Psoriasis is one of the most common skin diseases, and every hundredth resident suffers from it.
Psoriasis is a disease for the development of which several factors are important at once: from hereditary predisposition (psoriasis in relatives) to disorders in the work of the nervous, endocrine, immune system and other factors.
Reasons
The causes of psoriasis are not completely known.
The principle of the mechanism of the disease is to disrupt the division of skin cells, which causes autoimmune reactions (autoimmune reactions - occur in the body, do not depend on external threats).
The upper layer of the skin (epidermis) consists mainly of keratinocytes - cells that produce keratin. Keratin is a protein, and its properties enable it to perform the protective function of the skin. Keratinocytes form in the deep layers of the epidermis and slowly move to its surface, maturing during movement and acquiring new properties.
At the end of their "maturation", keratinocytes form a stratum corneum on the surface of the skin. Then the keratinized cells die and the peels are left alive, thus ending the life path of the keratinocytes. This ensures continuous skin renewal.
The normal path of keratinocytes from the deep layer to the surface takes a month. With psoriasis, their lifespan is reduced to a few days, leading to the appearance of scaly, psoriatic foci because the skin does not have time to get rid of keratinized cells.
When they appear, psoriatic deposits are usually accompanied by itching and redness. This indicates an autoimmune reaction in the deep layers of the skin, resulting in swelling of the thick layer of skin (dermis). The dermis contains blood and lymph vessels.
It is not certain why the process of keratinocyte formation is accelerated, but it is known that a hereditary factor plays a significant role.
The development of frequent psoriasis can begin due to:
- mental trauma and constant stress conditions;
- skin damage;
- transmitted infectious disease;
- taking some medications;
- hormonal disorders;
- allergic reactions (typical allergens: citrus fruits, eggs, chocolate);
- alcohol intoxication;
- climate change.
The psoriatic triad is a characteristic symptom of the disease that occurs when the skin is scraped.
Stearin stain(increased peeling after scraping, which gives the surface of the papule a resemblance to a crushed drop of stearin).
Thermal film(appearance after complete removal of scales of wet, thin, shiny, transparent surface).
Accurate bleeding(the appearance of droplets of blood that do not connect with each other).
What happens to the skin with psoriasis?
In psoriasis, the structure of the skin is disturbed, the epidermis becomes thinner, the processes of keratinization of the skin (accumulation of keratin protein) are disturbed, and some layers of the normal epidermis disappear. In the next stage of the disease, the accumulations of cells responsible for inflammation are located in the protective surface horny layer of the epidermis and in the zone of parakeratosis, around the dilated vessels of the skin.
Characteristic plaques and scales appear on the surface of the skin.
Psoriasis is not just a common disease, it has many manifestations and even masks other diseases.
Localization of psoriasis sites:
- elbows and knees;
- sacrum and groin;
- scalp (seborrheic psoriasis);
- flexion surfaces and folds of skin: inner surface of elbow and knee joints, groin and armpits, area under the breast (inverse psoriasis);
- palms and soles of the feet (palmar-plantar psoriasis);
- nail plate psoriasis.
Common symptoms of psoriasis
The main symptoms of psoriasis are:
- psoriatic plaques;
- impermeability of the affected area of skin;
- itching.
Symptoms by type of psoriasis:
- exudative psoriasis (affected areas of skin peel and moisturize, a yellow crust forms on the surface of the rash);
- intertriginous psoriasis (more common in children, foci appear red, with mild peeling, sometimes wet can be mistaken for diaper rash);
- old psoriasis (characterized by large deposits that do not disappear for a long time);
- rupioid psoriasis (another form of chronic psoriasis, characterized by cone-shaped plaque);
- guttate psoriasis (abundant rash of small papules).
Types of psoriasis
- Common psoriasis (vulgar, plaque);
- Generalized psoriasis (widespread, postular);
- Droplet psoriasis (according to the type of rash);
- Arthropathic psoriasis (with joint damage);
- Other types of psoriasis (seborrheic and others).
Psoriasis vulgaris is the most common form of the disease.
Psoriasis begins with the appearance of rashes, often few in number, in typical places: in the elbows and knees. Also, the characteristic localization of the rash is the scalp and trunk area. There is usually a clear link between the appearance of a rash and the action of the provoking factor.
Factors that cause psoriasis can be stress, skin trauma, a recent infectious disease, and regular alcohol consumption.
Worsening of the disease usually occurs in the cold season - this is a winter type of psoriasis. The summer type is rarer. Mixed forms of psoriasis have now been reported. Over time, the number of rashes increases. They form characteristic psoriatic plaques. Kebner's phenomenon is noticed - the appearance of new plaques at the sites of skin trauma. Patients typically have deposits that remain on the skin even without deterioration.
The disease runs cyclically:
- Progressive phase (increase in the number of rashes);
- Stationary phase (new rashes do not appear);
- Regressive phase (regression of rash, appearance in their place of areas of skin without pigment).
Psoriasis vulgar, photo
Diagnosis
When diagnosing psoriasis, first of all, a detailed examination of the skin is required.
Thin skin, bleeding in places, loose plaques are signs of psoriasis. In the presence of these symptoms, the doctor conducts a series of diagnostic measures to exclude the presence of other events with similar manifestations. For the final diagnosis, blood tests, smears and skin biopsies are performed as needed. If the joints are affected, magnetic resonance imaging (MRI) is prescribed and X-rays are taken to identify the lesions.
Psoriasis vulgaris, treatment
Psoriasis is a systemic disease with cutaneous manifestations and requires complex treatment: local and systemic therapy. The disease is chronic and treatment is aimed at reducing the number and severity of exacerbations and achieving a skin condition acceptable to the patient.
In the progressive phase of psoriasis, all aggressive procedures are canceled: ultraviolet radiation, baths. It is important that patients with psoriasis handle the skin carefully and carefully, so as not to injure it to avoid worsening and the appearance of new plaques.
Diet for psoriasis
Psoriasis is often accompanied by liver disease, so it is important to avoid alcohol, fatty, fried, smoked foods. It is equally important to be moderate in carbohydrate intake, as this changes the pH of the skin and increases the risk of rash infection.
Prophylaxis
Psoriasis prevention refers to maintaining a healthy lifestyle. This helps prevent the onset of other diseases because the body’s immune system is protected from stress and can withstand external threats.
Psoriasis prevention measures include:
- proper skin care;
- relaxing massage to improve blood circulation;
- proper nutrition, it is desirable to avoid allergenic foods and exclude (limit) the intake of spicy, fatty, sour, smoked, salty foods, as well as citrus fruits;
- dairy-vegetable diet;
- sufficient amount of moisture in the body;
- elimination of alcohol and smoking and other bad habits;
- increased physical activity;
- outdoor walks;
- avoiding stressful situations;
- taking vitamins of groups A, B, C, D, E;
- choosing wide clothing made of natural materials that will not exterminate and cause irritation.
Remedies for psoriasis
Systemic therapy for psoriasis is aimed at reducing the proliferation of skin epithelium, stabilizing the keratinization of skin cells and cell membranes. Vitamin A-based preparations (retinoids), cytostatics are used for this. Of the most modern treatments, so-called biological drugs are used to neutralize substances that cause inflammation.
UFO treatments with ultraviolet rays of group B (in solariums, rays of group A) have been used for many years, which reduce inflammation and contribute to the death of altered cells. PUVA therapy is the simultaneous use of ultraviolet radiation and a special substance that increases the sensitivity of the skin to it.
An effective remedy for psoriasis
Local treatment is no less important than systemic treatment. Helps reduce skin inflammation. Medications are prescribed depending on the stage of psoriasis.
Progressive phase
- Exfoliating ointments and lotions;
- anti-inflammatory hormonal ointments with calcitriol;
- emollients to relieve itching and dryness of the skin.
Stationary stage
- UVB therapy;
- concentrated exfoliating ointments;
- emollients to regenerate the skin and reduce dryness.
Regressive phase
- concentrated exfoliating ointments;
- emollients to regenerate the skin and reduce dryness.
Psoriasis cream
Psoriasis creams and ointments have different purposes and are used in different stages of the disease, and hormonal anti-inflammatory ointments and creams are used to stop inflammatory processes on the skin. There are several classes of hormonal drugs. They have different absorption capacities and different activities. When used in children, they try to avoid the application of hormonal drugs to the face and neck, the area of skin folds - places where the skin is thinner. Topical preparations based on calcipotriol (a derivative of vitamin D) also have an anti-inflammatory effect. This is a later generation of drugs. They are not currently used during pregnancy and breastfeeding.
Salicylic ointment and salicylic acid lotion are designed to remove flakes from strong dandruff. Salicylic acid not only has an exfoliating effect, but also increases the effectiveness of local hormonal drugs. In the stationary and regressive stage, when the inflammation has become less active, salicylic acid-based agents are used in higher concentrations.
Means for restoring the structure of the skin and removing dryness are used during the entire period of treatment, as well as together with ultraviolet radiation in order to reduce itchy skin. Once discounts appear, these products help maintain the protective properties of the skin and reduce the risk of new outbreaks.
An effective cream for psoriasis
The modern approach to care and assistance for dry skin is based on the saturation of the epidermis with moisture and is called corneotherapy (derived from the "corneo" - corneal or horny layer of the epidermis).
Corneotherapy is aimed at restoring the stratum corneum of the epidermis and its protective functions, which enables the improvement of the condition of the skin as a whole. The works of the founder of corneotherapy, Albert Kligman, enabled the creation of special means - emollients.
How do softeners work?
within 1 hour after applying the emollient: - the condition of the skin improves due to the fact that the emollients "lock" moisture in it.
6 hours after applying emollient: - the skin structure is restored due to the content of special regenerating natural lipids (ceramides and other useful fats).
24 hours after applying the emollient: - there is a clinical improvement of the skin condition due to the penetration of moisturizing components into the deep layers of the epidermis and the renewal of the surface layers of the skin (up to 24 hours from the beginning of application).