Psoriasis — causes, symptoms, pictures, types and treatment of psoriasis

Psoriasis — a chronic non-communicable diseases, dermatosis, affecting primarily the skin. Psoriasis usually causes the formation of excessively dry, red spots on the surface of the skin. However, some patients with psoriasis have no visible lesions.

Psoriasis

The severity of the disease may vary in different patients and even in one and the same patient during the periods of remission and exacerbation in a very wide range, from small local lesions to fully cover the entire body of plaque psoriasis. Often there is a tendency to progression of the disease over time (especially if untreated), to the weighting and increased frequency of exacerbations, increase the area affected, and involvement of new areas of the skin. In some patients there is a continuous course of the disease without spontaneous remissions, or even a continuous progression. Often also affects the nails on the hands and/or feet (psoriatic onihodistrofiya). Nail involvement may be isolated and observed in the absence of cutaneous lesions. Psoriasis can also cause inflammation of the joints, the so-called psoriatic arthropathy or psoriatic arthritis. From 10% to 15% of patients with psoriasis also suffer from psoriatic arthritis.

There are many different means and methods for the treatment of psoriasis, but due to the chronic recurrent nature of the disease itself and often there is the tendency to progression over time, psoriasis is a fairly difficult to treat the disease. Complete cure is not currently possible (that is, psoriasis is incurable at the current level of development of medical science), but possible more or less long, more or less complete remission (including life). However, it is always a risk of relapse.

Causes of psoriasis

  • Stress, depression;
  • Infection of the skin, in particular viruses, bacteria (staphylococci. Streptococcus), fungi (Candida);
  • Genetic predisposition;
  • Metabolic disorders that affect the regeneration of skin cells;
  • A failure in the endocrine system (hormonal disorders)
  • Plaque
  • Diseases of the gastrointestinal tract enteritis, colitis, dysbacteriosis (dysbiosis);
  • Allergies;
  • Diseases of the liver.

Learn more about the causes of psoriasis

The impaired barrier function of the skin (in particular, mechanical injury or irritation, friction and pressure on the skin, overuse of soap and detergents, contact with solvents, detergents, alcohol-containing solutions, the presence of infected lesions on the skin or skin allergies, excessive dryness of the skin) also play a role in the development of psoriasis.

Psoriasis is a lot of what psychic tv skin disease. Most patients experience suggests that psoriasis may spontaneously improve or worsens for no apparent reason. Studies of various factors associated with the occurrence, development or exacerbation of psoriasis tend to be based on the study of small, usually hospital (not outpatient), that is certainly more severe groups of patients with psoriasis. Therefore, these studies often suffer from lack of representativeness of the sample and the inability to identify causal relationships in the presence of a large number of others (including yet unknown or not discovered) factors that can influence the nature of psoriasis. Often different studies found conflicting findings. However, the first signs of psoriasis often appear after a trauma (physical or mental), damage to the skin in places the first appearance of psoriatic lesions, and/or past streptococcal infection. Conditions, according to a number of sources that could contribute to the aggravation or worsening of psoriasis include acute and chronic infections, stress, climate change, and the change of seasons. Some medicines, according to several sources, are associated with worsening of psoriasis or even can cause its initial appearance. Excessive alcohol consumption, Smoking, overweight or obesity, poor diet can aggravate psoriasis or encumber its treatment, provoke aggravation. Hairspray, some creams and hand lotions, cosmetics and perfumes, household chemicals can also cause exacerbation of psoriasis in some patients.

Plaque psoriasis

Psoriasis most often develops in patients with initially dry, sensitive skin than patients with oily or well-moisturized skin, and is much more common in women than in men. One and the same patient psoriasis often first is in areas more dry or more thin skin than in thick skin areas, and is particularly often in places of damage of the integrity of the skin, including scratches, scuffs, abrasions, scratches, cuts, in areas that are exposed to friction, pressure or contact with aggressive chemicals, detergents, solvents. It is assumed that this phenomenon lesions of psoriasis primarily dry, delicate or injured skin associated with infection, that the infecting organism penetrates into the skin easily with minimal secretion of sebum (which under other circumstances, protects the skin from infections) or skin damage. The most favorable conditions for the development of psoriasis, thus, opposite to the most favorable conditions for a fungal infection of the feet (the so-called "athlete's foot") or the armpits, groin area. For the development of fungal infections is most favorable moist, wet skin, for psoriasis, on the contrary, dry. Penetrated into dry skin infection causing dry (non exudative), chronic inflammation, which, in turn, causes the symptoms characteristic of psoriasis, such as itching and increased proliferation of skin cells. This in turn leads to a further increase in dryness of the skin due to inflammation and enhanced proliferation of keratinocytes and because infecting the body consumes moisture, which otherwise would serve to moisturize the skin.

The symptoms of psoriasis

  • Severe itching on the skin;
  • The appearance on the skin small rashes to the development of more liquid, reveal, form a crust, then joined into a single inflammatory areas and covered by a grayish-white, sometimes with a yellowish tinge (the so-called psoriatic plaques);
  • Bleeding plaques;
  • Nail psoriasis it first thickens, then delaminates and nail disappears;
  • Possible pain in the joints.
Chronic plaque psoriasis

Severity of psoriasis (psoriasis stage)

Psoriasis usually klassificeret on severity for:

  • Psoriasis of 1 degree (mild with lesions less than 3% of the surface of the skin);
  • Psoriasis 2 degree (moderate severity with lesions from 3 to 10% of the surface of the skin);
  • Psoriasis grade 3 (severe, involving more than 10% of the surface of the skin).

Psoriatic lesions of joints is regarded as a severe form of psoriasis, regardless of the area affected of the skin.

Types of psoriasis

Psoriasis can appear in diverse forms. Options include psoriasis vulgaris (simple, ordinary), or, otherwise, plaque psoriasis (psoriasis vulgaris, plaque psoriasis), pustular psoriasis (pustular psoriasis), drop-shaped or dot psoriasis (guttate psoriasis), psoriasis flexor surfaces (flexural psoriasis). This section provides a brief description of each type of psoriasis along with its code according to the International classification of diseases (ICD-10).

Plaque psoriasis, or psoriasis vulgaris, psoriasis vulgaris, simple psoriasis (psoriasis vulgaris) is the most common form of psoriasis. It is observed in 80% — 90% of all patients with psoriasis. Plaque psoriasis vulgaris most often seen in the typical spots on the surface of healthy skin sites inflamed, red, hot skin, covered with grey or silvery-white, easy peeling, scaly, dry and thickened skin. Red skin under easily removable gray or silver layer is easily injured and bleeding, as it contains a large number of small vessels. These sites are typical psoriatic lesions are called psoriatic plaques. Psoriatic plaques tend to increase in size and merge with neighboring plaques, forming the whole plate plaques ("paraffin lakes").

Psoriasis flexor surfaces (flexural psoriasis), or "inverse psoriasis" (inverse psoriasis) usually looks as sleek, scaly or with minimal peeling, not especially protruding above the surface of the skin red inflamed spots, which are located exclusively in the skin folds, with no or minimal lesions in other areas of the skin. Most often, this form of psoriasis affects the folds in the vulva, groin, inner thighs, underarms, under folds increased when overweight stomach (pannus psoriatic), and in the skin folds under the Breasts in women. This form of psoriasis is particularly vulnerable to deterioration under the influence of friction injury to the skin and sweat, and is often accompanied or complicated by secondary fungal infection or streptococcal pyoderma.

Causes of psoriasis

Guttate psoriasis (guttate psoriasis) is characterized by a large number of small spots on the surface of healthy skin, dry, red or purple (up to purple), similar in shape to the drops, tear or small dots, circles elements of destruction. These psoriatic elements usually cover large surfaces of the skin, most commonly the thighs, but can also occur on the shins, forearms, shoulders, scalp, back, neck. Guttate psoriasis is often first develops or is exacerbated after a streptococcal infection, usually after strep throat or streptococcal pharyngitis.

Pustular psoriasis or exudative psoriasis is the most severe of skin forms of psoriasis looks like raised above the surface of the healthy skin vesicles or blisters filled with uninfected, transparent inflammatory exudate (pustules). The skin under and above the surface and around the pustules is red, hot, swollen, red and thick, it peels off easily. There may be a secondary infection of the pustules, in this case, the exudate becomes purulent. Pustular psoriasis can be limited, localized, with the most frequent sites are distal extremities (hands and feet), that is, lower leg and forearm, it is called palmoplantaris pustules (palmoplantar pustulosis). In other more severe cases, pustular psoriasis can be generalized, with widespread pustules across the surface of the body and the tendency to merge them into larger pustules.

Nail psoriasis, or psoriatic onihodistrofiya leads to different changes in the appearance of the nails on the fingers or toes. These changes may include any combination of color change of the nails and nail bed (yellowing, whitening), the appearance of the nails and under the nails dots, spots, cross-striations of the nail lines, thickening of the skin under the nails and around the nail bed, separation and thickening of the nail, complete loss of nails (onycholysis) or the development of increased brittle nails.

Psoriatic arthritisor psoriatic arthropathy, arthropathic psoriasis is accompanied by inflammation of the joints and connective tissue. Psoriatic arthritis can affect any joints, but most often the small joints of distal phalanges of fingers and/or toes. It is typically causes swelling of the fingers and toes known as dactylitis psoriatic. Psoriatic arthritis can also affect the hip joints, knee joints, shoulder joints, joints of the spine (psoriatic spondylitis). Sometimes psoriatic arthritis knee or hip joints and especially psoriatic spondylitis is more pronounced, which leads to severe disability of the patient, inability to move without special tools. Mortality in these most severe forms of psoriatic arthritis is increased, since the immobilization of the patient in the bed contributes to pressure sores and pneumonia. Approximately 10 to 15 percent of patients with psoriasis also suffer from psoriatic arthritis.

Psoriasis on the stomach

Psoriatic erythroderma, or erythrodermic psoriasis appears widespread, often with generalized inflammation and desquamation, exfoliation of the skin on the whole or a large part of the surface of the skin. Psoriatic erythroderma may be accompanied by intense pruritus, edema of the skin and subcutaneous tissue,skin soreness. Psoriatic erythroderma is often the result of exacerbation of psoriasis vulgaris in its unstable course, especially when a sudden abrupt cancellation of systemic therapy or local glucocorticoids. Can also occur as a result of provocation alcohol, mental stress, intercurrent infections (such as colds). This form of psoriasis can be fatal because the extreme inflammation and peeling or exfoliation of the skin break the body's ability to regulate body temperature and barrier function of the skin, which may be complicated by generalized pyoderma or sepsis. However, a limited, localized psoriatic erythroderma may even be the first symptom of psoriasis, after transforming into psoriasis vulgaris plaque.