Psoriasis is a serious systemic dermatological disease. The disease is characterized by a chronic course, it is difficult, with periods of exacerbation, followed by remission. Psoriasis can take many forms, requires an integrated approach to treatment and is dangerous with a number of complications.
What is psoriasis?
Psoriasis is a dermatological disease that can occur in adults and children.
Psoriasis is a non-infectious inflammatory disease of the epidermis. The pathology is characterized by changes in the skin, which are manifested in the form of flaking and nodular formations.
The peculiarity of psoriasis is a chronic wavy course. The disease cannot be completely cured; therapy aims to reduce the symptoms and visible manifestations of the disease. Exacerbation periods are followed by periods of remission, which can last from several months to several years. It is the duration of remission that is the criterion for assessing the effectiveness of the selected treatment regimen.
Psoriasis appears for the first time at a young age. The disease can progress, causing joint complications. According to statistics, psoriasis reduces life expectancy by 7 years on average.
Although it is impossible to cure the pathology, you must not let the disease run its course. If alarming symptoms appear, you should see a dermatologist. A properly selected treatment regimen will allow you to live a full life, without looking back, for inflammation of the epidermis.
The causes of psoriasis
The exact reasons for the beginning of the pathological process have not been established. There are several theories about the origin of this pathology.
- The autoimmune nature of the development of the disease. This theory is widespread. Many doctors tend to believe that the inflammation of the epidermis is the result of an immunopathological malfunction of the body, as a result of which the human immune system begins to randomly attack the cells of the epidermis in different parts of the body. In response to this attack, an inflammation of the skin appears. This theory is also supported by one of the most common complications of psoriasis, psoriatic arthritis. In this case, the pathological process spreads from the skin to the connective tissue of the joints.
- Genetic theory.This theory explains why people with psoriasis can have children with the same diagnosis. In this case, the genetic characteristics only indicate the chance of developing the disease, but they do not predetermine psoriasis. For example, if parents are prone to several dermatitis and are diagnosed with psoriasis or severe forms of eczema, there is a risk that children will also develop chronic inflammation of the epidermis. However, quite often, totally healthy children are born to patients with psoriasis, who may never experience any dermatological disease in their entire lives, let alone psoriasis.
- Neurogenic theory.Another very common explanation of the causes of the development of the disease is neuropsychic stress. During studies carried out in the middle of the last century, it was found that patients with psoriasis have an increased content of the neurotransmitter acetylcholine in the nerve endings of Organs internal organs and in the epidermis. In response to neuropsychic stress, this neurotransmitter may theoretically cause the development of inflammation in the epidermis. In addition, in patients with psoriasis, brainstem dysfunction and vegetative vascular disorders have also been revealed. All of this points to the neurotic nature of the disease.
- Theory of exchange.Presumably, psoriasis can result from a general metabolic disorder. The lack or deficient absorption of certain vitamins and minerals can lead to a change in the structure of the epidermis and make it susceptible to negative influences, due to which inflammation develops.
Having dealt with the supposed causes of the development of the disease, you should pay attention to the factors that can potentially lead to the onset of inflammation. We are talking here about a type of trigger or trigger, under the influence of which the primary manifestation of psoriasis or exacerbation after remission occurs. These triggers include:
- infectious diseases; parasite infestation
- hormonal changes;
- allergic reactions; immunodeficiency
- damage to the skin;
- aggressive external influences on the epidermis.
Infectious diseases can impair the functioning of the immune system. Often, after severe infections in adolescents and young people, the primary manifestation of psoriasis is seen. From that moment, the diagnosis of a person is made, who stays with him for life. Infections are not the direct cause of the disease, but cause its manifestations. In addition, parasitic invasions of the liver can trigger the onset of inflammation.
Young women or adolescents are more likely to have the primary manifestation of psoriasis in the context of hormonal disorders. Puberty is associated with pronounced changes in the functioning of the body and rapid growth, which leads to disruption of the immune system and, theoretically, can act as a trigger for the appearance of inflammation in the skin.
When acetylcholine is high, stress is one of the most obvious triggers.
Severe stress is the cause of the primary manifestation of psoriasis in 65% of cases. The same condition can lead to the interruption of remission and the beginning of an exacerbation.
Psoriasis symptoms can also appear in areas of severe skin damage. Thermal exposure, burns, deep wounds - all of these are potentially dangerous for a person prone to this disease. Damage to the epidermis can lead to the onset of an exacerbation and is especially dangerous in the early stages of the disease, since plaque-like neoplasms form at the sites of the lesions. In some patients, exacerbations are due to ultraviolet exposure.
Is psoriasis contagious?
The photo very clearly describes the peculiarity of the symptoms of psoriasis disease. If the inflammation is located in open areas of the body visible to other people (forearms, hands and palms, face and neck), patients may experience misunderstandings and disgust. However, despite specific symptoms, psoriasis is not an infectious disease, which means that it is not contagious.
Contact with the skin of a psoriasis patient is absolutely safe for a stranger. The disease is not transmitted by air droplets, hematogenic or sexually, as it is a consequence of internal disorders of the organism, but it is not an effect of pathogenic microbes.
Many people are intimidated by the appearance of skin affected by psoriasis. This can have a negative impact on the patient's sense of identity, which often leads to psychological problems, such as complex and personal dissatisfaction. A person who is diagnosed for the first time will have to face problems in society. In some cases, doctors recommend a psychotherapy course to accept your illness and social adaptation.
The mechanism of development of psoriasis
The mechanism of development of psoriasis disease consists of excessive proliferation of the main cells of the epidermis, keratinocytes. This process leads to the development of inflammation, which is manifested by the infiltration of the skin by lymphocytes and macrophages. Visually, this is expressed in a change in the structure of the epidermis. It becomes dense, keratinization appears. Psoriasis skin is very scaly.
The inflammatory process leads to a change in the blood microcirculation in the affected area. Due to the thickening of the epidermis, there is a strong fragility of the capillaries, causing the affected areas to acquire a purple color.
The scaly skin on the surface of the plaque produces a grayish tint. In addition, psoriasis is characterized by severe dryness of the epidermis.
The process of forming new foci of the disease is called progressive psoriasis. This stage takes a certain amount of time and is then replaced by a stationary stage. It is characterized by the absence of any changes in the nature of the rash or in the number of skin lesions.
The stationary stage is replaced by the regressive one over time. At the same time, the plaques shrink in size, gradually heal and become almost invisible. Clearing the skin of inflammation is the beginning of remission. How long it will last is impossible to predict in advance, but sooner or later remission is replaced by a progressive stage of the disease.
Typical signs of psoriasis:
- chronic undulating course;
- specificity of foci of inflammation of the skin; progression
- with each exacerbation;
- changes in the epidermis and capillaries of the affected area.
The peculiarity of psoriasis treatment methods depends on the form of the disease. In total, several clinical forms are distinguished, with symptoms and characteristics specific to the course.
Classification of psoriasis - clinical forms and characteristics of symptoms
The symptoms of psoriasis depend on the form of the disease. This pathology is characterized by a wide variety of forms and signs, which makes self-diagnosis difficult.
Depending on the type of inflammation, there are three main forms of the disease:
- plate-like or ordinary; pustular
- ; tear-shaped
Plaque or common form of the disease is the most common type of psoriasis, diagnosed in 80% of cases. This pathology can affect any part of the body. The disease is characterized by the formation of a dense nodular rash. The skin at the site of the rash becomes inflamed and red. Over time, the nodules fuse into foci large enough that rise above the skin.
Generally, there is no itchiness in plaque psoriasis. Discomfort is possible due to dry skin. Itching is usually seen with additional exposure to allergens.
Pustular psoriasis of the skin is characterized by the formation of small vesicles filled with light exudate. The disease begins with the formation of dense nodules under the skin, which, increasing in size, take the form of a rash with blisters. In this case, the bubbles are located deep in the epidermis, they hurt when pressed and are easily damaged. The skin around the pustules swells, turns red, and the peeling starts over time with easily detachable scales. Most of the time, the disease affects the skin of the feet, hands and back, but it can also spread to the body.
Guttate psoriasis has this name due to the characteristic aspect of the rash. It is shaped like a drop, with a pronounced edge. The skin around the elements of the rash is swollen, red, itchy and sore. At the center of the rash, the epidermis does not change. The tear form of the disease follows in a generalized way, that is, the pathology spreads throughout the body.
Psoriasis can affect any part of the body. In addition, the following forms of the disease are differentiated according to the location of the rash:
- flexor surface psoriasis;
- psoriatic onychodystrophy;
- arthropathic psoriasis;
- psoriatic erythroderma.
Flexor psoriasis affects only skin folds. At the same time, the rash does not look like a plaque, but it is a small red spot with a smooth, shiny surface. Areas of spread of the disease - inguinal folds, armpits, the area under the mammary glands in women. The pathology proceeds in a very mild way, but is dangerous by the addition of a secondary infection due to damage to the spots. Most of the time, this form of the disease is aggravated by mycoses.
Onychodystrophy in the context of psoriasis is an injury to the nail plates. The pathology rarely acts as an independent disease, most often as a complication of plaque psoriasis on the feet and hands. The disease is manifested by a change in the color and structure of the nail plates. They become pale, they become brittle. In advanced forms, this leads to complete and irreversible destruction of the nails.
Arthropathic psoriasis is also rarely an independent disease. This is a systemic pathology that affects connective tissue. This form of the disease is characterized by inflammation of the epidermis and joints. Psoriatic arthritis affects the small joints of the fingers and toes and causes their deformation. In severe cases, it is dangerous to develop disability due to loss of motor function in diseased joints.
The symptoms of psoriatic arthritis are clear in the photo - they are swelling and thickening of the fingers, joint deformity and limited mobility
How psoriasis starts: symptoms of the early stage
In severe pathology, the affected areas may merge, forming symptoms of extensive size.
The exact appearance of psoriasis at an early stage depends on the form of the disease. Psoriasis vulgaris begins with dense nodules under the skin. They rise above the epidermis, are well palpable, but do not cause discomfort. The skin around the nodules starts to peel off quickly. After a while, the nodules fuse into large outbreaks of the eruption, forming a plaque.
Pustular psoriasis begins with deep lumps under the skin that are invisible from the outside, but perfectly palpable. The skin around the rash elements swells, hurts with pressure and mechanical damage.
Guttate psoriasis is the formation of small rashes on large areas of the skin. The most common localization areas are thighs, chest, back. The rash looks like a drop with a pronounced edge.
To understand what psoriasis looks like in the early stage, you must know the specifics of the changes in the skin during inflammation - the nodules appear earlier, later they fuse and only then do large plaques form.
In the early stages of the disease, peeling is moderately expressed, regardless of the form of the disease. As the skin progresses, it changes, becomes dense, large flaking spots appear
Symptoms and characteristics of the different forms of the disease
The appearance of psoriasis in the body depends on the form of the disease. Each type of pathology has its own characteristics.
Characteristics of psoriasis vulgaris:
- location: legs, arms, forearms, back, chest, neck;
- forms of skin rash: large, dense plaques with abundant flaking;
- there is no discomfort other than a feeling of tightness;
- After the plaque heals, the skin remains stained.
Psoriasis vulgaris leads to decreased pigment production in the affected area. After the plaques are resolved, when age spots heal completely and disappear, age spots resemble psoriasis. In place of the plaques, there may be brown spots, light areas due to insufficient pigmentation or purple spots that look like scars.
Specificity of symptoms of pustular psoriasis:
- location: distal extremities of the limbs; rash form
- : dense vesicles with uninfected exudate (not purulent);
- secondary symptoms: pain and itching, malaise, fever;
- there is a risk of infection of the elements of the rash.
Pustular psoriasis is the most serious form of the disease. In rare cases, it becomes widespread, affecting the skin of the entire body. In this case, the bubbles can merge into large formations. After resolution, the scars may remain on the skin.
Psoriasis in gout has the following features:
- location: legs, thighs, shoulders, neck, hairy areas of the body's skin;
- shape of the rash: small dots, drops or circles, with the swollen skin around the rash;
- without pain or itching;
- body temperature may increase when a rash appears.
Guttate psoriasis often develops in a context of decreased immunity after an infectious disease, despite the fact that the disease itself is autoimmune, not infectious. This form of the disease usually appears for the first time in adolescence, after suffering a streptococcal infection.
An experienced doctor can easily identify the symptoms of psoriatic diseases by visual examination.
Plaque psoriasis is easy to diagnose. A visual examination is sufficient for an experienced dermatologist to make a preliminary diagnosis. In addition, a test is performed for the so-called psoriatic triad. This is a specific skin reaction that occurs in response to scraping the plaque.
Guttate psoriasis is also diagnosed based on visual examination. In pustular psoriasis, a differential diagnosis is made with bacterial dermatoses.
In the case of psoriasis of flexed surfaces, further examination is necessary to exclude the fungal nature of skin inflammation. No specific laboratory tests are necessary, as psoriasis does not cause changes in the composition of the blood.
How is psoriasis treated?
How psoriasis can be cured depends on the form and severity of the symptoms. The pathology cannot be completely cured; therapy aims to achieve stable remission. The peculiarity of psoriasis is that there is no universal treatment regime. For psoriasis, treatment includes:
- drug therapy;
- nutritional adjustments; physical therapy;
- spa treatment.
There are several basic medicines, but they are not suitable for all patients. The main task of the doctor is to determine the types of medications suitable for a given patient. In addition, in some cases, it is necessary to try a dozen different drug treatment regimes before selecting the optimal direction of drug therapy.
Ointments and creams for the skin
How can psoriasis be cured? Scientists and doctors have been battling this problem for over a dozen years, but there are still no drugs that effectively cure the disease. Conservative therapy suggests the use of ointments and creams for the skin.
The means of external use are divided into indifferent and hormonal.
Hormonal ointments are not safe and in some cases cause symptoms to worsen, so dermatologists are increasingly abandoning this treatment method, opting for indifferent ointments and physiotherapy.
Indifferent ointments are prepared with a natural composition, enriched with various vitamins and microelements. They aim to stop inflammation, reduce flaking and smooth skin.
Herbal ointments with anti-inflammatory properties can be used in the treatment of psoriasis. In the absence of allergies, the use of propolis medications is permitted. Ointments with petroleum derivatives are widely used, which effectively softens the skin.
In case of severe inflammation, hormone therapy is used. These are corticosteroid ointments. In severe cases, injections of such drugs may be prescribed.
In addition to topical products, psoriasis requires pills. If vitamin D production is impaired, intake of this substance is indicated. Be sure to prescribe hepatoprotectors, as inflammation of the epidermis adversely affects liver function, especially with a prolonged course of psoriasis.
The disease is exacerbated by stress. Neuroses and other mental disorders lead to the worsening of the course of the disease. In this sense, traditional therapy is necessarily complemented by sedatives. For psoriasis, anxiolytic drugs are prescribed to combat stress. For long-term use, one can prescribe medicinal valerian, tincture of peony root or anise.
The most recent methods of treating psoriasis are methods that aim to suppress the excessive proliferation of skin cells. In severe forms of the disease, immunosuppressants and antineoplastic drugs may be prescribed.
Physiotherapy is a must for treatment. For psoriasis, apply:
- PUVA therapy;
- ultraviolet irradiation (UFO);
- laser therapy;
- selective phototherapy;
Each method has its own characteristics, however, all methods of influencing the inflamed epidermis stimulate metabolic processes and stop excessive cell proliferation.
In the event of an exacerbation of psoriasis in the summer under the influence of ultraviolet rays, it is necessary to approach the issue of physiotherapy carefully. Ultraviolet techniques can backfire and worsen symptoms.
Electrosleep is indicated for severe mental problems and severe stress. This method has very good results in the treatment of psoriasis.
Therapy with folk remedies for psoriasis includes the use of homemade emollient ointments and medicinal plants with sedative properties.
To reduce edema of the skin, baths with fir branches, rubbing the skin with chamomile decoction are recommended. Ointments are prepared based on egg yolks, butter, lard. Its main purpose is to soften the skin, so it will not cure psoriasis.
For internal ingestion, decoctions of lemon balm, St. John's wort and chamomile are recommended. At home, you can prepare sedative tinctures of valerian root or anise.
Nutrition for psoriasis
The diet plays an important role in the treatment. With the exacerbation of psoriasis, it is recommended to exclude allergenic foods from the diet. Since the disease negatively affects the functioning of the liver, alcohol, fatty and fried foods should be abandoned. Smoked meats and pickles, semi-finished products, soft drinks and coffee are prohibited.
Fruits and vegetables, lean meats and fish should be preferred. For psoriasis, it is useful to eat nuts, as they are rich in B vitamins, necessary for the normal functioning of the nervous system.
Spa treatment is medical care performed with the aim of preventing and rehabilitating psoriasis.
Mineral water treatment is widely used in psoriasis. Patients are recommended hot springs from the Carpathians, Bulgaria, Turkey. A good result is achieved when visiting sanatoriums and changing rooms, where hydrotherapy is performed with the help of fish that eat keratinized skin particles.
For psoriasis, salt spray and sea salt, therapeutic sludge is useful. Sanatorium treatment is recommended annually. Together with medication and physical therapy, this method helps to achieve sustained remission.
Psoriasis and the army
The mild form of psoriasis does not always dispense with military service. With widespread psoriasis on the skin, which is often exacerbated, a man can be classified in category "B", but it is necessary to undergo a complete medical examination and present a certificate of treatment results every six months.
In the case of a generalized form of the disease with complications in the joints and ineffectiveness of the immunosuppressive treatment, a man can be classified in the category "D".
Quality of life and prognosis
Psoriasis significantly worsens quality of life, mainly due to problems of social adaptation in the generalized form of the disease. Complicated psoriasis negatively affects general well-being and worsens the functioning of internal organs, especially the liver.
The complications of psoriasis extend to the joints. In severe cases, this can lead to deformation, impaired motor activity and disability.
At the same time, the right therapy allows the patient to live to the fullest. Although in psoriasis the prognosis is conditionally unfavorable, since the disease is incurable, the person can learn to live with his diagnosis.