Psoriasis (translated from the Greek "psora" - "skin disease, scabs") is a chronic pathology of a non-infectious nature, also known as scaly lichen, which mainly affects the areas of the skin on the knee and elbow joints, lower back and on the head. There is also psoriasis of the joints, bones, nails, external genitals and internal organs, but these forms are rarely diagnosed. The pathology is difficult to cure, therefore, when the first symptoms, red rashes appear, an urgent need to consult a doctor.
The first sign of psoriasis, which is part of the triad of pathology symptoms. It is characterized by increased peeling after scraping the affected surface with a spatula. Over time, there is a separation from the papules of silvery-white scales. Their removal is not difficult, since they become loose and weakly adhere to the psoriatic papule. The surface of neoplasms (rashes) turns white, and the particles crumble and resemble shavings.
The first phenomenon of the triad is explained by the development of parakeratosis (improper functioning of the epithelium, which leads to a violation of the formation of the stratum corneum). To combat deviations at the initial stage, local non-hormonal agents (creams, ointments) are used.
It is characterized by the removal of a thin layer of tissue from the papules, which has a shiny structure and looks like polyethylene. It is easily separated by any impact (pressure, friction, etc. ) after removing dried flakes.
The terminal film is the last layer that is removed from the skin. Further scraping leads to the last stage of the triad - drip bleeding.
At this stage, medicinal herbal baths, drugs with antiallergic effect, ointments on a natural basis (without corticosteroids and hormones) are used.
After removing the terminal film, drip bleeding occurs on the affected area of the skin (auspits symptom or "bloody dew") and accelerated growth of neoplasms is noted, which sometimes reach the size of a pea and are called lenticular. In some cases, the papules enlarge to the diameter of a small coin and differentiate as nummular. With the progression of the disease, their growth increases and when combined, psoriatic plaques are formed.
For treatment, retinoids, immunomodulators, anti-inflammatory drugs, physiotherapy are used.
The disease can be recognized by other characteristic signs, the main of which are 4:
- The rim is red, not covered with scales, which forms around the papules.
- On a clean area of the skin, small rashes are visible (usually appears before the progressive stage of psoriasis).
- A symptom that helps to distinguish psoriasis from seborrheic dermatitis is characteristic of the active stage of the pathology. It is accompanied by the appearance of papules with clear boundaries on the scalp; this does not happen with seborrheic dermatitis.
- A light, shiny rim of skin appears around the formation. The symptom is typical for the stage of regression of the disease and appears when the papules disappear.
What does it look like
In most cases, the onset of the pathology is imperceptible: at an early stage, psoriasis affects small areas of the skin, mainly on the bends of the limbs, the head and along the hairline.
Attention!Beginning manifestations occur at the site of constant mechanical irritation of the skin, for example, where clothing rubs and presses.
- excessive dryness of the skin;
- peeling of pathological elements;
- general deterioration of health (weakness, lethargy, fever).
There are 3 stages of development of pathological papules:
- Progressive.The appearance of a rash of a bright pink hue, surrounded by a rich, slightly vague rim. In the center of the papules, the skin peels off, giving the formations a white color. At this stage, the rash may appear at the site of scratches, skin injuries, bites, cuts, punctures, or burns.
- Stationary.It begins 1-4 weeks after the onset of the disease. New plaques do not appear, old ones acquire a light color, the intensity of peeling decreases.
- Regressive.The color of plaques and papules fades, their infiltration decreases and the formations dissolve. The average duration of the decay period is from 2 to 6-8 months.
Symptoms of the disease depending on the types:
- Plaque(common or vulgar). The most common type of pathology. On various parts of the body (more often on the elbows, knees, head), oval or round plaques of a red hue appear, covered with silvery-white scales on top.
- Seborrheic.It mainly occurs on the scalp. It manifests itself as peeling and itching, spreads to the area behind the ears and the skin along the hairline.
- Pustularthe type is considered the most severe form, develops quickly and affects large areas of the skin. Painful rashes appear on the body, which are accompanied by a local increase in temperature, weakness, headache, diarrhea. Vesicles filled with exudate soon form in the lesions. In the future, the spots progress, merge with each other, forming large lesions on the body.
- Intertriginous.Typical for children, accompanied by the appearance of bright red papules, with slight peeling (it may not be there).
- Exudative.The affected areas of the skin not only peel off, but also get wet, yellowish crusts form on the surface of the plaques.
- Psoriatic erythroderma.Red plaques with silvery, yellow or white scales are observed throughout the body. It is accompanied by an increase in lymph nodes, an increase in body temperature. In the future, the formations merge into large spots that cause irritation and itching.
- Psoriatic arthritis.It is accompanied by "articular syndrome", in which the skin in the area of the joints (on the wrists, phalanges of the fingers, the spine, and so on) is affected, and if measures are not taken in a timely manner, the disease affects the joints.
- Teardropaccompanied by profuse rashes, consisting of many small plaques. In this case, the papules are in the form of drops, their color is from bright red to purple.
- Point.It is characterized by the formation of small spots on various areas of the body, resembling dots, and there may be no peeling of the dermis.
- Rupioid.One of the types of chronic psoriasis. Crusts appear on the formations, they become higher, taking the shape of a cone.
- Oldmanifests itself in large papules that do not pass for a long time, sometimes papillomas and warts form on them.
- Psoriatic onychialeads to deformation of the nails, the appearance of yellow-brown spots under them.
- Palmar-plantar.Appears on palms and soles. The main symptoms are skin thickening, dryness, cracks.
- Psoriasis of the mucous membranesaffects the oral cavity and provokes the appearance of plaques on the mucous membrane.
Localization of psoriasis
In most cases, rashes appear on the surface of the elbows or between the toes. Less commonly, papules are noted on the forearm.
Attention!The hands are characterized by a plaque form of pathology, but others are also found. Its sign is small specks of a red hue, quickly covered with white scales, the affected skin coarsens.
Psoriatic formations mainly occur on the legs in the knee area, but it is possible that they form on other parts of the legs.
The first rash is single and small with a clear outline, but loose, inflamed and heavily flaky. These pinpoint papules spread rapidly to form conglomerates.
Often develops against the background of seborrhea, affects the hairline, forming the so-called psoriatic crown. Skin formations gradually grow and spread over the entire surface, resembling dandruff. This localization occurs quite often, less often a rash appears on the ears or behind them.
The nail plate can be affected by the type:
- Thimble- point form of psoriasis. Small pits appear on the nails, which resemble needle prick marks.
- Onychomycosis- the nail changes color, becomes dull, thickens noticeably and begins to flake off. Through the plate, a psoriatic papule surrounded by a reddish rim is visible, similar to an oil spot.
Usually manifests itself as characteristic papules that merge with each other. Psoriasis is more common on the back, less often on the neck, abdomen, hips, formations can be drop-shaped, point-like and plaque-shaped.
It is rarely affected, the rash is located in the nasolabial folds, in the area of \ u200b \ u200bthe temples and eyebrows, around the eyes. Rarely, the pathology affects the border of the lips, the rash resembles herpes.
Palms and feet
Both zones are affected simultaneously, but there have been cases when the pathology developed only on the feet or palms. On the soles, the disease is often combined with fungal pathology, which greatly complicates diagnosis and therapy.
This type of psoriasis is divided into 3 types:
- Papular-plaque- the formations are dense, do not protrude above the skin, it is difficult to separate the scales from the plaque. The rash occurs in the marginal areas, accompanied by edema and keratosis.
- Psoriatic callus- round dense papules, consisting of keratinized epidermis. The skin layer gradually thickens and coarsens. As a result, it is easily injured, cracks appear. There is practically no redness, the size of the growths is from 2-3 millimeters to 2-3 centimeters.
- Vesicular-pustular- manifests itself in the form of serous-purulent papules. The bubbles reach 2 millimeters in diameter and tend to join.
Pathology can affect the joints of a person, which leads to a change in the structure of their tissues, which, with progression, entails soreness and deformation. External symptoms: a reddish rash appears on the skin. Internal signs - joints hurt, especially during sleep, stiffness of movement, swelling is felt.
Important!First, psoriasis affects the small joints of the feet and hands, then spreads to the knee and elbow, and at an advanced stage, the intervertebral joints already suffer.
Itching or not
In most cases, psoriatic disease is accompanied by itching of varying degrees of intensity, sometimes not only spots, but the whole body itch. At the initial stage, itching is mild, gradually increasing.
The degree of intensity also depends on the location of the pathology. For example, psoriasis on the head itches a lot, while the skin is peeling and falls off in large flakes, larger than normal dandruff in size. At the stationary stage, itching decreases, often giving way to burning sensation. During remission, all major symptoms are mild.
Itching worsens with:
- climate change;
- general intoxication;
- diseases of the digestive tract;
- accession of scabies, allergies;
- HIV infections.
The skin itches badly after drinking coffee, alcoholic beverages, spicy and spicy foods, chocolate and other allergens.
How to distinguish
- The nature of the rash.With eczema, blisters or blisters are filled with fluid that oozes periodically. Psoriasis is characterized by the appearance of dry scaly papules, when removed, blood appears.
- Itchy skin.From eczema, the body itches more than with psoriatic pathology.
- Colour.In psoriasis, the scales have a silvery tint, and in eczema, the affected areas become bright red or scarlet.
- Sore areas.Eczema affects the soft, sensitive areas of the skin, armpits, and groin. Psoriasis is characterized by a rash on rough, hard and thick layers of skin (knees, elbows, head, and others).
- The causes of the disease.Psoriasis is often caused by neurogenic factors, and eczema is caused by allergies and malfunctioning of the body.
- Features for rashes on the hands.With psoriasis, pits form on the nail plate, and eczema is similar to a fungal infection.
For seborrheic dermatitis
The clinical manifestations of the diseases are similar, but there are several features by which they can be distinguished:
- unhealthy shine of the skin and bloody cracks are characteristic of psoriasis, and this is not observed with seborrheic dermatitis;
- dermatitis, unlike psoriasis, is not accompanied by coarsening of the skin and its severe dryness;
- with psoriasis, the scales are silvery, and seborrhea is yellow or white;
- seborrheic scales are easily removed, but psoriatic ones are not;
- dermatitis is more often observed in places of accumulation of sebaceous glands, and scaly disease - throughout the body;
- psoriasis of the scalp protrudes noticeably beyond the hair growth area, and seborrheic pathology does not cross this line;
- the area of lesion with squamous lichen is much larger than that of dermatitis.
- Psoriasis appears in the presence of several provoking factors, for example, heredity, mechanical damage to the skin, malfunctioning of the immune system, and so on. The causative agent of the second disease is only the spores of parasitic fungi.
- Psoriatic pathology is not contagious, it is not transmitted either by airborne droplets, or sexually, or through touch.
Attention!The fungus (onychomycosis) affects any contact, including in public places - a sauna, a swimming pool, gyms, and so on. It is transmitted from animals and people.
- With psoriasis of the head, the structure of the hair does not change, while fungal disease leads to brittleness, dryness and hair loss.
- Unlike scaly lichen, onychomycosis of the legs and feet is accompanied by an unpleasant odor.
- With the defeat of scaly nails, their structure changes already at the initial stage, and with a fungus for a long time, the structure and color of the nail plates do not change.
From pink lichen
The hallmark of psoriasis is the "psoriatic triad". The disease grows gradually and goes through 3 stages. Pityriasis rosea (pityriasis) develops rapidly and is constantly progressing. In addition, pityriasis is a contagious disease, but scaly lichen is not.
- Atopic dermatitis (neurodermatitis) is of allergic origin and is triggered by a certain substance, for example, plant pollen, food, animal hair, and so on. The causes of psoriasis are different (heredity, reduced immunity, psychosomatics, mechanical damage to the skin, and so on).
- With neurodermatitis, the skin dries out and becomes rough, and with psoriasis it becomes scaly and bleeds.
- Plaques with dermatitis consist of separate small elements, in the case of shingles, the papules are uniform and covered with silvery scales.
- The color of the rashes with psoriasis is much brighter than with neurodermatitis.
The difference between gouty and psoriatic arthritis lies in the cause of development. Gout occurs when uric acid crystals are deposited in the cartilage of the joints. Deviation from the norm can be provoked by: arterial hypertension, obesity, taking diuretics, drinking alcohol, and so on.
Symptoms of psoriasis and gout are similar - severe pain at night, stiffness in movement, redness and swelling in the affected area. However, with psoriasis, in most cases, characteristic red rashes appear first, and then pain.
Other distinctive symptoms of gouty arthritis include:
- the presence of white nodules in the area of the affected joint;
- signs of kidney stones (back pain, blood in the urine, and others).