Psoriasis is one of the most common skin diseases; every hundredth inhabitant suffers from it.
Psoriasis is a disease for the development of which several factors are important at once: from hereditary predisposition (psoriasis in relatives) to disorders in the functioning of the nervous, endocrine, immune systems and other factors.
The causes of psoriasis are not fully understood.
The principle of the disease mechanism is to disrupt the division of skin cells, which causes an autoimmune reaction (autoimmune reaction - occurs inside the body, does not depend on external threats).
The top layer of the skin (epidermis) is mainly composed of keratinocytes - cells that produce keratin. Keratin is a protein, its properties make it possible to carry out the protective function of the skin. Keratinocytes are formed in the deep layers of the epidermis and slowly move to its surface, during the movement they mature and acquire new properties.
At the end of their "maturation", keratinocytes form a stratum corneum on the surface of the skin. Then the keratinized cells die off and exfoliate from the living ones, thus, the life path of keratinocytes comes to an end. This ensures continuous skin renewal.
The normal path of keratinocytes from the deep layer to the surface takes a month. With psoriasis, their life span is reduced to several days, this leads to the appearance of scaly, psoriatic foci, since the skin does not have time to get rid of keratinized cells.
When they appear, psoriatic plaques are usually accompanied by itching and redness. This indicates an autoimmune reaction in the deep layers of the skin, resulting in swelling of the thick layer of the skin (dermis). The dermis contains blood and lymph vessels.
It is not for certain why the process of formation of keratinocytes is accelerated, but it is known that a hereditary factor has a significant role.
The development of common psoriasis can begin due to:
- mental trauma and constant stressful conditions;
- damage to the skin;
- transferred infectious disease;
- taking some medications;
- hormonal disorders;
- allergic reactions (typical allergens: citrus fruits, eggs, chocolate);
- alcohol intoxication;
- changing of the climate.
The psoriatic triad is a characteristic symptom of the disease that occurs when the skin is scraped.
Stearin stain(increased peeling after scraping, giving the surface of the papules a resemblance to a crushed drop of stearin).
Thermal film(the appearance after complete removal of the scales of a wet, thin, shiny, translucent surface).
Pinpoint bleeding(the appearance of blood droplets not merging with each other).
What happens to the skin in psoriasis?
In psoriasis, the structure of the skin is disturbed, the epidermis becomes thinner, the processes of keratinization of the skin (accumulation of the keratin protein) are disrupted, and some layers of the normal epidermis disappear. At the next stage of the disease, clusters of cells responsible for inflammation are found in the protective superficial stratum corneum of the epidermis and in the area of parakeratosis, around the dilated 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.
Localization sites of psoriasis:
- elbows and knees;
- sacrum and loin;
- scalp (seborrheic psoriasis);
- flexion surfaces and folds of the skin: the inner surface of the elbow and knee joints, the groin and armpits, the area under the breast (inverse psoriasis);
- palms and surfaces of the feet (palmar-plantar psoriasis);
- psoriasis of the nail plates.
Common symptoms of psoriasis
The main symptoms of psoriasis are:
- psoriatic plaques;
- tightness of the affected skin area;
Symptoms by type of psoriasis:
- exudative psoriasis (the 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, the foci of occurrence are red, with slight peeling, sometimes wet ones can be confused with diaper rash);
- old psoriasis (it is characterized by large plaques that do not go away for a long time);
- rupioid psoriasis (another form of chronic psoriasis, characterized by the conical shape of the plaques);
- teardrop psoriasis (profuse rash of small papules).
Types of psoriasis
- Psoriasis ordinary (vulgar, plaque);
- Generalized psoriasis (widespread, postular);
- Psoriasis teardrop-shaped (by the type of rash);
- Arthropathic psoriasis (with joint damage);
- Other types of psoriasis (seborrheic and others).
Psoriasis vulgaris is the most common form of the disease.
Psoriasis begins with the appearance of rashes, often few in number, in typical places: in the elbows and knees. Also, the characteristic localization of the rash is the area of the scalp and trunk. Usually there is a clear connection between the appearance of rashes and the action of the provoking factor.
The provoking factors in psoriasis can be stress, skin trauma, a recent infectious disease, and regular alcohol consumption.
Usually, the exacerbation of the disease occurs in the cold season - this is the winter type of psoriasis. The summer type is more rare. Mixed forms of psoriasis are now noted. Over time, the number of rashes increases. They form characteristic psoriatic plaques. The Kebner phenomenon is observed - the appearance of new plaques in places of skin trauma. As a rule, patients have duty plaques that remain on the skin even without exacerbation.
The disease flows cyclically:
- Progressive stage (an increase in the number of rashes);
- Stationary stage (new rashes do not appear);
- Regressive stage (regression of rashes, the appearance in their place of skin areas without pigment).
Psoriasis vulgaris, photo
When diagnosing psoriasis, first of all, a detailed examination of the skin is required.
Thin skin, bleeding in places, loose plaques are signs of psoriasis. In the presence of these symptoms, the doctor conducts a number of diagnostic measures to exclude the presence of other events with similar manifestations. For the final diagnosis, blood tests, smears, and skin tissue biopsies are performed as needed. If the joints are affected, magnetic resonance imaging (MRI) is prescribed, and X-rays are taken to identify lesions.
Psoriasis vulgaris, treatment
Psoriasis is a systemic disease with skin manifestations, and complex treatment is needed: both local and systemic therapy. The disease is chronic and treatment is aimed at reducing the number and severity of exacerbations and achieving an acceptable skin condition for the patient.
In the progressive stage of psoriasis, all aggressive procedures are canceled: ultraviolet irradiation, baths. It is important that patients with psoriasis carefully and carefully handle the skin, do not injure it, in order to avoid exacerbation and the appearance of new plaques.
Diet for psoriasisOften psoriasis is accompanied by liver disease, so it is important to avoid alcohol, fatty, fried, smoked foods. It is equally important to be moderate in carbohydrate intake, as this changes the pH of the skin and increases the risk of infection of the rash.
Prevention of psoriasis is about maintaining a healthy lifestyle. This helps prevent the occurrence of other diseases, as the body's immune system is shielded from stress and can withstand threats from outside.
Psoriasis prevention measures include:
- suitable skin care;
- relaxing massage to improve blood circulation;
- proper nutrition, it is advisable to avoid allergenic foods and exclude (limit) the intake of spicy, fatty, pickled, smoked, salty foods, as well as citrus fruits;
- dairy-vegetable diet;
- a sufficient amount of moisture in the body;
- elimination of alcohol and smoking and other bad habits;
- increased physical activity;
- walks in the open air;
- avoidance of stressful situations;
- taking vitamins of groups A, B, C, D, E;
- choice of loose clothing of natural materials that will not chafe and cause irritation.
Means for the treatment of psoriasis
Systemic therapy for psoriasis is aimed at reducing the proliferation of skin epithelium, stabilizing the keratinization of skin cells and cell membranes. For this, preparations based on vitamin A (retinoids), cytostatics are used. Of the most modern treatments, the so-called biologics are used, which neutralize substances that cause inflammation.
For many years, UFOs have been used - treatment with ultraviolet rays of group B (in tanning beds, rays of group A), which reduce inflammation and contribute to the death of altered cells. PUVA therapy is the simultaneous use of ultraviolet radiation and a special substance that increases the sensitivity of the skin to it.
An effective remedy for psoriasis
Local treatment is no less important than systemic treatment. It helps reduce skin inflammation. The drugs are prescribed depending on the stage of psoriasis.
- exfoliating ointments and lotions;
- anti-inflammatory hormonal ointments with calcitriol;
- emollients to relieve itching and dry skin.
- UVB therapy;
- concentrated exfoliating ointments;
- emollients to restore skin and reduce dryness.
- concentrated exfoliating ointments;
- emollients to restore skin and reduce dryness.
Creams and ointments for psoriasis have different purposes and are used at different stages of the disease. Hormonal anti-inflammatory ointments and creams are used to stop inflammatory processes in the skin. There are several classes of hormonal drugs. They have different absorption capacities and different activities. When used in children, they try to avoid applying hormonal drugs to the face and neck area, the area of skin folds - places where the skin is thinner. Local preparations based on calcipotriol (a vitamin D derivative) also have an anti-inflammatory effect. This is a later generation of drugs. They are not currently used during pregnancy and lactation.
Salicylic ointment and salicylic acid lotion are designed to remove skin flakes with severe flaking. Salicylic acid not only has an exfoliating effect, but also increases the effectiveness of local hormonal drugs. In the stationary and regressive stage, when the inflammation has become less active, salicylic acid-based agents are used at a higher concentration.
Means for restoring the structure of the skin and eliminating dryness are used during the entire period of treatment, as well as in conjunction with ultraviolet irradiation to reduce itching of the skin. Once flare-ups have subsided, these products help maintain the skin's protective properties and reduce the risk of new breakouts.
An effective cream for psoriasis
The modern approach to care and assistance for dry skin is based on the saturation of the epidermis with moisture and is called corneotherapy (derived from "corneo" - corneal, or horny, layer of the epidermis).
Corneotherapy is aimed at restoring the stratum corneum of the epidermis and its protective functions, which makes it possible to improve the condition of the skin as a whole. The works of the founder of corneotherapy Albert Kligman made it possible to create special means - emollients.
How do emollients work?
within 1 hour after applying emollients: - the condition of the skin improves, due to the fact that emollients "lock" moisture in it.
6 hours after the application of emollients: - the structure of the skin is restored due to the content of special restoring natural lipids (ceramides and other useful fats).
24 hours after the application of emollients: - clinical improvement of the skin condition occurs due to the 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).