For centuries, mankind has been trying to discover all the secrets of this mysterious skin disease, but still much remains unknown. According to statistics, 4 to 7 percent of the population suffers from psoriasis, and men and women are equally susceptible to it. Usually, the first signs of psoriasis appear in puberty and can follow a person throughout his life, sometimes they decrease and disappear, sometimes they increase in strength.
Causes and risk factors for psoriasis
Psoriasisis a long-term inflammatory process of the skin, which is considered an autoimmune disease (associated with an allergic response to its tissues). This is a chronic skin disease that affects the cells of the outer layer of the epidermis. The condition usually appears as red, silvery scaly skin on the feet, knees, back, chest, etc. In most cases, psoriasis starts in small areas of the skin, which can then spread to large areas of the body. There are many causes and risk factors that can contribute to the development of this disease, and there are several theories that explain its development.
Autoimmune cause
Some studies suggest that psoriasis may occur due to a combination of genetic and environmental factors such as infections, trauma, stress, and certain medications. These factors can trigger a reaction of the immune system, which begins to fight against the body's tissues, including the skin.
However, the processes underlying psoriasis are still not fully understood. It is important to note that psoriasis is a multifaceted disease that manifests itself differently in each patient. Studying the mechanisms underlying psoriasis can help develop more effective treatments, reduce the risk of complications, and improve patients' quality of life.
Influence of metabolism
Metabolic disorders significantly affect skin condition and immunity in patients with psoriasis. Increased metabolism leads to the creation of toxins and free radicals, which contribute to inflammatory reactions. There is an imbalance in various metabolisms.
- With a disorder of protein metabolism in patients with psoriasis, the content of albumin in the blood decreases, and the content of globulin increases, which increases their sensitization.
- In fat metabolism, an increase in the content of lipids and cholesterol in the blood is observed.
- Reducing calories and eating plant-based foods can reduce the activity of psoriasis inflammation.
- Disorders in carbohydrate metabolism are almost always present.
- The metabolism of vitamins and minerals is also disturbed, which is manifested by a decrease in the content of vitamins C, A, B6, B12, iron, copper and zinc in the blood, but an increase in the content of vitamin C.
Infectious cause
This theory was widespread in the last century. It was believed that psoriasis can be caused by certain bacteria (streptococci), fungi and viruses, but these hypotheses have not been scientifically confirmed. However, dermatologists point out that any acute infectious process or chronic infection can cause psoriasis to recur. Special attention is paid to the virus theory. The latest research shows that RNA viruses, such as HIV and other retroviruses, can affect the genetic apparatus and cause the appearance of genes that predispose to the development of psoriasis.
Genetic predisposition
Inherited predisposition to autoimmune reactions is a risk factor for psoriasis. If a person's close relatives suffer from this disease, then the probability of developing it increases. Several genes may be associated with psoriasis, including the PSORS1-PSORS9 complex, in which PSORS1 is thought to be particularly active. It contains the genes HLA-C, HLA-Cw6, CCHCR1 and CDSN, which may contribute to the development of the disease. Genes affect metabolism, immunity and the development of autoimmune processes. However, the presence of these genes does not mean that a person will necessarily develop psoriasis. The development of the disease can be caused by other factors.
Neurogenic cause
Excessive stress on the nervous system, long-term stress and imbalance in the autonomic nervous system, which provides the innervation of blood vessels and internal organs, can be risk factors for the development of psoriasis. These factors can cause an imbalance in the endocrine system, changes in metabolic processes and disorders of the immune response, increased irritability or depression, constant fatigue, sleepiness and apathy, which can eventually lead to psoriasis.
Endocrine
Endocrine disorders that occur in psoriasis are quite common and can have a significant impact on the development of the disease. However, the link between them and psoriasis is not entirely clear and has not been proven. Experts believe that patients with psoriasis often suffer from dysfunction of the thyroid gland, pituitary gland and adrenal gland. Women can have problems with the menstrual cycle, and men with sexual function.
Symptoms and characteristics of psoriasis
Psoriasis is not only manifested by rashes on the skin, but also by other symptoms. It often begins in childhood or adolescence and is associated with hormonal disorders, vegetovascular dystonia and stress.
The first signs arefatigueImood swings. The main symptom is small pink bumps on the skin called papules, covered with whitish scales. The papules are surrounded by a lighter rim.
Over time, the elements of the rash can merge into large plaques of an unusual shape. The base of each papule isinflammatory infiltrate. The following types of rashes are distinguished:
- pinpoint (no more than 1 mm in diameter);
- in the form of a teardrop – (papules with droplets up to 2 mm in size);
- coin-shaped – (round papules-coins up to 5 mm in size).
The rash also has its own characteristics:
- stearic stain - if you scrape the surface of the papule;
- terminal film - after cleaning papules from scales, you can see a transparent film;
- blood dew (Auspitz phenomenon) – if the integrity of the film is damaged, small blood droplets may appear.
Is psoriasis contagious?
Many people believe that psoriasis is contagious, which is why they try to avoid contact with people who suffer from it. This can make the patient want to withdraw from others and can lead to serious psychological problems. However, studies have shown that psoriasis is not transmitted by contact with the patient. If all family members suffer from this disease, it only indicates the presence of a genetic factor in the development of the pathology.
Classification and stages of psoriasis development
There are currently three main stages in the development of psoriasis:
- The progressive phase, which is characterized by the constant formation of new skin rashes, which are accompanied by severe itching.
- Stationary phase, in which new formations stop appearing, and existing ones begin to heal.
- The regressive phase in which edges appear around the rash, and the skin affected by the rash becomes darker in color due to increased pigmentation.
In addition, there are several degrees of severity of the pathology:
- Mild degree, when no more than 3% of the skin surface is affected.
- Medium grade, characterized by 3-10% skin damage.
- Severe degree, in which the disease affects more than 10%.
Types of psoriasis
Psoriasisis a chronic skin disease that can manifest itself in different ways. Rashes, their location and damage to other systems and organs may differ. Depending on these characteristics, different forms of psoriasis are distinguished.
Simple (vulgar, plaque)
Plaque psoriasis is the most common form of this disease. Its symptoms include the appearance of light pink papules covered with white scales.
Elbow psoriasis
This is a typical manifestation of mild plaque psoriasis. A characteristic feature of psoriasis on the elbows is the presence of one or more permanent "on-call" plaques on the extensor side of the elbow joints. If these elements are exposed to trauma, exacerbation occurs.
Guttate psoriasis
Associated with bacterial (most commonly streptococcal) and viral infections, this type of psoriasis can cause inflammation. This condition often occurs in children and begins with the appearance of small, red, tear-shaped papules on the skin of the limbs, body or face. Papules have a scaly surface and can develop into erosions and ulcers, increasing the risk of infection.
This condition can develop rapidly or gradually become chronic, followed by periods of aggravation and weakening of symptoms. In rare cases, psoriasis can be more severe.
Palmoplantar psoriasis
This type of psoriasis often develops in people who do physical work and is often accompanied by severe itching and can lead to nail complications. Several subtypes of this type of psoriasis include:
- Fan plaque: large elements on the palmar and plantar surfaces with white scales that coalesce into fan plaques. This subtype is most often found on the hands.
- Circular: annular scaly elements on the palmar and plantar surfaces.
- Callosis: growth of rough epithelium with blistering.
- Pustular: This is a special subtype of psoriasis on the palms and soles of Barbera. Blisters and pustules containing pus appear on the areas under the toes, causing severe itching. The ulcers coalesce, then dry and form crusts. Characteristic elements of psoriasis also appear on other parts of the body.
Psoriasis on the legs can be associated with varicose veins and manifests itself mainly on the lower legs.
nail psoriasis
It can occur as a separate disease or as a complication of another type of psoriasis. The main symptom is small holes on the nail plate, which have different depths. These pits are usually more noticeable and painful when pressed than other types of dermatitis. In addition, symptoms include spontaneous nail separation, subungual bleeding (especially when wearing tight shoes), changes in nail color and surface, such as trachyonychia and koilonychia.
Psoriasis of the scalp
It can manifest itself as an independent disease or as part of a general pathological process. One of the characteristic features is weeping and the formation of crusts on part or the entire surface of the head. In this case, hair growth is not impaired, because the function of the hair root is not impaired. However, wetting creates a risk of infection, which can lead to damage to the hair follicles.
Seborrheic psoriasis
It occurs as a result of disorders in the work of the skin glands, which produce viscous sebum, which causes skin irritation and promotes inflammation - dermatitis. This condition quickly spreads over the entire head, covering it in the form of a cap and is accompanied by severe itching. There is sometimes weeping in the areas behind the ears and an infection may develop. A scalp covered with dandruff and crusts can look like the crown of psoriasis.
Psoriasis on the face
It usually appears in the area of the nasolabial triangle, the eyelids, above the eyebrows and in the areas behind the ears. The rash can coalesce, forming large areas of redness and swelling. If the work of the sebaceous glands is disturbed, the process may be accompanied by weeping, crusting and an increased risk of infection.
Genital psoriasis
Psoriasis affecting the genitals is an accompanying process that is usually accompanied by characteristic psoriatic rashes all over the body, which facilitates the diagnosis.
Psoriatic rash on the penis in men, labia majora in women and the surrounding areas of the skin are oval in shape and slightly raised above the surface of the skin. They are pink and scaly. It is practically not accompanied by itching. Sometimes the lesion process spreads to the mucous membrane and can take the form of vulvovaginitis in women and balanoposthitis in men.
In obese people, atypical psoriatic rash can be observed in folds located near the genitals (inguinal, intergluteal). In these areas, areas of intense red color appear, which have a mirror-like surface and do not peel off due to constant wetting.
Why is psoriasis dangerous?
Psoriasis can become very serious when the rash covers more than 10% of the skin. This condition is severe and prone to recurrence, and the rash can become moist, wet and susceptible to infection. Only timely and effective treatment of psoriasis can prevent the spread of the disease.
In some cases, psoriasis can be complicated by joint inflammation and the development of psoriatic polyarthritis, which can lead to joint dysfunction. In addition, the systemic autoimmune process caused by psoriasis can lead to the development of other autoimmune diseases, serious cardiovascular and digestive pathologies, and neurological reactions.
Neglecting the timely treatment of psoriasis can lead to complications, such as psoriatic erythroderma, which can occur due to improper treatment of psoriasis or as a result of exposure to various irritating factors on the skin. In psoriatic erythroderma, the skin becomes dark pink with a clear distinction between affected and healthy areas, as well as small and large scales. This condition requires immediate medical attention.
Complications of psoriasis
Lack of timely and adequate treatment of psoriasis can seriously damage vital organs and body systems, such as joints, heart, kidneys and nervous system. These consequences can lead to disability or even death.
Diagnostics
Usually, the diagnosis of psoriasis is made based on the typical symptoms of the skin lesions and their location. In some complex cases, additional tests may be needed to rule out other skin diseases.
Laboratory tests may include:
- A complete blood count that can reveal leukocytosis and anemia in psoriasis.
- Rheumatoid factor (RF) is a protein whose levels may be elevated in systemic inflammatory diseases involving joint damage, but in psoriasis its levels are usually normal.
- The erythrocyte sedimentation rate (ESR) is also usually normal, with the exception of pustular psoriasis and psoriatic erythroderma.
- Uric acid levels can be elevated in psoriasis, which can lead to confusion with gout.
- Antibodies to the human immunodeficiency virus (HIV) can be detected by the sudden onset of psoriasis.
Other tests, such as x-rays of the joints and skin biopsy, may be used in more complex cases to assess the severity of joint damage and differentiate psoriasis from other skin diseases.
Treatment
Treatment of psoriasis requires a comprehensive approach, including local treatment of skin lesions, medications, light therapy, and prevention of exposure to factors that aggravate the disease. The choice of treatment method depends on the type and severity of psoriasis. Treatment may include:
- external preparations (ointments for the outside, petroleum jelly, paraffin, vegetable oils and creams with anti-inflammatory effect, the amount of which depends on the nature of the lesion and is used daily);
- lotions and shampoos based on salicylic acid, as well as photosensitizers;
- drugs for oral administration (retinoids, vitamin D preparations and others);
- physiotherapeutic procedures;
- Daily baths with bath oil, oatmeal infusion, or sea salt can help soften the skin and reduce the inflammation that occurs with psoriasis. It is important to avoid hot water and scrubs, and to use a moisturizing cream after bathing;
- light therapy, which involves exposing the skin to ultraviolet light, may also be helpful (avoid burns);
- photochemotherapy using medium wave radiation;
- adherence to a special diet and general regimen.
When creating a treatment program, the gender and age of the patient, the presence of accompanying diseases, the general state of health and the influence of external factors are taken into account. Sometimes it is enough to change the lifestyle for healing, and in other cases several treatments are prescribed.
In addition to traditional methods, the treatment of psoriasis can include the use of modern laser technologies. Laser therapy can reduce the symptoms of pathology, achieve long-term remission and free the patient from unpleasant rashes and related problems. The special feature of laser therapy is that the special excimer laser acts only on the affected areas of the skin, without affecting healthy ones, which ensures a quick recovery without side effects. Laser therapy is safe and painless, requires no preparation and can be used regularly so that the patient can live without limitations.
The effectiveness of treatment depends on many factors, including hereditary predisposition, provoking factors, the stage of the disease and the specific nature of the lesion, so it is recommended first of all to consult a specialist and prescribe treatment measures based on clinical recommendations.
Prevention
Psoriasis is a disease that can be successfully treated if you consult a doctor in time and receive qualified help. With a simple form of psoriasis, the patient can work without any restrictions, except for work in chemical plants, where being at the workplace can be dangerous.
However, psoriasis can cause complications, such as psoriatic arthritis, which can limit work performance and lead to disability.
Psoriasis prevention is an important part of treatment. After recovery, patients should reconsider their lifestyle, get rid of bad habits, take care of treating other chronic diseases, monitor nutrition and increase physical activity, spend more time outdoors and do sports.
Nutrition for psoriasis
Diet for psoriasis is not strict, but proper nutrition plays an important role in complex treatment. When giving dietary recommendations, patients are advised to:
- Avoid food to which the body is hypersensitive and exclude it from the diet.
- Prefer fresh fruits, vegetables, berries, lean roasted or boiled meat and drink more.
- Avoid the following foods: onions, garlic, radishes, concentrated tea, coffee, alcohol, sweets, salty and sour foods, as well as foods that can cause an allergic reaction such as orange fruits, honey, nuts, cocoa and eggs.
- Avoid fatty foods of animal origin.