Psoriasis: symptoms, treatment and prevention

Psoriasis- one of the most common diseases, the frequency of which in the population increases constantly each year. And if we consider that absolutely all age categories are susceptible to this pathology, and its simple form quickly becomes a more complex one, then the question of appropriate therapy and prevention is indeed a very acute one.

According to statistics, approximately every 30 inhabitants of the planet suffer from this disease to one degree or another. What to do for those who get psoriasis? What medications and folk remedies can be treated? How to properly organize your meals? We will finally put all the points.

Psoriasis and its causes

Psoriasis is an autoimmune disease of very vague etiology - the exact cause, despite numerous studies in this area, is still unknown. This pathology is believed to be a consequence of genetically determined changes in the immune system, as a result of which chronic skin inflammation develops. However, its multifactorial nature is also not excluded - that is, involvement, along with heredity, and the influence of the external environment.

It is worth mentioning that the predisposing factors, according to the scientists, are quite different for different age groups: for example, if various types of bacterial infections, including, in particular, streptococcal infections, are considered triggers in children and then inadults, stress stimuli and nicotine abuse are key and alcohol, obesity and the use of certain medications (for example, adrenaline receptor blockers).

It is impossible to completely cure psoriasis; however, modern medicine is quite capable of significantly easing the course of the disease and maintaining a long-term remission in the patient.

There are several theories to explain the onset of psoriasis:

• infectious and parasitic;
• neurogenic;
• endocrine;
• metabolic;
• immunological;
• hereditary;
• molecular mimicry theory.

As with many other diseases, the cause of skin problems must be found in the intestine. Its length is 4 to 6 meters, and the internal surface is covered by villi, whose total area is comparable to the size of a tennis court - this allows the absorption processes to occur much more efficiently. Interestingly, the cells of the mucous membrane of the small intestine are completely renewed every 3-5 days. In addition, up to 70% of human immunocytes are concentrated here. Therefore, one of the most common causes of psoriasis is considered to be leaky gut syndrome (LEPS).

The deviation from the normal functioning of the intestinal mucosa is full of malabsorption, that is, a violation of the assimilation of basic nutrients (proteins, fats, carbohydrates, vitamins, minerals). In addition, the negative impact on the body of toxins and allergens increases: under these conditions, it is much easier for them to enter the bloodstream. The direct link between psoriasis and inflammatory bowel disease has been proven in several studies.

Other studies by scientists confirm that a special microflora forms on the skin of a patient with psoriasis, which is significantly different from the healthy skin microbiome.

In the area of psoriatic lesions, a mass of various bacteria is concentrated, whose stability is significantly less than that of normal skin - in particular, colonization by Staphylococcus aureus is observed, which has an extremely negative effect on the course of the inflammatory process.

Types of psoriasis

1. Plaque psoriasis. . . In 90% of cases, the dermatologist is faced with this particular form of the disease, also known as simple or common. First, small separate areas appear on the skin, elevated above the level of the healthy dermis. These inflamed areas are called psoriatic plaques. Gradually, they grow, merging with neighboring points as a whole.
2. Reverse psoriasis.This diagnosis is given to patients who develop smooth red spots in the folds of the skin and inside the folds - in the groin area, in the inner thighs, under the breasts. Unlike simple psoriasis, the inflammation foci are practically not covered by scales, but due to their location and constant friction, they cause great discomfort to patients. In addition, there is a danger of reinfection by streptococci or fungi, because in places where stains are located, due to high humidity and temperature, ideal conditions are created for the reproduction of microorganisms.
3. Guttate psoriasis.This type of disease has its name due to the format of the formations. The lesions are drop-shaped, elevated above the level of healthy skin. A common trigger for this form of psoriasis is a previous streptococcal infection, as we mentioned earlier. It turns out that the patient's immunity, affected during the fight against infection, is severely weakened - its resources are not unlimited and, like all living beings, it takes time to recover - and it is in this context that an autoimmune disease is activated.
4. Pustular psoriasis.It is considered the most severe form, accompanied by the formation of bubbles filled with a clear liquid. Inflammation of the skin begins around the outbreaks, with swelling and thickening. With a secondary exacerbation, the likelihood that it is quite high, the bubbles fill with pus. Localized foci of pustular psoriasis on the arms and legs. In difficult cases, there is an ubiquitous localization of blisters on the body, their rapid growth and the danger of infection of the entire surface of the skin.

5. Nail psoriasis.This type of disease changes the appearance and structure of the nail plates on the hands and feet. The nails thicken, lose their natural color, give off an unpleasant odor. The skin around the nail bed becomes thick, thick ridges are formed. In advanced cases, nails can disappear without subsequent growth.
6. Psoriatic arthritis.In this case, the disease affects the joints and connective tissues. Most of the time, the inflammation affects the distal phalanges of the extremities. There is psoriatic dactylitis - swelling of the fingers. The hip and knee joints are also exposed to the devastating effects of the ongoing disease. There are frequent cases of disability with loss of the ability to move independently.
7. Psoriatic erythroderma.Scaly patches appear on the skin, while the peeling of the affected layer is observed. Patients experience extreme discomfort due to constant itching and swelling. Most of the time, this diagnosis is made for patients who have already been treated for simple psoriasis, but have not completed therapy or changed their medication.

Symptoms of the disease

The first manifestation of psoriasis is a small rash. The papules grow quickly, reaching points with a diameter of 4 to 8 cm, they become more and more numerous and dry scales form on the surface. In advanced cases, individual stitches merge and the injury affects large areas of the body. Psoriatic papules can be distinguished from other skin diseases by their round shape with clear borders, bright red or pink color and silvery white scales. They appear first in the areas of the skin, whose integrity is violated as a result of abrasions, wounds, cold ulcerations, constant friction. There are three characteristic signs that confirm the beginning of the development of psoriasis:

1. Stearin stain phenomenon- dry particles are easily separated from the affected surface, revealing an area that looks like a drop of wax or sterol.
2. Psoriatic phenomenonfilm (terminal). The subsequent cleaning of the scales papules allows you to see a transparent, moist film, the skin under which it is inflamed.
3. Auspitz Phenomenon. . . Removal of the terminal film leads to the appearance of small drops of blood on the surface of the stain.

This triad of psoriasis is unique - its presence allows the correct diagnosis to be made unambiguously. However, different parts of the body have their own characteristics of manifestation of the disease.

• Psoriasis in the body.The back, neck, abdomen, thighs and lower legs are most affected by guttate psoriasis. Small papules, which are in the form of drops, gradually grow, rising above the surface of the skin. This form of the disease is often diagnosed in people who have had a staph infection.

• Psoriasis on the hands.The most common sites for the appearance of psoriatic papules on the hands are the elbows and interdigital spaces - while, as a rule, a plaque shape is observed, in which small individual fragments fuse into a single lesion area covered by dry scales. The forearms are much less likely to be affected.
• Psoriasis on the legs.The disease begins with single skin rashes in the knee area. The inflamed areas disturb patients with severe flaking and itching, rapidly increase in size and merge with the surrounding areas.
• On the palms and feet.In most cases, simultaneous defeat of the palms and feet is recorded, but in some patients the disease affects the stratum corneum of the purely upper or lower extremities. As a result of the growth of psoriatic papules, thickening and wrinkling of the skin occurs with new cracks.
• Scalp psoriasis.Firstly, skin rashes appear on the forehead, neck and also behind the ears. First, patients notice in themselves unique scaly formations that grow, fuse with those located nearby and, over time, can affect the entire scalp. The papules itch a lot, causing a constant need to scratch the skin - the resulting sores and cracks are likely to become the gateway to infection. Dry particles are separated from harmful formations - first small, somewhat similar to dandruff, and then larger flakes.

• On the face, ears, neck.The location of psoriatic papules on the face is an exception in the usual clinical picture. In rare cases, when this happens, the disease affects the areas around the eyes and eyelids, as well as the cheeks and tongue. Formations in the neck spread quickly - to the back or head. The ears are the site of development of seborrheic psoriasis. Papules may appear inside and outside the cartilaginous shell. When making the diagnosis, it is important not to confuse the disease with seborrheic eczema, which has similar symptoms.
• On the nails.There are three options for the initial manifestation of psoriasis on the nail plates. The first is the appearance of small dotted depressions. The second is a thickening of the nails, a change in their natural color to gray or yellow. With the development of nail psoriasis, the plaque exfoliates, the upper particles are easily separated. And finally, the third is a deformation of the nail, accompanied by a loss of smoothness by the plaque and the appearance of depressed areas.

• Symptoms of psoriasis in children.At an early age, the disease develops differently: the main location for red scaly skin rashes is the skin folds: inguinal, on the elbow and popliteal, on the neck. The papules itch a lot, the children go through constant torments, they get irritated and restless. In general, all clinical variants seen in children are similar to those seen in adults. The differences concern purely the manifestations, the location of the pathological process and the course of the disease itself.

4 stages of psoriasis

Clinical dermatology, based on differences in symptoms, degree of skin lesions and duration, distinguishes three stages of the course of psoriasis. However, there is an opinion that the initial stage should be recognized as yet another mature stage in the development of the disease.

1. Initial state.The first sign of psoriatic lesions is small skin rashes. The places of its appearance can be different and depend on the type of disease. Primary papules are no more than 3 mm in size, painted a pale pink color, which after 3-4 days is replaced by a gray flower - dead dermis particles form on the spot. This process is accompanied by itching and burning, and it worsens overall health. In general, the formation of plaques in the initial phase takes up to three weeks and, at that time, the person has the chance to delay the development of the pathology.
2. Progressive.At this stage, the disease affects important areas of the skin: for example, in normal psoriasis, plaques are formed, with other forms, papules characteristic of them. In the process of developing the disease, individual patches fuse, covered by gray scales. The symptom by which the progressive stage is determined is the Köbner phenomenon (isomorphic reaction). Any damage to the skin after some time is accompanied by the appearance of a rash of psoriasis at this location. Another confirmation that the disease is actively developing is the appearance of drops of blood, similar to dew, after the removal of the plaque. The duration of this phase depends on the type of injury. On average, it takes two weeks to two months.
3. Stationary stage.During this period, a thick gray-white or gray crust forms. The pink edges disappear. The skin is rough, the dry particles are constantly exfoliated from it. The itchy and burning sensation becomes less uncomfortable, but it also does not disappear completely. New papules are not formed. This stage can be quite long.
4. Regressive stage.Final stage of development of the disease, during which there is a gradual reduction and resorption of plaques. The itch doesn't bother you anymore. A clear sign of regression is Voronov's symptom, when the papules are surrounded by white rings. The fading of the spots occurs from the center to the periphery, as a result of the formation of bizarre patterns on the skin. At the end of the regressive stage, only areas of skin with a slightly different shade than healthy areas resemble psoriasis. There is no need to talk about complete recovery in the case of psoriasis. The end of the regressive phase indicates that the disease cycle is complete and can return at any time. For the remission to be prolonged, it is necessary to pay attention to health: avoid provocative factors, eat a diet, be observed by the dermatologist.

Examination plan for psoriasis

1. General clinical analysis of blood.
2. Research on the content of vitamins D, B12 and folic acid in the blood.
3. Blood test for ALT (alanine aminotransferase), AST (aspartate aminotransferase), direct bilirubin, alkaline phosphatase, gamma-glutamyl transferase, cholesterol with lipid profile, creatinine, glucose, insulin, total protein.
4. Blood for rheumatoid factor, c-reactive protein, uric acid, ASLO.
5. Ferritin, transferrin, serum iron are indicators of anemia (in particular, chronic diseases).
6. Thyroid panel: TSH, T4 sv, TK sv.
7. Coprogram.
8. KhMS according to Osipov.
9. Ultrasound of Organs abdominal organs.

Traditional treatments for psoriasis

Early therapy.

The sooner a person who has discovered the first signs of skin lesions to consult a doctor, the greater the chances of taking timely measures that will prevent the disease from developing rapidly and transition to a chronic form - and therefore will significantly improve the condition. general standard of living.

One of the most commonly prescribed drugs at the beginning of the disease is salicylic ointment. It has an anti-inflammatory and antimicrobial effect, it has a keratolytic effect, due to which the plaques are purified from the keratinized particles. To reduce itching, mothball ointment is also used.

Progressive stage therapy.

At this stage, an integrated approach to treatment is required and only an experienced specialist can provide it. Treatment aims to alleviate symptoms by ridding the body of toxins. To normalize metabolic processes, intramuscular injections of calcium gluconate are often prescribed. Sodium thiosulfate relieves inflammation and eliminates intoxication.

To hydrate inflamed skin, special emulsions and salicylic ointment are used. Tar-containing media are contraindicated in a progressive phase: they act irritating and increase the patient's suffering.

When the intensity of the inflammation decreases, physiotherapy procedures can be connected. Psoriasis patients are submitted to ultraviolet irradiation, PUVA therapy and paraffin applications. Corticosteroids and cytostatics are not used unnecessarily, these potent drugs are needed exclusively in difficult and advanced cases.

To reduce allergic manifestations, antihistamines and sedatives are prescribed to reduce nervousness. Diuretics help to reduce swelling of inflamed skin and remove toxins from the body.

Stationary therapy.

At this stage, the inflammation disappears, the plaques are covered by a dry crust, so funds are needed that will relieve the discomfort of the appearance of scales. These are tar shampoos, oil-based emulsions.

In many patients, ultraviolet irradiation and the PUVA technique have a good effect. If there is no improvement, doctors prescribe cytostatics.

Regressive therapy.

In the final period of the disease cycle, constant correction of treatment methods is necessary, depending on the patient's current condition. Prevention is replacing active therapeutic actions.

The patient receives recommendations for changes in diet and lifestyle in general. To avoid the return of the skin lesion, it is necessary to avoid stressful situations that trigger the formation of psoriatic plaques.

Typically, doctors give patients the following advice:

• reconsider lifestyle: make adjustments to the diet, get enough sleep, move more;
• ensure normal vitamin levelsD, iron, B vitamins, proteins in the body;
• normalize the digestive tract: exclude hypoacidity, impaired bile output, SIBO and CIGR (syndromes of excessive bacterial growth and, consequently, fungal growth);
• getting rid of chronic infection outbreaks: clean the oral cavity, undergo treatment with an otorhinolaryngologist;
• dealing with concomitant somatic pathology: hypothyroidism, insulin resistance, metabolic syndrome, etc.

Traditional methods to get rid of psoriasis

• Initial state.At the first sign of skin damage, juniper and lavender oils are effective. They soothe irritated areas of the dermis, heal small lesions and relieve the feeling of tightness. A few drops of oil are added to a cream of neutral composition, for example, for children, and applied to the rash that appears. Another popular method of dealing with the initial manifestations of psoriasis is the use of 3% hydrogen peroxide. Any measures, even the most harmless at first, can be applied after consulting a dermatologist. Changes in diet, avoiding unhealthy foods and alcohol are also common recommendations for traditional healers.

• Progressive stage.In the stage of rapid development of the disease, an infusion of celandine is added to the curative oils and hydrogen peroxide. To prepare it, you will need stems of fresh or dried plants and salt water. Alcoholic tinctures are contraindicated, they can aggravate the condition of the affected skin. It is necessary to insist on celandine for at least several hours and, before applying the healing solution to the plates, treat them with birch tar.
• Stationary stage.At the stage of finishing the formation of new papules, you can use proven popular methods that will definitely not harm the patient. This includes the use of sulfuric ointment and salicylic solution.
• Regressive stage.In the final stage of the disease course, hirudotherapy (leech therapy) is often used. Although this method is not officially recognized by traditional medicine, many experts do not rule out its effectiveness. The procedures are performed in 3 to 10 days, depending on the patient's health status.

Prevention of psoriasis: how to prevent the development of the disease

• Skin care.To minimize the likelihood of psoriatic damage in the presence of a genetic predisposition, simple ways to maintain skin health will help: water and hardening procedures (sea baths, baths with herbal extracts and salts, contrast showers, cold wateringin the air, etc. ); use soft sponges and avoid hard cloths that can damage the skin; the use of detergents of natural composition, without aggressive chemical components.
• Ultraviolet rays.Several studies have proven the beneficial effect of sun exposure on the skin with a tendency to form psoriatic plaques. Moderate doses of ultraviolet light help to accelerate tissue regeneration and reduce inflammation. Sunbathing should not be abused: excessive rays can cause the disease to worsen.

• Clothing.Synthetic fabrics, tight styles, plenty of belts and zips - all of this is contraindicated for patients with psoriasis, even in remission. The clothes must be natural, hypoallergenic, baggy, causing no disturbance that can lead to the return of pronounced symptoms. Dark tones should be avoided for aesthetic reasons; silvery white scales are less visible in light-colored clothing.
• Injuries.For psoriasis patients, any small wound, scratch, abrasion can cause the progressive stage to return and secondary skin infection. They must be extremely careful to avoid injury.
• Cosmetic and household products.Not all remedies are suitable for keeping people with these diagnoses clean. When choosing shower gels, soaps, shampoos, it is important to pay attention to their composition, giving preference to those containing natural ingredients. It is best to buy therapeutic series of care products that are sold in pharmacies. Mops with solid particles are absolutely contraindicated: they are able to restart the disease process due to minor skin injuries. Household chemicals should also be selected based on health safety, do not use aggressive chlorine and alkali cleaning powders. Gloves should be worn when cleaning to avoid negative effects on the skin of the hands.
• Vitamin therapy.Maintaining the balance of vitamins is suitable for everyone, and especially for people with chronic dermatitis. Complex preparations keep the body in good condition, help to resist viruses and prevent metabolic disorders.

Psoriasis- this is not a death sentence, but a very serious reason to reconsider the rules by which you lived before. Your allies on the way to tame the disease must be competent professionals - dermatologists, nutritionists, therapists. With their help, as well as through a deliberate approach to treatment, you can learn to live in comfort, despite your diagnosis.