Psoriasis - what is it, symptoms and treatment

Psoriasis is a chronic inflammatory disease of the body, accompanied by a predominant skin lesion with the formation of erythematous spots and plaques that have clear boundaries and silvery scales on the surface.

The course of this disease is characterized by periods of exacerbation and remission (reduction of symptomatic manifestations). Unfortunately, medicine has not yet determined the exact and reliable cause of psoriasis, but a hereditary factor has been clearly observed which, in combination with trigger factors, contributes to the triggering moment of the appearance of this disease. A link between the occurrence of psoriasis and antigens of the HLA system was discovered.

Between 1 and 5% of the world's population suffers from this very unpleasant disease, and fair-skinned people are at a higher risk of developing psoriasis than black people.

The disease can manifest itself at any age, but the periods of 20-30 years and 50-60 years are considered critical.

Important!Psoriasis is not contagious to others, but it causes inconvenience to the patient himself, because the rashes that appear during the disease are not only a cosmetic defect, but are also accompanied by unpleasant itching. In addition, the manifestation of psoriatic arthritis is possible, which significantly worsens the patient's quality of life.

The rashes are mostly localized in the scalp, on the surface of the elbows and knees, in the areas of skin folds and genitalia. Nails, buttocks and the area around the eyebrows can often be affected. The nature and appearance of the rash depends on the type of psoriasis.

Causes of psoriasis

Medicine has not yet discovered the nature of psoriasis, some doctors talk about autoimmune causes. Another theory that explains the origin of the disease is the disruption of the normal process of maturation and division of skin cells. Heredity and stress are also considered to be the cause.

Genetic predisposition to psoriasis, allergies and frequent disorders of the skin barrier (strong friction, exposure to chemicals, influence of products containing alcohol) can cause the disease to worsen.

To known triggers that causepsoriasis, to relate:

  • Koebner's phenomenon is the appearance of fresh rashes at the site of skin irritation in the acute phase of some dermatoses;
  • Sunburns or other types of burns;
  • HIV infection;
  • Beta-hemolytic streptococcal infection, which causes guttate psoriasis;
  • Use of drugs (especially beta blockers, lithium, angiotensin-converting enzyme inhibitors);
  • Severe emotional stress;
  • Alcohol consumption;
  • Tobacco for smoking;
  • obesity;
  • Hormonal imbalance, especially in women during menopause and pregnancy;
  • Disorders in the digestive system.

The main cause of the development of the disease is excessive, accelerated growth and division of skin cells in combination with the inflammatory process in the dermis. In other words, the skin cells lying in the lower layer of the epidermis begin to grow rapidly and put pressure on the cells lying above. This process is accompanied by significant peeling of the skin and is called parakeratosis. Excessive stimulation of the immune system is considered to be the main link in the origin of this mechanism.

Psoriatic plaques on the elbow treated with medical cream

Symptoms and signs of psoriasis

Rashes associated with psoriasis are asymptomatic or accompanied by itching. They are most often localized on the scalp, extensor surfaces of knees and elbows, sacrum and buttocks (especially in the gluteal fold), and in the genital area. Fingernails and toenails, the skin of the eyebrows, armpits and navel can be affected. The rash can merge with the lesions and cover large anatomical areas and areas of skin between them. Depending on the type of psoriasis, the rash can have different external manifestations.

As a rule, the rash is discrete and is represented by erythematous papules or plaques, which are covered with dense, silvery, shiny scales. The rash appears gradually. Remissions and exacerbations occur spontaneously or after exposure to provoking factors.

It develops in 5-30% of patientspsoriatic arthritis, which can cause disability for the patient. This process can lead to joint destruction.

Important!Psoriasis does not threaten the patient's life, but it does damage his self-image. In addition to the patient's appearance changing, it also takes a lot of time to treat skin rashes and maintain cleanliness of clothes and bedding, which greatly reduces the patient's quality of life.

Types of psoriasis

  • vulgar(common or chronic plaque) psoriasis, in which the rashes have the appearance of individual plaques covered with silvery scales. Plaques can coalesce as the disease progresses. Among all subtypes, this type of psoriasis is the most common and accounts for about 90%.
  • inverse psoriasisaccompanied by a rash that appears in the area of natural folds and can form cracks.
  • guttate psoriasischaracterized by multiple skin rashes with a diameter of 0. 5-1. 5 cm. It often occurs after streptococcal pharyngitis.
  • palmoplantar psoriasisit manifests as plaques on the palms and soles, which can coalesce.
  • nail psoriasisaffects the nail plates in the form of pointed depressions and grooves with discoloration and thickening of the nail. Changes in the nails in psoriasis often resemble changes in a fungal infection.
  • pustular psoriasisfollowed by the formation of pustules on the palms, soles or eventual damage to one of the fingers. There may also be a generalized form.
  • erythrodermic psoriasisit manifests itself as a sudden or gradual appearance of redness in patients with psoriatic plaques, when the plaques themselves are mild or absent. It usually occurs due to improper treatment of psoriasis vulgaris.

Methods for diagnosing psoriasis

When symptoms of psoriasis appear, the patient should consult a dermatologist. He will conduct an external examination of the affected areas of the skin and collect a complete medical history.

Psoriasis has a general similarity with other dermatological diseases, especially in the first stages of manifestation. It is important to exclude the presence of fungal infections on the hands and nails. The seborrheic type of psoriasis requires a special differential diagnosis to exclude seborrheic eczema, pityriasis rosea, and papular syphilis.

In case of active disease and large lesions of the epidermis, visual analysis of scraping is used. In the scraping process, the exfoliation intensifies. At the place of the removed scale, a smooth, thin film is visible, which is removed by mechanical action and reveals a moistened surface with drops of blood.

Diagnosing psoriasis in most cases is not difficult, it is enough just to examine the patient's skin. The doctor must exclude errors in the diagnosis and determine the presence of other diseases and other pathologies that occur against the background of psoriasis.

In rare cases, diagnosis requires a biopsy. If non-classical clinical signs are present, the need for them should be considered. There is mild, moderate and severe severity of the disease depending on the area of the affected skin. Damage to less than 10% of the skin corresponds to mild severity. There are more sophisticated methods for assessing disease severity, but these are used in clinical trials.

Treatment of psoriasis

There are a large number of factors that depend on the development of the disease and its various manifestations. Therefore, many treatments for psoriasis have been developed. Often these methods are combined, including drug and non-drug interventions.

The treatment plan is made depending on the severity of the disease, the area of the affected skin and the severity of symptoms such as redness, itching, peeling. Age and gender, disease stage and general condition of the patient, presence of accompanying diseases are also taken into account, as they can limit the choice of treatment methods.

Treatment of psoriasis should lead to reduction of clinical manifestations (rash and other symptoms), improvement of the patient's general condition and restoration of his working ability.

When treating psoriasis, it is necessary to follow a diet and take proper care of the skin, because there is a risk of liver damage. In such cases, it is recommended to reduce the amount of fatty foods in the patient's diet, to give up alcohol, sweets (simple sugars) and starchy foods. The emphasis in the diet should be on proteins: lean meat, fish, dairy products, vegetables and fruits. Be sure to pay attention to allergic reactions or intolerance to certain products.

In order to improve the patient's quality of life and get rid of the disease, it is necessary to use an integrated approach:

  • Local treatmentOintments and creams cope well with peeling and itching in small areas where the disease is localized. Hormonal ointments, salicylic acid, retinoids and moisturizing creams are particularly effective in treating psoriasis on the face and hands.
  • Drug therapyit is used as an additional method of effective treatment of psoriasis when ointments do not help. Medicines reduce the inflammatory process, remove swelling and itching and block the increased activity of skin cells. But it is worth considering that pills have many side effects (increased fatigue, lack of appetite, high blood pressure). That is why it is very important to follow all the recommendations of the doctor regarding the dose of the drug.
  • When psoriasis is localized on the head and neck, usemedical therapeutic shampoos: antifungal, tar, containing corticosteroids. The shampoo eliminates pathogenic pathological inflammations, removes scales, relieves itching and burning.
  • Therapeutic injections of antihistaminesblock severe itching, biological drugs have a beneficial effect on the immune system.

Unfortunately, today there are no possibilities for a complete cure of psoriasis. Any treatment for psoriasis aims to eliminate the signs of the disease for a long time and prolong the remission. But treatment of psoriasis is necessary, despite the slow chronic course of the disease, because long-term absence of therapy can lead to disability of the patient.