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 the most affected.

The disease causes severe psychological discomfort to the patient;due to the presence of defects in appearance, it becomes difficult for a person to adapt to the team and communicate with people.Severe forms of psoriasis can cause disability.It is impossible to completely cure the pathology.However, adequate treatment allows you to achieve a stable remission and restore your previous quality of life.

What is psoriasis

The main symptom of the disease is the presence of psoriatic plaques - pink scaly patches of different sizes, 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 in the immune system.In each layer of the epidermis (there are 5 in total - basal, prickly, granular, shiny and horny) there are keratinocytes (about 90% of them in the entire epidermis).Depending on the layer in which they are located, 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.Its synthesis occurs in the basal layer.Then they move up, where each time they perform a new function.Upon reaching the stratum corneum, they lose their nucleus and transform into corneocytes (peculiar sacs containing keratin).Now their function is a barrier.Having survived life, corneocytes exfoliate from the surface of the skin.Keratinocytes live for about 2 to 4 weeks and are then replaced by new ones.

In psoriasis, under the influence of a malfunction in 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 people of any age (in total, about 4% of the world's population suffers from it).However, the disease occurs most often in people under 20 and over 55 years of age.Fair-skinned people suffer from psoriasis quite often;among representatives of the Negroid race, 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 about the origin of this disease:

1. Hereditary disease – it is believed that the tendency to develop psoriasis is transmitted genetically.
2. Consequence of immunity disorders caused by infections, inappropriate lifestyle, climatic conditions and bad habits.

Reference!In 40% of patients suffering from this pathology, family members also suffered from psoriasis.In addition, close relatives of patients often had 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 diseases and the use of certain medications (most often glucocorticosteroids, beta-blockers, lithium salts).

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

• Injuries, fractures.
• Freezing.
• Sunburn.
• Smoking.
• Alcohol abuse.
• Obesity.
• Damage to the skin by chemicals.
• Food allergies.
• Parasitic infestations.
• Pregnancy and childbirth.
• Other skin diseases are 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 more frequently.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 pull away from the nail bed.
2. Guttate psoriasisit manifests itself as a small rash, located mainly on the chest and back.The rash is accompanied by itching in the affected areas of the skin.Usually the symptoms of the disease disappear after 4-6 months and do not appear again.However, the patient may later develop another form of psoriasis.This happens half the time.Guttate psoriasis is usually seen in children and adolescents.It often develops as a result of an infection, usually following a bacterial throat infection.
3. Reversible psoriasisresponds well to treatment, sometimes it is possible to achieve a stable remission without relapses.Red, weeping plaques appear only on 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 develops more often in elderly patients.
4. pustular psoriasisIt is a serious and dangerous form.In some cases, it develops quickly and suddenly.It is characterized by the appearance of blisters with purulent contents on the soles of the feet and palms, then the affected skin thickens and begins to actively peel off.Later, the eruption spreads over large areas.In advanced cases, skin over the entire body may be affected.Pustular psoriasis can threaten the patient's life.It mainly affects adults.

Psoriasis develops in 3 stages:

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

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

In the stationary phasethe appearance of rashes stops.Existing plaques stop increasing in size, but active peeling begins over the entire affected surface.

In a regressive stagethe plates become denser, their elements dissolve and flaking 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 frequently in the autumn-winter period than in the spring-summer period.

Psoriasis symptoms

The symptoms of psoriasis are:

• Pink rashes or white patches covered in 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 develops arthritis as a result of psoriasis.Therefore, it is necessary to start treatment as early as possible to prevent the development of complications.

Diagnosis

Psoriasis has a very characteristic clinical picture, so diagnosis is generally not difficult.If you scrape the papules (plaques), 3 main phenomena will be observed:

1. Stearin stain - with light scraping, 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 board, it leaves a shiny, moist surface.
3. Bloody dew - if you scratch the terminal film, small drops of blood will appear on it.

In some cases, a piece of dead skin is taken for analysis for differential diagnosis.

Psoriasis treatment

The main goal of medical measures is not to cure the patient (since this is impossible), but to achieve a stable remission.A comprehensive treatment is carried out, the plan for which is developed in accordance with the progress of a particular person's disease.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 along with the administration of a dermatotropic agent.
• The use of detoxification methods - indication of immunomodulators, procedures that cleanse the blood.
• In some cases, taking nonsteroidal anti-inflammatory drugs.

If concomitant diseases are diagnosed, they will also be treated.

Lifestyle with psoriasis

The patient must take into account that the treatment of the disease will last a lifetime.In many ways, the duration of remission depends on this.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 sugar and salt intake.You should pay attention to products that contain 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 the water for a long time - you should swim and bathe less often, it is recommended to take a short shower.
• Hard cloths should be replaced with a soft sponge or cotton cloth and common soap with a product with a neutral pH.
• After bathing, you should not wipe yourself, 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 and light clothing, made from soft natural fabrics, as the pressure of clothing items on the skin can provoke the development of new rashes.
• Itching often forces the patient to scratch themselves, which can cause skin damage - to avoid further damage, it is best to cut the nails short.
• You should avoid drying out your skin, so avoiding air conditioning will be beneficial, as will humidifying indoor air.
• Although sunbathing can be beneficial for psoriasis, excessive exposure to ultraviolet light can worsen the condition – you should consult your doctor about your sun exposure regime.
• Any risk of skin irritation must 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 state of the whole organism.

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