Squamous lichen is one of the most common chronic dermatoses. 5-7% (according to different authors) of the population across the planet suffer from its symptoms of varying severity. This disease is better known as psoriasis. And if pathology was previously studied only from the point of view of skin lesions, it is now more often considered a systemic process, covering almost all organs. Therefore, doctors sometimes use the term "psoriatic disease", which to a greater extent characterizes clinical symptoms and pathophysiological processes.
The main cause of the pathology is called a specific autoimmune reaction, a predisposition to which it is inherited. In other words, to the question of how infectious psoriasis is, doctors answer it unequivocally - the disease is not at all dangerous to others. For the appearance of your symptoms, a combination of hereditary genetic mutations and the influence of certain provocative factors that trigger a chain of immunological reactions is necessary.
The main link in the pathogenesis of this dermatitis is the tendency of keratinocytes, which constitute the majority of epidermal cells, to increased proliferation, that is, division. In this case, the pathological processes can cover any part of the body - the scalp (seborrheic shape), the nails of the fingers and toes, the plantar and palmar area, etc. But, in most cases, psoriasis is located symmetrically on the flexed surfaces of the limbs, around the large joints (elbows, knees in the leg region), along the spine, including the nape.
Depending on the pathogenic mechanisms of development of pathology, psoriasis is divided into two types. The first occurs in almost 70% of patients. Its occurrence is associated with a complex system of HLA antigens, a form of the disease characterized by manifesting itself at a relatively early age. This usually occurs at the age of 20-25, but recently there has been a tendency for the appearance of plaque or teardrop skin rashes, characteristics of psoriasis, even in babies (usually the skin on the buttocks, genitals and face isaffected). Pictures of these symptoms can be easily found on the net.
In addition to external manifestations, the development of the disease is usually accompanied by significant violations of Organs internal organs, which are:
- Diseases of the endocrine system. In adolescent girls and women, exacerbations of pathology are often associated with the menstrual cycle, breastfeeding period, etc. In most patients, a decrease in the glucocorticoid function of the adrenal glands is also detected (modern scientists are trying to relate this to the mechanism of development of the disease).
- Metabolic diseases. These are significant disorders of nitrogen metabolism, a decrease in albumin content with a simultaneous increase in the level of α-, β- and γ-globulins. In addition, changes in lipid metabolism are detected, manifested in the form of hypercholesterolemia and hyperlipidemia. In the course of clinical studies, conducted in the late 1990s, experts established a relationship between the severity of the manifestations that characterize psoriasis and the level of free cholesterol.
- Destructive changes in connective tissue. Arthropathy occurs on average in 5-10% of patients, and if with a common form of pathology it occurs in 6-7% of cases, then with pustular - in 32%. Psoriatic arthritis can occur in different ways, the severity of clinical manifestations is due to genetic characteristics. But usually the disease starts aggressively and in 2 years it causes serious destructive changes in the joints, which often leads to deficiency. In addition, there is a clear relationship between the intensity of the inflammatory process in the cartilaginous tissue and in the epidermis.
- Abnormalities in the activity of the cardiovascular system. In the early stages, psoriasis is accompanied by rhythm disturbances in the form of tachy- or bradycardia, an increase in the size of the ventricles, fibrotic changes in the structure of the myocardium and defects of the mitral valve.
- Disorders of the gastrointestinal tract. In 93% of patients diagnosed with psoriasis, atrophic changes in the mucous membrane of the digestive system are revealed. A decrease in the secretion of hydrochloric acid, essential enzymes, is also observed. The nutrient absorption process is interrupted, which leads to vitamin deficiency. In addition, the functional activity of the liver also decreases.
Varieties of psoriasis
- On Organs genitals
- In the head
Psoriasis is usually diagnosed by specific clinical manifestations of the disease, which differ significantly from the symptoms of common dermatitis, the main symptom of which is severe itching. But, relatively recently, restricted laboratory blood tests have generally become available to identify specific markers of autoimmune processes. This is the determination of the concentration of various interleukins, some forms of HLA and tumor necrosis factor.
In difficult cases, a diagnostic biopsy is used. This is usually necessary to differentiate between lichen planus and pink lichen, seborrheic dermatitis, toxicoderma and other types of dermatoses and bacterial pustules. If psoriatic arthritis is suspected, X-ray and ultrasound examination of the joints is required.
Haemoscanning is widely offered in some cities. This is a diagnostic method based on the detection of a variety of diseases, including psoriasis, by a drop of blood. But in medical scientific circles, this technique is treated with great skepticism.
Psoriasis is a chronic disease subject to constant relapse, and doctors sometimes have difficulty saying what can cause it. Therefore, patients are strongly advised to follow a strict diet and limit the use of cosmetics. For home skin care, only special shampoos and creams are shown.
The treatment of psoriasis is complex and includes the use of external agents and medications in the form of injections and pills. Thus, for local therapy, it is customary to prescribe ointments with corticosteroids, in addition to drugs that help to soften the skin. The severe form of the disease, especially psoriatic arthritis, requires the use of strong and cytostatic immunosuppressants. Complexes with vitamins are prescribed.
In the remission phase, pathologies can be treated in a sanatorium. The patient is offered sunbathing or solarium, application of tar in the affected areas of the skin, a variety of physiotherapeutic procedures. The patient's psycho-emotional state also plays an important role in the therapy process.
Psoriasis disease: classification and symptoms
There are many classification systems for this pathology, but the most convenient and, therefore, common division is considered to be based on the characteristics of the course, prognosis and clinical picture.Therefore, psoriasis disease is of the following types:
- psoriasis vulgaris, which by the nature of the rash can be inverted, with spots, seborrheic, etc. ;
- psoriatic arthritis with primary involvement of the joints;
- psoriatic erythroderma, in which, in addition to skin manifestations, systemic manifestations are also characteristic;
- pustular psoriasis, which, in turn, is divided into generalized (Tsumbush-type disease) and palmoplantar (Barber-type psoriasis). The difference between these forms is in the later forecast. The former belongs to the types of disease that progress rapidly and is therefore deadly, while the clinical signs of the latter are quite amenable to drug control.
Psoriasis disease in most patients is characterized by a symmetrical arrangement of papular rash. But doctors emphasize that any area not only of the skin, but also of the nails can be affected. The main element of the rash is the so-called pink epidermal papule. It has a flat shape, a rough surface and is covered with silvery-white scales that easily peel off when scraped. This shadow occurs due to the accumulation of air bubbles.
The size of the papules depends on the stage of the disease. At first, it measures a few millimeters, but over time, the rash spreads and merges into large plates in various ways. Psoriasis can also be accompanied by a combination of separately located papules and an extensive rash.
A characteristic feature of the pathology is the Kebner phenomenon, also called the psoriatic triad.
Thus, when a plate is scraped, the following changes occur:
- begins an abundant separation of silver scales, reminiscent of splinters of a candle (the phenomenon of "stearin stain");
- after removing the scales, a "varnished" wet surface opens (the phenomenon of psoriatic film);
- with more skin scraping, drip bleeding begins (the "blood dew" phenomenon).
Another classification of pathology is based on the appearance of the rash and the size of the resulting papules. For example, there are these types of psoriasis: stippled, when the elements of the rash are similar to the head of a pin, annulled when circles are formed from the rash, geographic when the papules merge into an image that looks like a map, etc.
In 85% of patients, skin lesions are located on the arms and legs, in 70% of cases they extend to the trunk. In half of the patients (mainly girls and women), the pathology covers the genitals. Often, these rashes are combined with the formation of papules in the area of hair growth on the crown, temples, back of the head, usually here the rash is of a focal nature. The defeat of the palms of the hands and soles of the feet is observed in approximately every ten patients, in which case extensive rounded and scaly plaques are formed, covered by furrows.
This is important
Psoriasis is a genetically determined autoimmune disease, so it is not contagious to other people. Symptoms can be controlled with certain medications, but some of them can only be dispensed at the pharmacy with a prescription.
Psoriasis disease: causes, severity, impact on a person's lifestyle
The exact causes of the pathology were established relatively recently. Only with the advent of means to study hereditary genetic mutations could specialists explain why psoriasis develops. It has now been precisely established that the cause of the development of the pathology is an autoimmune process in the context of a hereditary predisposition.
Symptoms of skin lesions occur after exposure to certain factors that stimulate the processes of intensified keratinocyte division and as a result of the weakening of the mechanisms that suppress them.
Causes that can cause psoriasis include:
- nervous or mental trauma, severe stress;
- endocrine pathologies (diabetes mellitus, thyroid disorders);
- chronic infectious diseases, usually caused by streptococci;
- fungal infections of a systemic or local nature;
- immunodeficiency states;
- disorders of metabolic processes, especially lipids and proteins;
- a sudden change in the hormonal background;
- long-term untreated parasitic infestations.
Currently, hypotheses are raised about the possible effect of various viruses on the epidermal cell's genetic apparatus.
Depending on the severity of the clinical symptoms and the area where the skin lesions are located, psoriasis can occur in three stages:
- Mild, characterized by the appearance of single papules, almost complete absence of itching and areas of skin peeling.
- Mediumis accompanied by damage of 3% to 10% of the skin surface, so the symptoms are much stronger, disorders of the digestive and cardiovascular systems occur.
- Severe courseThe pathology is characterized by the presence of foci of inflammation in more than 10% of the surface of the epidermis. Concomitant organ diseases are pronounced.
Psoriasis disease, like other dermatological pathologies, has a significant impact on quality of life, since the skin is the main visible part of the body. And his condition undoubtedly affects a person's attractiveness. And your self-esteem depends a lot on the degree of acceptance in society, the breadth of your circle of friends, the arrangement of your personal life.
The non-aesthetic clinical manifestations of psoriasis, which are noticeable to the naked eye, lead to a special position for one person, among others. The patient feels that he is constantly looked at and sometimes ridiculed and condemned. Therefore, the patient must cover the defects with clothing and a beard. In addition, unknown daily problems for healthy people constantly arise with the choice of a hairdresser, a beautician, a place to swim both in the pool and in the open sea.
All of these factors have a significant impact on a person's psychosomatic state. There are constant problems of adaptation in the team, which is especially important for a teenager. People often struggle to start a family, find a job, etc. The undesirable reactions to the use of various medications designed to relieve psoriasis disease do not affect the human condition in the best way.
Psoriasis of skin diseases: main treatments, recipes and nutrition
So far, it is impossible to completely get rid of this pathology, and the therapy aims to suppress the process of uncontrolled division of epidermal cells. Therefore, it is necessary to ensure that psoriasis skin disease moves to the remission stage and to prolong this stage as long as possible.
There is no generally accepted treatment regimen for pathology today, so doctors choose funds for local or systemic use based on the severity of the disease's symptoms, the condition of the person and the area of the affected skin surface. Preparations for external use are only suitable for mild psoriasis. In other cases, combined treatment is necessary.
- moisturizing and anti-inflammatory creams with keratolytic action based on lanolin, salicylic acid, coal tar etc. ;
- ointments with corticosteroids, which have pronounced anti-inflammatory properties, these medications are the most common way to eliminate the symptoms of psoriasis skin disease;
- topical application of vitamin D derivatives to prevent side effects from the use of hormonal creams;
- oral retinoids, inhibiting epidermal cell division and stabilizing cell membranes;
- cytostatics that suppress the autoimmune reaction;
- multivitamin complexes;
- drugs containing enzymes; hepatoprotectors;
- psychotropic drugs.
This is important
Psoriasis dermatosis is not infectious, therefore, antibiotics are not used in its treatment, being necessary only in case of complications.
Birch tar is the most commonly recommended alternative therapy. At night, it should be applied to the affected areas of the skin, a little sauce and then covered with linen or cotton diapers. Wrap it all up with parchment or just thick paper, but in no case use cellophane for these purposes. Cover with a woolen shawl and secure with a bandage. The procedure is repeated three times, after which it is necessary to bathe with soap. Continue this course for up to a month. Instead of birch tar, grated raw potatoes can be applied to the lesions.
Skin psoriasis requires a hypoallergenic diet. But at the same time, it must be rich in all the necessary vitamins and minerals. The basis of the diet is vegetables and fruits, with the exception of tomatoes, eggplants, peppers, citrus fruits, red apples, raspberries, strawberries, etc. You can eat herbs, root vegetables, garlic and onions.
Lean cooked meat and vegetables are good sources of protein. The diet can also include cereals, wholemeal flour products, natural dried fruits, vegetable oils. However, you must refrain from honey. It is also recommended to consume at least one and a half liters of water per day, to reduce the amount of salt and animal fats. Alcoholic beverages, chocolate and other cocoa products are contraindicated. It is absolutely necessary to stop smoking.
The prevention of pathology is especially necessary for people whose closest relatives know firsthand that psoriasis is a skin disease. First, nervous overloads should be avoided, if necessary to control the emotional state with sedatives. In addition, it is necessary to avoid the consumption of food, the use of cosmetics and medicines that can cause symptoms of an allergic reaction. Timely cleaning of outbreaks of viral or bacterial infection is also necessary.