Psoriasis

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

The disease causes severe psychological discomfort in the patient; due to the presence of defects in appearance, it becomes difficult for the 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 allows you to achieve stable remission and restore your previous quality of life.

What is psoriasis

The main symptom of the disease is the presence of psoriatic plaques - flaky pinkish spots of different sizes, which are accompanied by itching.Most often they are located on the scalp (they can also be present along the hairline, behind the ears), elbows, knees, and can also occur on the 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 dilate.

Psoriasis develops due to a malfunction of the immune system.In each layer of the epidermis (there are 5 in total - basal, spinous, granular, shiny and horny) there are keratinocytes (about 90% of them in the entire epidermis).Depending on which layer they are located in, keratinocytes perform different functions (regeneration, synthesis of keratin or other proteins, prevention of skin dehydration, protection of the lower layers of the skin).

Keratinocytes are constantly renewed.Their synthesis occurs in the basal layer.Then they move higher, where each time they perform a new function.Having reached the stratum corneum, they lose their nucleus and turn into corneocytes (peculiar sacs containing keratin).Now their function is barrier.Having outlived their life, corneocytes exfoliate from the surface of the skin.Keratinocytes live for about 2-4 weeks, then are replaced by new ones.

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

Psoriasis can develop in a person of any age (in total, about 4% of the world population suffers from it).However, the disease most often occurs in people under 20 and over 55 years of age.Fair-skinned people suffer from psoriasis quite often; among representatives of the Negroid race, the pathology is detected much less frequently.

Causes of psoriasis

The exact causes of psoriasis have not yet been identified.However, the most common are 2 theories of the origin of this disease:

1. Hereditary disease – the tendency to develop psoriasis is believed to be passed on genetically.
2. A consequence of immunity disorders caused by infections, poor lifestyle, climatic conditions, and bad habits.

Reference!In 40% of patients suffering from this pathology, relatives also suffered from psoriasis.Also, close relatives of patients often experienced a latent form of psoriasis, manifested by changes in the structure of capillaries.

Most often, the “push” to start the development of psoriasis is emotional overload (in 50% of cases), focal infections, metabolic disorders, diabetes mellitus, liver disease, and the use of certain medications (most often glucocorticosteroids, beta-blockers, lithium salts).

There are other factors that “trigger” the disease or provoke its exacerbation:

• Injuries, fractures.
• Frostbite.
• Sunburn.
• Tobacco smoking.
• Alcohol abuse.
• Obesity.
• Damage to the skin by chemicals.
• Food allergies.
• Parasitic infestations.
• Pregnancy and childbirth.
• Other skin diseases - eczema, dermatitis.

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

Types and stages of psoriasis

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

1. Common psoriasisdevelops most often.It is characterized by the presence of itchy plaques with a scaly surface on the skin.Also, with this form, discoloration of the nails and the appearance of small white spots on them are often observed.In some cases (in advanced stages), the nails move away from the nail bed.
2. Guttate psoriasismanifests itself as a small rash, localized mainly on the chest and back.The rash is accompanied by itching in areas where the skin is affected.Usually the symptoms of the disease disappear after 4-6 months and no longer appear.However, the patient may subsequently develop another form of psoriasis.This happens about half the time.Guttate psoriasis is usually seen in children and adolescents.It often develops as a result of infection, most often after a bacterial infection of the throat.
3. Reversible psoriasisresponds well to treatment, sometimes it is possible to achieve stable remission without relapses.Red, weeping plaques appear only in some parts of the body, in the folds, and do not spread further.Typically, rashes appear in the groin area or under the mammary glands, also in the armpits.Reversible psoriasis most often develops in older patients.
4. Pustular psoriasisis a severe and dangerous form.In some cases it develops rapidly and suddenly.It is characterized by the appearance of blisters with purulent contents on the soles and palms, then the affected skin thickens and begins to actively peel off.Later, the rash spreads over large areas.In advanced cases, the skin of the entire body may be affected.Pustular psoriasis can threaten the patient's life.Affects mainly adults.

Psoriasis develops in 3 stages:

1. Progressive.
2. Stationary.
3. Regressive.

Progressive stagecharacterized by the appearance of multiple nodular rashes and their spread to new areas of the body.The plaques gradually increase in size.

At stationary stagethe appearance of rashes stops.The existing plaques stop increasing in size, but active peeling begins over the entire affected surface.

In a regressing stageplaques become denser, their elements dissolve, peeling decreases.Then, at the site of the rash, spots devoid of pigment remain.

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 are:

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

Reference!About 1 in 10 patients develop arthritis as a result of psoriasis.Therefore, it is necessary to start treatment as early as possible to prevent the development of complications.

Diagnostics

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

1. Stearin stain - with slight scraping, the peeling intensifies, and the rash becomes similar to a crushed drop of stearin.
2. Terminal film - if you remove the scales from the surface of the plaque, it has a shiny, moist surface.
3. Bloody dew - if you scratch the terminal film, pinpoint droplets of blood appear 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 stable remission.Comprehensive treatment is carried out, the plan of which is developed in accordance with the course of the disease in a particular person.It includes:

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

If concomitant diseases are diagnosed, they are also treated.

Lifestyle with psoriasis

The patient must take into account that treatment for the disease will last throughout his life.In many ways, the duration of remission depends on it.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, watermelons) and other foods that can provoke the development of allergic reactions.It is also advisable to avoid spicy, fatty, fried, smoked foods, rich meat and fish broths.Seasonings are excluded: ketchup, mayonnaise, mustard, etc.You should limit your intake of sugar and salt.You should pay attention to products containing fiber, Omega acids, 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 for a long time - you should swim and take a bath less often, it is recommended to take a short shower.
• Hard washcloths should be replaced with a soft sponge or cotton cloth, and regular soap with a pH-neutral product.
• After a shower, you should not wipe, but pat your skin with a towel - this will avoid damaging the plaques and increasing itching.
• After water procedures, the skin must be moisturized with cream.
• It is necessary to give preference to spacious, light clothing made from soft natural fabrics, since the pressure of clothing items on the skin can provoke the development of new rashes.
• Itching often forces the patient to scratch, which can cause injury to the skin - to avoid new damage, it is better to cut your nails short.
• Drying the skin should be avoided, so avoiding air conditioning will be beneficial, as will humidifying the indoor air.
• Although sunbathing can be beneficial for psoriasis, excessive exposure to ultraviolet light can aggravate the disease - you should consult your doctor about your sun exposure regimen.
• Any risk of skin irritation should be avoided.
• Cuts and wounds can cause new rashes to appear, so you need to protect yourself from them.
• Stress is a common trigger for exacerbation of the disease, so it is necessary to avoid traumatic situations whenever possible.
• It is necessary to avoid physical inactivity (inactivity) - moderate physical activity will benefit the condition of the whole organism.

If you feel worse, you should immediately consult a doctor to prevent the disease from progressing to a more severe stage or the occurrence of complications.