Psoriasis can manifest itself in diverse forms.Psoriasis options include vulgar (simple, ordinary) or, otherwise, plaque psoriasis (psoriasis vulgaris, Plaque psoriasis), pustular psoriasis, drop -shaped or point psoriasis, flexor psoriasis)surfaces (Flexural psoriasis).This section provides a brief description of each variety of psoriasis together with its code according to the international classification of diseases (ICD-10).
Plush -shaped psoriasis, or Ordinary psoriasis, vulgar psoriasis, simple psoriasis (psoriasis vulgaris) It is the most common form of psoriasis.It is observed in 80% - 90% of all patients with psoriasis.Plush-shaped vulgar psoriasis is most often manifested in the form of typical areas raised over the surface of healthy skin of the areas of inflamed, red, hot skin covered with gray or silver-white, easily exfused, scaly, dry and thickened skin.Red skin under an easily removed gray or silver layer is easily injured and bleeding, as it contains a large number of small vessels.These areas of typical psoriatic damage are called psoriatic plaques.Psoriatic plaques tend to increase in size, merge with neighboring plaques, forming whole plate plate (“paraffin lakes”).
Psoriasis of the flexion surfaces (Flexural psoriasis), or "Reverse psoriasis". Usually it looks like smooth, not peeling or with minimal peeling, red inflamed spots that are not particularly protruding above the skin surface, located exclusively in the folds of the skin, in the absence or minimum lesion of other areas of the skin.Most often, this form of psoriasis affects the folds in the external genital organs, in the groin, on the inner surface of the hips, axillary depressions, folds under an obesity of the stomach (psoriatic pannus), and on the folds of the skin under the mammary glands in women.This form of psoriasis is especially susceptible to deterioration under the influence of friction, skin injury and sweat, and is often accompanied or complicated by a secondary fungal infection or streptococcal pyoderma.
Guttate psoriasis (Guttate psoriasis) It is characterized by the presence of a large amount of small, raised above the surface of healthy skin, dry, red or purple (up to purple color), similar in shape to drops, tears or small dots, circles of the elements of the lesion.These psoriatic elements usually strengthen large surfaces of the skin, the most often hips, but can also be observed on legs, forearms, shoulders, the hairspent of the head, back, neck.Ground -shaped psoriasis often develops or exacerbates after streptococcal infection, in typical cases - after streptococcal tonsillitis or streptococcal pharyngitis.
Pustular psoriasis or Exudation psoriasis It is the most severe of the skin forms of psoriasis and looks like bubbles or blisters raised above the surface of healthy skin, filled with unfortunate, transparent inflammatory exudate (pustules).The skin under and above the surface of the pustules and around them is red, hot, edematous, inflamed and thickened, easily exfoliates.The secondary infection of the pustules may be observed, in which case the exudate acquires a purulent character.Pustulous psoriasis can be limited, localized, while its most frequent localization is the distal ends of the limbs (arms and legs), that is, the lower leg and forearm, this is called palmoplantar pustules (Palmoplantar Pustulosis).In other, more severe cases, pustular psoriasis can be generalized, with the widespread spread of pustules over the entire surface of the body and the tendency to merge into larger pustules.
The causes of psoriasis
Impaired barrier function of the skin (in particular, mechanical trauma or irritation, friction and pressure on the skin, abuse of soap and detergent, contact with solvents, household chemicals, alcohol -containing solutions, the presence of infected foci on the skin or skin allergy, excessive dry skin) also play a role in the development of psoriasis.
Psoriasis - This is in many ways an idiosinratic skin disease.The experience of most patients suggests that psoriasis can spontaneously improve or, conversely, aggravate for no apparent reason.Studies of various factors associated with the emergence, development or exacerbation of psoriasis are tended to based on the study of small, usually hospital (not outpatients), that is, obviously heavier, groups of patients with psoriasis.Therefore, these studies often suffer from the insufficient representativeness of the sample and from the inability to identify causal relationships in the presence of a large number of other (including still unknown or unconfigured) factors that can influence the nature of the course of psoriasis.Often, in different studies, contradictory finds are found.Nevertheless, the first signs of psoriasis often appear after suffered stress (physical or mental), skin damage in places of the first appearance of psoriatic rashes, and/or transferred streptococcal infection.The conditions, according to a number of sources that can contribute to the exacerbation or worsen of the course of psoriasis, include acute and chronic infections, stress, climate change and the change of seasons.Some drugs, in particular, lithium carbonate, beta-blockers, antidepressants, antimalarial drugs, anticonvulsants, according to a number of sources, are associated with a deterioration in psoriasis or can even provoke its primary occurrence.Excessive alcohol consumption, smoking, overweight or obesity, improper nutrition can weight the course of psoriasis or complicate its treatment, provoke exacerbations.Hair varnish, some creams and handles for hand, cosmetics and perfumes, household chemicals can also provoke an exacerbation of psoriasis in some patients.
Patients suffering from HIV infection or AIDS often suffer from psoriasis.This seems to be paradoxical for researchers of psoriasis, since treatment aimed at reducing the number of T cells or their activity generally helps to treat psoriasis, and HIV infection or, moreover, AIDS is accompanied by a decrease in the number of T cells.However, over time, with the progression of HIV infection or AIDS, an increase in the viral load and a decrease in the number of circulating CD4+ T cells, psoriasis in HIV-infected patients or AIDS patients worsens.In addition to this riddle, HIV infection is usually accompanied by a strong shift of the cytokine profile towards the Th2, while vulgar psoriasis in non-infected patients is characterized by a strong shift of the cytokine profile towards Th1.According to the currently adopted hypothesis, a reduced amount and pathologically altered activity of CD4+ T-lymphocytes in patients with HIV infection or AIDS cause hyperactivation of CD8+ T-lymphocytes, which are responsible for the development or aggravation of psoriasis in HIV-infected or patients with AIDS.However, it is important to know that most patients with psoriasis are healthy in relation to HIV carriage, and HIV infection is responsible for less than 1 % of psoriasis cases.On the other hand, psoriasis in HIV-infected people occurs, according to various sources, with a frequency of 1 to 6 %, which is approximately 3 times higher than the frequency of psoriasis in the general population.Psoriasis in patients with HIV infection and especially AIDS often proceeds extremely difficult, and is poorly lended or not at all amenable to standard methods of therapy.
Psoriasis most often develops in patients with initially dry, thin, sensitive skin than in patients with oily or well -moistened skin, and is much more common in women than in men.In the same patient, psoriasis most often first appears in areas of dry or thinner skin than in oily skin, and especially often appears in places of damage to the integrity of the skin, including combing, abrasions, scratches, cuts, in places undergoing friction, pressure or contact with aggressive chemicals, detergents, detergents, and detergents, solublers, solublers, solublers.(This is called Kebner's phenomenon).It is assumed that this psoriasis lesoride phenomenon is primarily with dry, thin or injured skin associated with the infection with the fact that the body infects (probably most often streptococcus) easily penetrates the skin with minimal secretion of skin fat (which, under other conditions, protects the skin from infections) or in the presence of skin damage.The most favorable conditions for the development of psoriasis are thus opposite to the most favorable conditions for the development of the fungal infection of the feet (the so -called “athlete leg”) or armpits, the inguinal region.For the development of fungal infections, the most favorable, wet skin, for psoriasis, on the contrary, dry.The infection that has penetrated dry skin causes dry (non -expess) chronic inflammation, which, in turn, causes symptoms characteristic of psoriasis, such as itching and increased proliferation of skin cells.This, in turn, leads to further increased dryness of the skin, both due to inflammation and enhanced proliferation of keratinocytes, and due to the fact that the infected body consumes moisture, which otherwise would serve to moisturize the skin.To avoid excessive dryness of the skin and reduce symptoms of psoriasis, patients with psoriasis are not recommended to use washcloths and scrubs, especially rigid ones, since they not only damage the skin, leaving microscopic scratches, but also scrap from the skin the upper protective cornea and skin lard, which protecting the skin from drying out and from the penetration of germs.It is also recommended to use a talcum or baby puffing after washing or bathing to absorb excess moisture from the skin, which, otherwise, will “get” an infected agent.Additionally, it is recommended to use products that moisturize and feed the skin, and lotions that improve the function of the sebaceous glands.It is not recommended to abuse soap, detergents.You should try to avoid skin contact with solvents, household chemicals.
Diagnosis of psoriasis
The diagnosis of psoriasis is usually simple and based on a characteristic appearance of the skin.There are no diagnostic procedures or blood tests specific to psoriasis.Nevertheless, with active, progressive psoriasis or its severe course, deviations in blood tests can be found, confirming the presence of an active inflammatory, autoimmune, rheumatic process (increasing the titles of rheumatoid factor, acute phase proteins, leukocytosis, increased ESR, etc.), as well as endocrine and biochemical disorders.Sometimes a biopsy of the skin is necessary to exclude other diseases of the skin and histological confirmation (verification) of the diagnosis of psoriasis.During a biopsy of the patient with psoriasis, clusters of the so-called tears of retail, thickening of a layer of keratinocytes, their histological immaturity, massive skin infiltration with T-lymphocytes, macrophages and dendritic cells, signs of increased proliferation of keratinocytes and immunocompetent cells, accelerated angiogenesis in a layer of skin under the skin under a layer of skin under a layer of skin under a layer of skin under a layer of skin under a layer of skin under a layer of skin underPluts.Another characteristic sign of psoriasis is point hemorrhages and the ease of bleeding from the skin under the plaque during its scravation, which is associated both with the acceleration of angiogenesis and the pathologically increased permeability and brittle of skin vessels in the lesion (Aushpitz symptom).
Alternative treatment of psoriasis
For the symptomatic treatment of vulgar psoriasis, some of the countries in some of the countries use ichthyotherapy in some resorts with open thermal springs.The Garra Rufa fish that live there eat the skin on psoriatic plaques, without touching healthy areas.After such treatment, an improvement in the condition of patients is observed by six months or more.A successful location in subtropics allows you to combine rest in comfortable hotel rooms with Fish SPA procedures and sea baths.At your request, the hotel cook will prepare a special diet.The water in a bath with the Garra Rufa fish passes a three -stage cleaning system (mechanical, running ultraviolet sterilization and biological purification).The sun, sea, fresh air, special diet-all this in the complex helps to achieve a positive effect of baths with miracle fishing.Daily sprinkling with a mixture of powdered sugar and potato starch will help remove psoriatic plaques.
Treatment of psoriasis with folk remedies
- To cope with psoriasis, Give up fat, pork, smoking, chocolate, spices, alcohol, coffee and sweets.Enrich the diet with fermented milk products, fresh herbs, baked apples, fish and nettle salads.Eat a lot of vegetable oils rich in indispensable fatty acids) and products containing lecithin.
- Eat food In boiled, boiled or stewed (excluded fried and smoked) from the diet.
- Refuse food that increase acidity in the body- give preference to products that alkalize the body.Some people on the Web have repeatedly testified that only a change in nutrition in the direction of alkalization contributed to the complete restoration of health, not only from psoriasis itself, but also of old chronic diseases.
- Wash Only children's or tar soap, regularly taking baths with decoctions of celandine, hops and violets of three -color.
- Follow Surgery (1-2-day starvation).