs, knees, back, chest, etc. In most cases, psoriasis begins in small patches of skin, which can then spread to large areas of the body. Many causes and risk factors can contribute to the development of this disease, and there are many theories to explain its occurrence.
Autoimmune cause
Some studies suggest that psoriasis may be caused by a combination of genetic and environmental factors, such as infections, trauma, stress, and certain medications. These factors can trigger an immune system response that starts fighting the body's tissues, including the skin.
However, the processes underlying psoriasis are still not fully understood. It is important to note that psoriasis is a multifaceted disease that manifests itself differently in each patient. Studying the underlying mechanisms of psoriasis can help develop more effective treatments, reduce the risk of complications, and improve patients' quality of life.
Effect of metabolism
Metabolic disorders significantly affect the condition of the skin and immunity of patients suffering from psoriasis. Increased metabolism leads to the formation of toxins and free radicals, which contribute to inflammatory reactions. There is an imbalance in various metabolisms.
- In the case of disorders of protein metabolism in patients with psoriasis, the albumin content of the blood decreases and the content of globulins increases, which increases their sensitization.
- An increase in the lipid and cholesterol content of the blood can be observed during fat metabolism.
- Reducing calories and eating plant-based foods can reduce the activity of psoriatic inflammation.
- There are almost always disturbances in carbohydrate metabolism.
- The metabolism of vitamins and minerals is also damaged, which manifests itself in a decrease in the content of vitamins C, A, B6, B12, iron, copper and zinc in the blood, but an increase in the content of vitamin C.
Infectious cause
This theory was widespread in the last century. It was believed that psoriasis could be caused by certain bacteria (streptococci), fungi and viruses, but these hypotheses have not been scientifically confirmed. However, dermatologists point out that any acute infectious process or chronic infection can cause psoriasis to recur. Special attention is 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
Inheriting a tendency to autoimmune reactions is a risk factor for psoriasis. If a person's close relatives suffer from this disease, the likelihood of developing it increases. Several genes may be associated with psoriasis, including the PSORS1-PSORS9 complexes, in which PSORS1 is thought to be particularly active. It includes the HLA-C, HLA-Cw6, CCHCR1 and CDSN genes, 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 also be caused by other factors.
Neurogenic cause
Excessive strain on the nervous system, long-term stress and imbalance of the autonomic nervous system, which ensures the innervation of blood vessels and internal organs, can be risk factors for the development of psoriasis. These factors can cause an imbalance in the endocrine system, changes in metabolic processes and disorders of the immunological response, increased irritability or depression, constant fatigue, sleepiness and apathy, which in turn can lead to psoriasis.
Endocrine
Endocrine disorders occurring with psoriasis are quite common and can have a significant impact on the development of the disease. However, the connection between them and psoriasis is not entirely clear and has not been proven. Experts believe that patients with psoriasis often suffer from dysfunction of the thyroid gland, pituitary gland, and adrenal glands. Women may have problems with their menstrual cycle, and men with sexual function.
Symptoms and characteristics of psoriasis
Psoriasis manifests itself not only in skin rashes, but also in other symptoms. It often begins in childhood or adolescence and is associated with hormonal disturbances, vegetative-vascular dystonia and stress.
The first signs are afatigueAndmood swings. The main symptom is small pink bumps on the skin covered with whitish scales, called papules. The papules are surrounded by a lighter rim.
Over time, the elements of the rash can merge into large, unusually shaped plaques. The basis of each papule isinflammatory infiltrate. The following types of rashes can be distinguished:
- needle point (up to 1 mm in diameter);
- teardrop-shaped – (up to 2 mm droplet papules);
- coin-shaped – (round papules-coins up to 5 mm).
The rash also has its own characteristics:
- stearin stain - if you scratch the surface of the papule;
- terminal film - after cleaning papules from scales, a transparent film is visible;
- bloody dew (Auspitz phenomenon) – if the integrity of the film is damaged, small drops of blood may appear.
Is psoriasis contagious?
Many people believe that psoriasis is a contagious disease, so they try to avoid contact with those who suffer from it. This can lead the patient to withdraw from others and lead to serious psychological problems. However, studies have shown that psoriasis is not spread through contact with the patient. If all family members suffer from this disease, this only indicates the presence of a genetic factor in the development of the pathology.
Classification and developmental stages of psoriasis
Currently, there are three main stages in the development of psoriasis:
- A progressive stage characterized by the constant development of new skin rashes accompanied by severe itching.
- The stationary phase, when the appearance of new formations stops, and the existing ones begin to heal.
- A regressive stage when fringes appear around the rash and the skin affected by the rash becomes darker in color due to increased pigmentation.
In addition, the pathology has several degrees of severity:
- Mild, when no more than 3% of the skin surface is affected.
- Medium degree, characterized by 3-10% damage to the skin.
- Severe, in which more than 10% of the disease is affected.
Types of psoriasis
Psoriasisis a chronic skin disease that can manifest itself in several ways. Rashes, their location and damage to other systems and organs can be different. Depending on these characteristics, different forms of psoriasis are distinguished.
Simple (vulgar, plaque)
Plaque psoriasis is the most common form of the disease. 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 psoriasis of the elbows is the presence of one or more permanent "elbow" plaques on the extensor side of the elbow joints. If these elements are exposed to trauma, exacerbation occurs.
Guttate psoriasis
In connection with bacterial (most often streptococcal) and viral infections, this type of psoriasis can cause inflammation. This condition often occurs in children and begins with the appearance of small, red, tear-shaped papules on the skin of the limbs, body or face. Papules have a scaly surface and can develop into erosions and ulcers, increasing the risk of infection.
This condition can develop rapidly or gradually become chronic, followed by periods of worsening and relief of symptoms. In rare cases, psoriasis can be more severe.
Palmoplantar psoriasis
This type of psoriasis often develops in people who do physical work and is often accompanied by severe itching and can lead to complications on the nails. There are several subtypes of this type of psoriasis:
- Plaque fan-shaped: large elements on the palms and soles with white scales that coalesce into fan-shaped plaques. This subtype is most often found on the hand.
- Circular: ring-shaped scaly elements on the palms and soles.
- Callosalis: growth of rough epithelium with callus formation.
- Pustular: This is a distinct subtype of Barber's psoriasis on the palms and soles. Blisters and pustules containing pus appear in the areas under the big toes, causing severe itching. Ulcers coalesce, then dry out and form crusts. The characteristic elements of psoriasis also appear in other parts of the body.
Psoriasis on the legs can be accompanied by varicose veins and is mainly manifested on the lower legs.
Nail psoriasis
It can occur as an independent disease or as a complication of another type of psoriasis. The main symptom is small pits on the nail plate, which are of different depths. These pits are usually more noticeable and painful when pressed than other types of dermatitis. In addition, symptoms include spontaneous nail detachment, subungual bleeding (especially when wearing tight shoes), changes in nail color and surface, such as trachyonychia and koilonychia.
Psoriasis of the scalp
It can manifest itself as an independent disease or as part of a general pathological process. One characteristic feature is weeping and crusting on part or all of the head. In this case, hair growth is not damaged, as the function of the hair roots is not damaged. However, wetting poses a risk of infection, which can lead to damage to the hair follicles.
Seborrheic psoriasis
It develops as a result of a malfunction of the skin glands that produce viscous sebum, which causes skin irritation and promotes inflammation - dermatitis. This condition quickly spreads over the entire head, covering it in the form of a cap and accompanied by severe itching. The areas behind the ears sometimes develop weeping and infection. Scalp covered with dandruff and crusts can look like a psoriatic crown.
Psoriasis on the face
It usually appears in the nasolabial triangle, the eyelids, the areas above the eyebrows and behind the ears. The rashes may coalesce, forming large redness and swelling. If the function of the sebaceous glands is impaired, the process may be accompanied by weeping, crust formation and an increased risk of infection.
Genital psoriasis
Genital psoriasis is an underlying process that is usually accompanied by characteristic psoriasis rashes all over the body, which makes diagnosis easier.
Psoriasis rashes on the penis in men and on the labia majora and surrounding skin areas in women are oval in shape and slightly raised above the surface of the skin. They are pink and fluffy. It is practically not accompanied by itching. Sometimes the lesion process spreads to the mucous membrane and can appear in the form of vulvovaginitis in women and balanoposthitis in men.
Atypical psoriasis rashes can be observed in the folds near the genitals (inguinal, intergluteal) in obese people. In these areas, areas of intense red color appear, which 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 severe and prone to recurrence, and the rash may become wet, moist, and susceptible to infection. Only timely and effective treatment of psoriasis can prevent the spread of the disease.
In some cases, psoriasis can complicate the inflammation of the joints 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, severe cardiovascular and digestive diseases, and neurological reactions.
Ignoring timely treatment of psoriasis can lead to complications such as psoriasis erythroderma, which can occur due to improper treatment of psoriasis or the effect of various irritants on the skin. With psoriatic erythroderma, the skin becomes deep pink, with a clear distinction between affected areas and healthy ones, as well as small and large peeling. This condition requires emergency medical attention.
Complications of psoriasis
If psoriasis is not treated in time and properly, it 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.
Diagnostics
Psoriasis is typically diagnosed based on the characteristic symptoms of the skin lesions and their location. In some complex cases, additional tests may be necessary to rule out other skin diseases.
Laboratory tests may include:
- A complete blood count that can detect leukocytosis and anemia in psoriasis.
- Rheumatoid factor (RF) is a protein whose level can be increased in systemic inflammatory diseases with joint damage, but in psoriasis its level is usually normal.
- The erythrocyte sedimentation rate (ESR) is also usually normal, except in pustular psoriasis and psoriatic erythroderma.
- Uric acid levels can be elevated in psoriasis, which can be confused with gout.
- Antibodies against the human immunodeficiency virus (HIV) can be detected during the sudden onset of psoriasis.
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 to differentiate psoriasis from other skin conditions.
Treatment
Psoriasis treatment requires a comprehensive approach, including local treatment of skin lesions, medication, light therapy, and prevention of exposure to factors that worsen the disease. The choice of treatment method depends on the type and severity of psoriasis. Treatment may include:
- external preparations (external ointments, petroleum jelly, paraffin, vegetable oils and anti-inflammatory creams, the amount of which depends on the nature of the lesion and is used daily);
- body lotions and shampoos based on salicylic acid, as well as photosensitizers;
- drugs intended for oral administration (retinoids, vitamin D preparations and others);
- physiotherapy procedures;
- Daily baths with bath oil, oatmeal infusion or sea salt can help soften the skin and reduce the inflammation caused by psoriasis. It is important to avoid hot water and scrubbing, and to use a moisturizing cream after bathing;
- light therapy, which involves exposing the skin to ultraviolet light, may also be helpful (avoid burns);
- photochemotherapy with medium-wave radiation;
- following a special diet and a general diet.
When developing the treatment program, the gender and age of the patient, the presence of accompanying diseases, the general state of health and the influence of external factors are taken into account. Sometimes a lifestyle change is enough to cure, in other cases more courses are prescribed.
In addition to traditional methods, the treatment of psoriasis may also include the use of modern laser technologies. Laser therapy can reduce the symptoms of pathology, achieve long-term remission, and free the patient from unpleasant rashes and related problems. The peculiarity of laser therapy is that the special excimer laser acts only on the affected skin areas, without affecting healthy ones, which ensures rapid healing without side effects. Laser therapy is safe and painless, requires no preparation and can be used regularly so that the patient can live without limitations.
The effectiveness of the treatment depends on many factors, including hereditary predisposition, provoking factors, the stage of the disease and the specific nature of the lesion, therefore it is recommended to consult a specialist and prescribe treatment measures based on clinical recommendations.
Prevention
Psoriasis is a disease that can be successfully treated if you see a doctor in time and get qualified help. In the case of a simple form of psoriasis, the patient can work without restrictions, except for work in chemical plants, where being at work can be dangerous.
However, psoriasis can cause complications, such as arthritis, which can limit work and lead to disability.
Psoriasis prevention is an important part of treatment. After recovery, patients should rethink their lifestyle, get rid of bad habits, take care of other chronic diseases, monitor their diet and increase physical activity, spend more time outdoors and do sports.
Nutrition for psoriasis
The psoriasis diet is not strict, but proper nutrition plays an important role in the complex treatment. When making nutritional recommendations, patients are advised to:
- Avoid foods that your body is hypersensitive to and eliminate them from your diet.
- Give preference to fresh fruits, vegetables, berries, lean fried or boiled meat and drink more.
- Avoid the following foods: onions, garlic, radishes, strong tea, coffee, alcohol, sweets, salty and sour foods, and foods that can cause an allergic reaction, such as orange fruits, honey, nuts, cocoa, and eggs.
- Avoid fatty foods of animal origin.