Psoriasis: symptoms, treatment and prevention

Psoriasis- one of the most common diseases, whose frequency in the population is constantly increasing every year. And if we take into account that absolutely all age categories are susceptible to this pathology, and its simple form quickly becomes more complex, then the question of proper therapy and prevention is really very acute.

According to statistics, approximately every 30 inhabitants of the planet suffer from this disease to one degree or another. What to do to those who suffer from psoriasis? What medicines and folk remedies can be treated? How to properly organize your meals? Let's finally put all the points.

Psoriasis and its causes

Psoriasis is an autoimmune disease of rather unclear etiology - the exact cause, despite numerous studies in this area, is still unknown. It is believed that this pathology is a consequence of genetically conditioned changes in the immune system, as a result of which chronic inflammation of the skin develops. However, its multifactorial nature is also not excluded - in other words, involvement, along with heritage and the influence of the external environment.

Significantly, predisposing factors, according to scientists, are quite different for different age groups: for example, if different types of bacterial infections, including, in particular, streptococcal infections, are thought to trigger in children, then in adults, stress stimuli and nicotine abuseare the most important, and alcohol, obesity, and the use of certain medications (e. g. , adrenaline receptor blockers).

It is impossible to completely cure psoriasis, however, modern medicine is able to significantly alleviate the course of the disease and maintain long-term remission in the patient.

There are several theories that explain the appearance of psoriasis:

• infectious and parasitic;
• neurogenic;
• endocrine;
• metabolic;
• immunological;
• hereditary;
• molecular mimicry theory.

As with many other conditions, the cause of skin problems should be found in the intestines. Its length is 4 to 6 meters, and the inner surface is covered with fringes, the total area of which is comparable to the size of the tennis court - this allows the absorption processes to take place much more efficiently. Interestingly, the cells of the small intestinal mucosa completely regenerate every 3-5 days. Moreover, up to 70% of human immunocytes are concentrated here. Thus, one of the most common causes of psoriasis is considered to be bowel leakage syndrome (LEPS).

Deviation from the normal functioning of the intestinal mucosa is fraught with malabsorption, ie a violation of the assimilation of basic nutrients (proteins, fats, carbohydrates, vitamins, minerals). In addition, the negative impact on the body of toxins and allergens increases: in such conditions it is much easier for them to enter the bloodstream. A direct link between psoriasis and inflammatory bowel disease has been proven in numerous studies.

Other works by scientists confirm that a special microflora is created on the skin of a patient with psoriasis, which is significantly different from the microbiome of healthy skin.

In the area of psoriatic lesions is concentrated a mass of different bacteria whose stability is significantly lower than the stability of normal skin - especially observed colonization of Staphylococcus aureus, which has an extremely negative effect on the inflammatory process.

Types of psoriasis

1. Plaque psoriasis. . . In 90% of cases, dermatologists are faced with this particular form of the disease, also known as simple or plain. First, separate small areas appear on the skin, raised above the level of a healthy dermis. These inflamed areas are called psoriatic plaques. They gradually grow, merging with the adjacent spots into one whole.
2. Reverse psoriasis.This diagnosis is given to patients who develop smooth red spots in the folds of the skin and inside the folds - in the groin area, on the inside of the thighs, under the breast. Unlike simple psoriasis, the foci of inflammation are practically not covered with scales, but due to their position and constant friction, they cause serious discomfort to patients. In addition, there is a risk of re-infection with streptococcus or fungus, since in places where the spots are localized, due to high humidity and temperature, ideal conditions are created for the reproduction of microorganisms.
3. Guttate psoriasis.This type of disease is named after the shape of the formations. The lesions are drop-shaped, raised above the level of healthy skin. A common trigger for this form of psoriasis is a previous streptococcal infection, as mentioned earlier. The fact is that the patient's immunity, affected during the fight against the infection, is seriously weakened - his resources are not unlimited and, like all living beings, it takes time to recover - and it is in this area that the autoimmune disease is activated.
4. Pustular psoriasis.It is considered the most severe form, followed by the formation of blisters filled with clear liquid. Inflammation of the skin begins around the focus, swelling and thickening appear. With secondary exacerbations, the likelihood of which is quite high, the bubbles fill with pus. Localized foci of pustular psoriasis on the hands and feet. In severe cases, blisters are ubiquitous on the body, their rapid growth and the risk of infection of the entire skin surface.

5. Nail psoriasis.This type of disease changes the appearance and structure of the nail plates on the hands and feet. Nails thicken, lose their natural color, emit an unpleasant odor. The skin around the nail layer is rougher, thick ridges are formed. In advanced cases, the nails may disappear without subsequent regrowth.
6. Psoriatic arthritis.In this case, the disease affects the joints and connective tissue. Inflammation most commonly affects the distal phalanges of the extremities. There is psoriatic dactylitis - swelling of the fingers. Hip and knee joints are also exposed to the devastating effects of ongoing disease. There are frequent cases of disability with loss of ability to move independently.
7. Psoriatic erythroderma.Scaly spots appear on the skin, while peeling of the affected layer is noticed. Patients feel extreme discomfort due to constant itching and swelling. Most often, this diagnosis is made in patients who have already been treated for simple psoriasis but have not completed therapy or have changed medication.

Symptoms of the disease

The first manifestation of psoriasis is a small rash on the skin. The papules grow rapidly, grow to a spot 4 to 8 cm in diameter, become larger and dry scales form on the surface. In advanced cases, individual sites merge and the lesion affects large areas of the body. Psoriatic papules can be distinguished from other skin diseases by a round shape with clear borders, red or bright pink color, and silvery-white scales. They first appear on those areas of the skin whose integrity has been damaged as a result of scratches, wounds, frostbite, constant friction. There are three characteristic signs that confirm the onset of psoriasis:

1. The stearin stain phenomenon- Dry particles are easily separated from the affected surface, revealing an area that looks like a drop of wax or sterol.
2. Psoriatic phenomenon(terminal) film. Further cleaning of the papules with scales allows you to see a transparent and moist film, the skin under which it is inflamed.
3. Exhaust phenomenon. . . Removing the final film leads to the appearance of the smallest drops of blood on the surface of the stain.

This triad of psoriasis is unique - its presence enables an unmistakable correct diagnosis. However, different parts of the body have their own characteristics of disease manifestation.

• Psoriasis on the body.Guttate psoriasis most commonly affects the back, neck, abdomen, thighs and lower legs. Small papules, resembling droplets in shape, gradually grow, rising above the surface of the skin. This form of the disease is often diagnosed in people who have had a staphylococcal infection.

• Psoriasis on the hands.The most common places for the appearance of psoriatic papules on the hands are the elbows and interdigital spaces - while as a rule a form of plaque is observed in which individual small fragments merge into one area of the lesion covered with dry scales. Forearms are much less likely to be affected.
• Psoriasis of the legs.The disease begins with a single rash in the knee area. Inflamed areas disturb patients with severe peeling and itching, they increase rapidly and merge with the adjacent ones.
• On the palms and soles of the feet.In most cases, there is a simultaneous defeat of both palms and feet, but in some patients the disease affects the stratum corneum of the purely upper or lower extremities. As a result of the growth of psoriatic papules, there is a thickening, roughening of the skin with further cracking.
• Scalp psoriasis.First of all, the rash appears on the forehead, nape of the neck, and also behind the ears. First, patients notice within themselves individual scaly formations that grow, merge with those located nearby, and over time can affect the entire scalp. The papules are very itchy, which causes a constant urge to scratch the skin - the resulting wounds and cracks are likely to become the gateway to infection. Dry particles separate from damaging formations - first small, somewhat similar dandruff, and then larger flakes.

• On the face, ears, neck.The localization of psoriatic papules on the face is quite an exception in the usual clinical picture. In rare cases, when this happens, the disease affects the areas around the eyes and eyelids, as well as the cheeks and tongue. Formations on the neck spread quickly - on the back or head. Lice are the site of development of seborrheic psoriasis. Papules can appear both inside and outside the cartilage. When making a diagnosis, it is important not to confuse the disease with seborrheic eczema, which has similar symptoms.
• On the nails.There are three possibilities for the initial manifestation of psoriasis on the nail plates. The first is the appearance of small dotted depressions. The second is the thickening of the nails, the change of their natural color to gray or yellow. With the further development of psoriasis, the nail plate peels off, and the upper particles are easily separated. And, finally, the third is the deformation of the nail, followed by the loss of smoothness of the plate and the appearance of depressed areas.

• Symptoms of psoriasis in children.At an early age, the disease develops differently: the main localization of red scaly rashes are skin folds: inguinal, in the elbow and popliteal folds, on the neck. The papules are very itchy, the children experience constant torment, become irritable and restless. In general, all clinical variants observed in children are similar to those observed in adults. The differences concern purely the manifestations, the location of the pathological process and the course of the disease itself.

4 stages of psoriasis

Clinical dermatology, based on differences in symptoms, degree of skin lesions and duration, distinguishes three phases of psoriasis. However, there is an opinion that the initial stage must be recognized as another full-fledged stage in the development of the disease.

1. Initial phase.The first sign of psoriatic lesions are small rashes. The places of their occurrence can be different and depend on the type of disease. Primary papules are not larger than 3 mm, they are painted in a pale pink color, which after 3-4 days is replaced by a gray inflorescence - dead particles of the dermis are formed on the spot. This process is accompanied by itching and burning, and general health deteriorates. In general, plaque formation in the initial stage lasts up to three weeks and during this time the person has the opportunity to slow down the development of pathology.
2. Progressive.At this stage, the disease affects significant areas of the skin: for example, in normal psoriasis, plaques are formed, and for other forms, papules characteristic of them. In the process of disease development, individual spots merge with each other, covered with gray scales. The symptom that determines the progressive stage is the Köbner phenomenon (isomorphic reaction). Any skin damage after some time is accompanied by the appearance of a psoriasis rash at this site. Another confirmation that the disease is actively developing is the appearance of drops of blood, similar to dew, after the removal of plaque. The duration of this phase depends on the type of lesion. On average, it takes two weeks to two months.
3. Stationary stage.During this period, a thick grayish-white or gray crust is formed. The pink edges disappear. The skin becomes rough, dry particles are constantly peeling off it. The itching and burning sensation becomes less annoying, but it also doesn’t go away completely. No new papules form. This phase can be quite long.
4. Regressive phase.The final phase of the development of the disease, during which there is a gradual reduction and resorption of plaques. Itching no longer bothers. A clear sign of regression is Voron's symptom, when the papules are surrounded by white rings. Spot fading occurs from the center to the periphery, resulting in bizarre patterns on the skin. At the end of the regression phase, only the areas of the skin that differ slightly in shade from the healthy ones resemble psoriasis. There is no need to talk about complete recovery in case of psoriasis. The end of the regressive phase indicates that the disease cycle is complete and can return at any time. To prolong remission, it is necessary to pay attention to health: avoid provoking factors, follow a diet, adhere to a dermatologist.

Psoriasis examination plan

1. General clinical blood test.
2. Investigation of the content of vitamins D, B12, folic acid in the blood.
3. Blood test for ALT (alanine aminotransferase), AST (aspartate aminotransferase), direct bilirubin, alkaline phosphatase, gamma-glutamyl transferase, cholesterol with lipid profile, creatinine, glucose, insulin, total protein.
4. Blood for rheumatoid factor, c-reactive protein, uric acid, ASLO.
5. Ferritin, transferrin, serum iron are indicators of anemia (especially chronic diseases).
6. Thyroid: TSH, T4 st, TK st.
7. Coprogram.
8. KhMS according to Osipov.
9. Ultrasound of abdominal organs.

Traditional treatments for psoriasis

Early therapy.

The sooner a person who discovers the first signs of a skin lesion sees a doctor, the more likely he or she is to take timely measures to prevent the disease from developing rapidly and becoming chronic - and therefore significantly improve overall living standards.

One of the most commonly prescribed medications at the onset of the disease is salicylic ointment. It has anti-inflammatory and antimicrobial effects, keratolytic effect, which is why plaques are cleaned of keratinized particles. Naphthalene ointment is also used to reduce itching.

Therapy in a progressive phase.

An integrated approach to treatment is needed at this stage and can only be provided by an experienced professional. The treatment is aimed at relieving symptoms, ridding the body of toxins. Intramuscular injections of calcium gluconate are often prescribed to normalize metabolic processes. Sodium thiosulfate relieves inflammation and eliminates the manifestations of intoxication.

Special emulsions and salicylic ointment are used to moisturize inflamed skin. Tar-containing agents are contraindicated in the progressive phase: they have an irritating effect and increase the patient's suffering.

When the intensity of inflammation decreases, physiotherapy procedures can be combined. Patients with psoriasis were shown ultraviolet radiation, PUVA therapy and paraffin application. Corticosteroids and cytostatics are not used unnecessarily, these powerful drugs are needed only in severe and advanced cases.

To reduce allergic manifestations, antihistamines are prescribed, and sedatives to reduce nervousness. Diuretics help reduce swelling of inflamed skin and remove toxins from the body.

Inpatient therapy.

At this stage the inflammation fades, the plaques are covered with a dry crust, so means are needed to alleviate the discomfort due to the appearance of scales. These are tar shampoos, oil-based emulsions.

In many patients, ultraviolet radiation and the PUVA technique have a good effect. If there is no improvement, doctors prescribe cytostatics.

Regression therapy.

In the final period of the disease cycle, constant correction of treatment methods is required, depending on the patient's current condition. Prevention is the replacement of active therapeutic actions.

The patient receives recommendations for a change in diet and lifestyle in general. To avoid the return of the skin lesion, it is necessary to avoid stressful situations that trigger the formation of psoriatic plaques.

Doctors usually give patients the following advice:

• reconsider the way of life: adjust your diet, get some sleep, move more;
• ensure normal vitamin levelsD, iron, B vitamins, proteins in the body;
• normalize the digestive tract: exclude hypoacidity, impaired bile flow, SIBO and CIGR (bacterial overgrowth syndromes and, consequently, fungi);
• get rid of the foci of chronic infection: sanitize the oral cavity, undergo treatment by an ENT doctor;
• deal with concomitant somatic pathology: hypothyroidism, insulin resistance, metabolic syndrome, etc.

Traditional methods of dealing with psoriasis

• Initial phase.At the first signs of skin lesions, spruce and lavender oils are effective. Soothes irritated areas of the dermis, promotes healing of minor injuries, relieves the feeling of tightness. A few drops of oil are added to creams of neutral composition, for example for children, and applied to the rash that appears. Another popular method of dealing with the initial manifestations of psoriasis is the use of 3 percent hydrogen peroxide. Any measures, even the most dangerous at first glance, can be applied after consulting a dermatologist. Changes in diet, avoiding unhealthy foods and alcohol are also common recommendations of traditional healers.

• Progressive phase.In the phase of rapid development of the disease, celandine infusion is added to medicinal oils and hydrogen peroxide. To prepare it, you will need fresh or dried plant stems and salt water. Alcoholic tinctures are contraindicated, they can worsen the condition of the affected skin. It is necessary to insist on celandine for at least a few hours, and before applying the medicinal solution on the plaques, treat them with birch tar.
• Stationary stage.In the phase of stopping the formation of new papules, you can use proven folk methods that will definitely not harm the patient. They include the use of sulfur ointment, salicylic solution.
• Regressive phase.In the final stage of the disease, chiropractic (leech therapy) is often used. Although traditional medicine does not officially recognize this method, many experts do not rule out its effectiveness. The procedures are performed within 3 - 10 days, depending on the patient's health condition.

Prevention of psoriasis: how to prevent the development of the disease

• Skin care.To reduce the likelihood of psoriatic damage in the presence of a genetic predisposition, simple ways to maintain skin health will help: water and firming procedures (bathing in the sea, baths with plant extracts and salts, contrast showers, pouring cold water in water). air, etc. ); use soft sponges and avoid hard washcloths that can damage the skin; use of detergents, natural composition, without aggressive chemical components.
• Ultra-violet rays.Several studies have proven the beneficial effect of sun exposure on skin prone to the formation of psoriatic plaques. Moderate doses of ultraviolet light help accelerate tissue regeneration and reduce inflammation. You should not abuse sunbathing: excess air can cause the disease to worsen.

• Clothes.Synthetic fabrics, tight styles, plenty of belts and buttons - all this is contraindicated for patients with psoriasis, even in the remission phase. Clothing should be natural, hypoallergenic, loose, should not create discomfort that can lead to the return of pronounced symptoms. Dark tones should be avoided for aesthetic reasons; silvery white scales are less visible on light-colored clothing.
• Injuries.For patients with psoriasis, any small wound, scratch, abrasion can cause a return of the progressive stage and a secondary skin infection. You should be extremely careful to avoid injury.
• Cosmetics and household products.Not all medications are suitable for maintaining cleanliness for people with such a diagnosis. When choosing shower gels, soaps, shampoos, it is important to pay attention to their composition, giving preference to those that contain natural ingredients. It is better to buy therapeutic series of care products sold in pharmacies. Peeling with solid particles is absolutely contraindicated: they are able to start the disease process due to the slightest injuries to the skin. Household chemicals should also be selected according to health safety, do not use aggressive chlorine and alkali-based cleaning powders. Gloves should be worn when cleaning to avoid adverse effects on the skin of the hands.
• Vitamin therapy.Maintaining a vitamin balance is indicated for everyone, especially for people with chronic dermatitis. Complex preparations keep the body in good condition, help it resist viruses and prevent metabolic disorders.

Psoriasis- this is not the death penalty, but a very serious reason to reconsider the rules you used to live by. Your allies on the path of domestication of the disease should be competent professionals - dermatologists, nutritionists, therapists. With their help, as well as through a conscious approach to treatment, you can learn to live comfortably, despite the diagnosis.