Psoriasis

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

The disease causes severe psychological discomfort in the patient;due to the presence of appearance defects, it is difficult for a person to adapt to the team and communicate with people.Severe forms of psoriasis can lead to disability.It is impossible to completely cure the pathology.However, proper treatment makes it possible to achieve a stable remission and restore the previous quality of life.

What is psoriasis

The main symptom of the disease is the presence of psoriatic plaques - flaky pink spots of various sizes accompanied by itching.They are most often located on the scalp (along the hairline, behind the ears), elbows, knees, genitals, buttocks, lower back and other parts of the body.Sometimes plaques appear on old scars.The pink color of the rash is due to the fact that the vessels in the affected areas expand.

Psoriasis is caused by a malfunction of the immune system.In all layers of the epidermis (5 in total - basal, spiny, granular, shiny and horny) keratinocytes are found (about 90% of the entire epidermis).Depending on the layer in which they are located, keratinocytes perform different functions (regeneration, synthesis of keratin or other proteins, prevention of drying of the skin, protection of the lower layers of the skin).

Keratinocytes are constantly renewed.Their synthesis takes place in the basal layer.They then move up, where each time they perform a new function.When they reach the stratum corneum, they lose their nucleus and turn into corneocytes (sacs containing special keratin).Now their function is the obstacle.After surviving their life, the corneocytes peel off the surface of the skin.Keratinocytes live for about 2-4 weeks and are then replaced by new ones.

In psoriasis, due to a malfunction of the immune system, the keratinocytes begin to divide much faster and their lifespan is reduced.Peeling occurs, accompanied by inflammation of the epidermis and dermis.

Psoriasis can develop at any age (approximately 4% of the world's population suffers from it).However, the disease most often occurs in people under 20 and over 55.People with fair skin suffer from psoriasis quite often;among representatives of the Negroid race, the pathology is observed much less often.

Causes of psoriasis

The exact causes of psoriasis have not yet been identified.However, the most common are two theories of the origin of the disease:

1. Hereditary disease – the tendency to develop psoriasis is thought to be inherited genetically.
2. It is the result of immune disorders caused by infections, improper lifestyle, climatic conditions and bad habits.

Reference!In 40% of patients with this pathology, their relatives also suffered from psoriasis.In addition, close relatives of patients often experienced the latent form of psoriasis, which manifested itself in changes in the structure of capillaries.

Most often, emotional overload (in 50% of cases), focal infections, metabolic disorders, diabetes mellitus, liver diseases, as well as taking certain medications (most often glucocorticosteroids, beta-blockers, lithium salts) represent the "push" to start the development of psoriasis.

There are other factors that "trigger" the disease or cause it to worsen:

• Injuries, fractures.
• Freezing.
• Sunburn.
• Smoking.
• Alcohol abuse.
• Obesity.
• Skin damage caused by chemicals.
• Food allergy.
• Parasitic infections.
• Pregnancy and childbirth.
• Other skin diseases - eczema, dermatitis.

Reference!It is well known that psoriasis is not contagious.The development of pathology in people whose close relatives suffer from this disease is explained by a genetic predisposition.Psoriasis does not spread from person to person.

Types and stages of psoriasis

There are many forms of psoriasis, but some of the most common are:

1. Common psoriasisoccurs most often.It is characterized by the appearance of scaly, itchy plaques on the skin.In addition, with this form, discoloration of the nails and the appearance of small white spots on them can often be observed.In some cases (at an advanced stage) the nails move away from the nail bed.
2. Guttate psoriasismanifests itself as a small rash, mainly on the chest and back.The rash is accompanied by itching in the areas where the skin is affected.Usually, the symptoms of the disease disappear after 4-6 months and do not appear again.However, the patient may subsequently develop another form of psoriasis.This happens about half of the time.Guttate psoriasis usually occurs in children and adolescents.It often develops as a result of an infection, most often after a bacterial infection of the throat.
3. Reversible psoriasisit responds well to treatment, sometimes it is possible to achieve a stable remission without relapses.The red, weeping plaques appear only in certain parts of the body, in the folds, and do not spread further.Rashes typically appear in the groin area or under the mammary glands, also in the armpits.Reversible psoriasis most often develops in older patients.
4. Pustular psoriasissevere and dangerous form.In some cases, it develops quickly and suddenly.It is characterized by the appearance of pus-filled blisters on the soles and palms, then the affected skin thickens and actively peels off.Later, the rash spreads to large areas.In advanced cases, the skin of the entire body may be affected.Pustular psoriasis can be life-threatening.It mainly affects adults.

Psoriasis develops in 3 stages:

1. Progressive.
2. Constant.
3. Decreasing.

Progressive stageit is characterized by the appearance of multiple nodular rashes and their spread to new areas of the body.Plaques gradually increase in size.

In stationary statethe appearance of rashes stops.The growth of the existing plaques stops, but active peeling begins on the entire affected surface.

In regression phasethe plaques become denser, their elements are dissolved, the exfoliation decreases.After that, non-pigmented spots remain at the site of the rash.

Reference! Psoriasis can also be classified according to seasonality: there are summer and winter forms, according to the development of exacerbations.Most often, relapses still occur more often in the autumn-winter period than in the spring-summer period.

Symptoms of psoriasis

Symptoms of psoriasis include:

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

Reference!About 1 in 10 patients develop arthritis as a result of psoriasis.Therefore, in order to prevent the development of complications, the treatment should be started as early as possible.

Diagnostics

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

1. Stearin stain - with gentle scratching, the peeling will intensify and the rash will resemble a crushed drop of stearin.
2. Terminal film - if you remove the scales from the surface of the plaque, you will have a shiny wet surface.
3. Blood Dew - if you scratch the terminal foil, drops of blood will appear exactly on it.

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

Treatment of psoriasis

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

• Local drug therapy - ointments, creams, shampoos, aerosols, lotions.
• General drug therapy - antihistamines, sedatives, vitamin injections, treatment with immunosuppressants, cytostatics, retinoids, corticosteroid hormones.
• Maintenance therapy - the patient is prescribed together with ultraviolet irradiation and taking a dermatotropic drug.
• Application of detoxification methods - appointment of immunomodulators, blood purification procedures.
• In some cases, taking non-steroidal anti-inflammatory drugs.

If concurrent diseases are diagnosed, they are also treated.

Lifestyle with psoriasis

The patient must take into account that the treatment of the disease lasts a lifetime.The duration of remission depends on many aspects.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.It is also advisable to avoid spicy, fatty, fried, smoked foods, rich meat and fish soups.Condiments are not included: ketchup, mayonnaise, mustard, etc.The intake of sugar and salt should be limited.It is worth paying attention to products containing fiber, Omega acid, vitamins A, E, C, group B, as well as zinc and calcium.

The following simple measures will help alleviate the condition:

• Refusal to stay in water - you need to swim and bathe less often, short showers are recommended.
• Hard cloths should be replaced with soft sponges or cotton cloths, and regular soap should be replaced with a pH-neutral product.
• After showering, don't wipe your skin, but wipe it with a towel - this way you can avoid damaging plaques and increasing itching.
• After water procedures, the skin must be moisturized with a cream.
• Preference should be given to loose, light, soft clothes made of natural materials, since the pressure of clothing on the skin can cause the development of new rashes.
• Itching often forces the patient to scratch, which can cause damage to the skin - to avoid further damage, it is better to cut the nails short.
• Dehydration of the skin should be avoided, so avoiding air conditioning will be beneficial, as will humidifying the indoor air.
• Although sun exposure can be beneficial for psoriasis, excessive ultraviolet light can make the condition worse - consult your doctor about your sun exposure regimen.
• The risk of skin irritation should be avoided.
• Cuts and wounds can cause new rashes, so you need to protect yourself from them.
• Stress is a common cause of disease exacerbation, so traumatic situations should be avoided if possible.
• Physical inactivity (inactivity) should be avoided - moderate physical activity improves the condition of the whole organism.

If you feel worse, consult a doctor immediately to prevent the disease from progressing to a more serious stage or developing complications.