Psoriasis is a chronic inflammatory disease of the body, which is accompanied by a predominant change in the skin, during which reddish spots and plaques are formed, which have clear boundaries and silvery scales on the surface.
The course of this disease is characterized by periods of exacerbation and remission (decrease in symptoms). Unfortunately, medical science has not yet identified the exact and reliable cause of psoriasis, but a hereditary factor has been clearly identified, which, together with the triggering factors, contributes to the triggering moment of the appearance of the disease. The relationship between the occurrence of psoriasis and the antigens of the HLA system was discovered.
1-5% of the world's population suffers from this very unpleasant disease, and light-skinned people are at a higher risk of developing psoriasis than black people.
The disease can manifest itself at any age, but the 20-30-year-old and 50-60-year-old periods are considered critical.
Important!Psoriasis is not contagious to others, but it also causes discomfort to the patient himself, since the rashes that occur during the disease are not only aesthetic defects, but also accompanied by unpleasant itching. In addition, the manifestation of psoriatic arthritis is possible, which significantly impairs the patient's quality of life.
The rashes mostly appear on the scalp, on the surface of the elbows and knees, in the skin folds and in the genital area. The area around the nails, buttocks and eyebrows can often be affected. The nature and appearance of the rash depends on the type of psoriasis.
Causes of psoriasis
Medical science has not yet revealed the nature of the occurrence of psoriasis, some doctors speak of autoimmune causes. The second theory that explains the occurrence of the disease is the disruption of the normal process of maturation and division of skin cells. Heredity and stress are also considered causes.
A genetic predisposition to psoriasis, allergies and frequent disruption of the skin's barrier function (strong friction, chemical exposure, effects of alcohol-containing products) can cause the disease to worsen.
- In the acute phase of some dermatoses, the Koebner phenomenon is the appearance of fresh rashes at the site of skin irritation;
- sunburn or other types of burns;
- HIV infection;
- Beta-hemolytic streptococcal infection causing guttate psoriasis;
- Use of drugs (especially beta-blockers, lithium, angiotensin-converting enzyme inhibitors);
- Severe emotional stress;
- Alcohol consumption;
- smoking tobacco;
- Obesity;
- Hormonal imbalance, especially in women during menopause and pregnancy;
- Disturbances in the digestive system.
The main reason for the development of the disease is the excessive, accelerated growth and division of skin cells, as well as the inflammatory process of the dermis. In other words, the skin cells located in the lower layer of the epidermis begin to grow rapidly and put pressure on the cells above it. This process is accompanied by significant peeling of the skin and is called parakeratosis. Overstimulation of the immune system is believed to be the main link in the occurrence of this mechanism.
Symptoms and signs of psoriasis
Rashes associated with psoriasis are asymptomatic or itchy. Most often, they are localized on the scalp, the extensor surface of the knees and elbows, the sacrum and the buttocks (especially in the gluteal fold), as well as in the genital area. The skin of the fingers and nails, eyebrows, armpits and navel may be affected. The rash may merge with the lesions and extend over large anatomical areas and the skin areas between them. Depending on the type of psoriasis, the rashes may have different external manifestations.
The rash is usually discrete and is 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.
It develops in 5-30% of patients
Important!Psoriasis does not threaten the patient's life, but it disturbs the patient's self-image. In addition to changing the patient's appearance, treating skin rashes and keeping clothes and bedding clean also takes a lot of time, which greatly impairs the patient's quality of life.
Types of psoriasis
vulgar (common or chronic plaque) psoriasis, in which the rashes show the appearance of individual plaques, covered with silvery scaling. Plaques can coalesce as the disease progresses. Of all the subtypes, this type of psoriasis is the most common and accounts for about 90%.inverse psoriasis accompanied by rashes that appear in the area of natural folds and can cause cracks.guttate psoriasis it is characterized by multiple skin rashes with a diameter of 0. 5-1. 5 cm. It often develops after streptococcal pharyngitis.palmoplantar psoriasis manifests as plaques on the palms and soles, which may coalesce.nail psoriasis it affects the nail plates, in the form of precise indentations and furrows, with discoloration and thickening of the nail. Nail changes caused by psoriasis often resemble changes caused by a fungal infection.pustular psoriasis it is accompanied by pus formation on the palms and soles, possibly by injury to one of the fingers. It can also be a generalized form.erythrodermic psoriasis in patients with psoriatic plaques, it manifests as a sudden or gradual onset of redness, when the plaques themselves are mild or absent. It usually appears due to improper treatment of vulgar psoriasis.
Methods for diagnosing psoriasis
When symptoms of psoriasis appear, the patient should consult a dermatologist. He performs an external examination of the affected skin areas and collects a complete medical history.
Psoriasis has a general similarity with other dermatological diseases, especially in the first stage of manifestation. It is important to exclude the presence of fungal infections in the hands and nails. The seborrheic type of psoriasis requires a special differential diagnosis to exclude seborrheic eczema, pityriasis rosea and papular syphilis.
In case of active disease and large changes in areas of the epidermis, visual analysis of scrapings is used. During scraping, the exfoliation intensifies. In place of the removed scale, a smooth, thin film is visible, which peels off under mechanical action and reveals a surface moistened with drops of blood.
Diagnosing psoriasis is not difficult in most cases, it is enough just to examine the patient's skin. The doctor must rule out mistakes in the diagnosis and determine the presence of other diseases and other pathologies that occur against the background of psoriasis.
In rare cases, diagnosis requires a biopsy. If non-classical clinical symptoms appear, the need for this should be considered. Based on the affected skin area, the severity of the disease is mild, moderate and severe. Damage to the skin of less than 10% corresponds to mild severity. There are more sophisticated methods of assessing disease severity, but these are used in clinical trials.
Treatment of psoriasis
The development of the disease and its various manifestations depend on many factors. Therefore, many remedies have been developed to treat psoriasis. These methods are often combined, including drug and non-drug interventions.
The treatment plan is drawn up depending on the severity of the disease, the affected skin surface and the severity of symptoms such as redness, itching, peeling. The age and gender of the patient, the stage and general condition of the disease, as well as the presence of concomitant diseases are also taken into account, as these may limit the selection of treatment methods.
Psoriasis treatment should lead to the reduction of clinical manifestations (rash and other symptoms), improvement of the patient's general condition, and restoration of work capacity.
In the treatment of psoriasis, it is necessary to follow a diet and take proper care of the skin, 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, to give up alcohol, sweets (simple sugars) and starchy foods. The diet should focus on proteins: lean meat, fish, dairy products, vegetables and fruits. Be sure to pay attention to allergic reactions or intolerance to certain products.
In order to improve the patient's quality of life and get rid of the disease, an integrated approach must be used:
Local treatment –Ointments and creams treat peeling and itching well in small areas where the disease is localized. Hormonal ointments, salicylic acid, retinoids and moisturizing creams are particularly effective in treating psoriasis on the face and hands.Drug therapy it is used as an additional method of effective treatment of psoriasis when ointments do not help. Medicines reduce the inflammatory process, remove swelling and itching, and block the increased activity of skin cells. But it is worth considering that the pills have many side effects (increased fatigue, loss of appetite, high blood pressure). Therefore, it is very important to follow all the recommendations of the doctor regarding the dosage of the drug.- If psoriasis is localized on the head and neck, use it
medicated therapeutic shampoos : antifungal, tar, containing corticosteroids. The shampoo eliminates the pathogens of pathological inflammation, removes scales, relieves itching and burning. Therapeutic antihistamine injections blocks severe itching, biological drugs have a beneficial effect on the immune system.
Unfortunately, it is not possible to cure psoriasis completely. The aim of any treatment for psoriasis is to eliminate the signs of the disease in the long term and prolong the remission. However, treatment of psoriasis is necessary despite the slow chronic course of the disease, as long-term lack of therapy can lead to disability of the patient.