Psoriasis (translated from the Greek "psora" - "skin disease, scabies") is a chronic pathology of non-infectious nature, also known as scaly lichen, which mainly affects the skin on the knee and elbow joints, lower back and head. There is also psoriasis of the joints, bones, nails, external genitalia, and internal organs, but these forms are rarely diagnosed. The pathology is difficult to cure, therefore, when the first symptoms appear, a red rash, a doctor should be consulted immediately.
Symptoms
Stearin stain
The first sign of psoriasis, which is part of a triad of pathology symptoms. It is characterized by increased peeling after scraping the affected area with a spatula. Over time, there is a separation from the papules of the silvery-white scales. Their removal is not difficult because they become loose and stick poorly to the psoriatic papule. The surface of the neoplasm (rash) becomes white, and the particles crumble and look like sawdust.
The first phenomenon of the triad is explained by the development of parakeratosis (improper functioning of the epithelium, which leads to a violation of the formation of the stratum corneum). Local non-hormonal agents (creams, ointments) are used to fight deviations in the initial phase.
Terminal Film
It is characterized by the removal of a thin layer of tissue from the papule that has a shiny structure and looks like polyethylene. It is easily separated by any blow (pressure, friction, etc. ) after removing the dried flakes.
The final film is the last layer that is removed from the skin. Further scraping leads to the last phase of the triad - drop by drop.
At this stage, medicinal herbal baths, drugs with anti-allergic effect, ointments on a natural basis (without corticosteroids and hormones) are used.
Accurate bleeding
After removal of the final film, drop by drop (auspits symptom or "bloody dew") occurs on the affected area of the skin and accelerated growth of neoplasms is recorded, which sometimes reach the size of a pea and is called lenticular. In some cases the papules grow to the diameter of a small coin and differ as nummular. As the disease progresses, their growth increases and when combined, psoriatic plaques form.
Retinoids, immunomodulators, anti-inflammatory drugs, physiotherapy are used for treatment.
The others
The disease can be recognized by other characteristic signs, of which the main 4:
- The rim is red, not covered with scales, which forms around the papules.
- Small rashes are visible on a clean area of skin (usually appearing before the progressive stage of psoriasis).
- The symptom that helps to distinguish psoriasis from seborrheic dermatitis is characteristic of the active phase of the pathology. It is accompanied by the appearance of papules with clear borders on the scalp; this does not occur with seborrheic dermatitis.
- A light, shiny rim of the skin appears around the formation. The symptom is typical of the stage of disease regression and occurs when the papules disappear.
How does it look like
In most cases, the onset of pathology is imperceptible: in the early stage of psoriasis, it affects small areas of the skin, mainly on the bends of the limbs, head and along the hairline.
Attention!The initial manifestations occur at the site of constant mechanical skin irritation, for example, where clothing rubs and presses.
Common symptoms:
- itching;
- excessive dryness of the skin;
- peeling of pathological elements;
- general deterioration of health (weakness, lethargy, fever).
There are 3 stages of development of pathological papules:
- Progressive.The appearance of a rash of a bright pink hue, surrounded by a rich, slightly indistinct rim. In the center of the papule, the skin peels off, giving the formations a white color. At this stage, the rash may appear at the site of scratches, skin injuries, bites, cuts, stings, or burns.
- Stationary.It starts 1-4 weeks after the onset of the disease. New plaques do not appear, old ones take on a light color, the intensity of peeling decreases.
- Regressive.The color of plaques and papules fades, their infiltration decreases and the formations dissolve. The average duration of the decay period is from 2 to 6-8 months.
Symptoms of the disease depending on the species:
- Plaque(common or vulgar). The most common type of pathology. On various parts of the body (more often on the elbows, knees, head) oval or round plaques of red hue appear covered with silvery white scales on top.
- Seborrheic.It mainly occurs on the scalp. It manifests as peeling and itching, spreading to the area behind the ears and the skin along the hairline.
- Pustularthe type is considered the most severe form, develops rapidly, and affects large areas of skin. Painful rashes appear on the body, which are accompanied by a local increase in temperature, weakness, headache, diarrhea. Exudate-filled vesicles soon form in the lesions. In the future, the spots progress, merging with each other, creating large lesions on the body.
- Intertriginous.Typical for children, accompanied by the appearance of bright red papules, with mild peeling (it may not be present).
- Exudative.The affected areas of the skin not only peel, but also get wet, yellowish crusts form on the surface of the plaque.
- Psoriatic erythroderma.Red deposits with silvery, yellow or white scales can be seen on the body. It is accompanied by an increase in lymph nodes, an increase in body temperature. In the future, the formations merge into large spots that cause irritation and itching.
- Psoriatic arthritis.It is followed by "joint syndrome", in which the skin in the area of the joints is affected (on the joints, phalanges of the fingers, spine and so on) and if measures are not taken in time In this way the disease affects the joints.
- Tearaccompanied by a copious rash, consisting of many small plaques. In this case, the papules are in the form of droplets, their color is from bright red to purple.
- Point.It is characterized by the formation of small spots on various parts of the body, resembling spots, and there may be no peeling of the dermis.
- Rupioid.One of the types of chronic psoriasis. The crusts appear on the formations, which become larger, taking the shape of a cone.
- Oldit manifests itself in large papules that do not last long, sometimes papillomas and warts form on them.
- Psoriatic onychialeads to deformation of the nails, the appearance of yellow-brown spots under them.
- Palmar-plantar.It appears on the palms and soles. The main symptoms are thickening of the skin, dryness, cracks.
- Mucosal psoriasisaffects the oral cavity and provokes the appearance of plaques on the mucosa.
Localization of psoriasis
Hands
In most cases, the rash appears on the surface of the elbows or between the fingers. Rarely, papules are noticed on the forearm.
Attention!Hands are characterized by a form of plaque pathology, but others can also be found. Its sign is small spots of red hue, quickly covered with white scales, the affected skin rough.
Legs
Psoriatic formations mainly occur on the legs in the knee area, but it is possible that they also occur on other parts of the legs.
The first rash is solitary and small, with clear outlines, but loose, inflamed, and very scaly. These exact papules spread rapidly and form conglomerates.
The head
It often develops in the background of seborrhea, affecting the hairline, forming the so-called psoriatic crown. Skin formations gradually grow and spread over the entire surface, resembling dandruff. This localization occurs quite often, less often the rash appears on the ears or behind them.
Fingernails
The nail plate can be affected by the type:
- Thimble- spotty form of psoriasis. Small dimples appear on the nails that resemble traces of a needle prick.
- Onychomycosis- the nail changes color, becomes dull, noticeably thickens and begins to peel. A psoriatic papule surrounded by a reddish rim, similar to an oil stain, can be seen through the plaque.
The body
It usually manifests as characteristic papules that connect with each other. Psoriasis is more common on the back, less often on the neck, abdomen, hips, formations can be in the form of drops, spiky and in the form of plaques.
Face
Rarely affected, the rash is found in the nasolabial folds, in the area of the temples and eyebrows, around the eyes. Rarely when the pathology affects the edge of the lips, the rash resembles herpes.
Palms and feet
Both zones were affected at the same time, but there were cases when the pathology developed only on the feet or palms. On the soles of the feet, the disease is often combined with fungal pathology, which greatly complicates the diagnosis and therapy.
This type of psoriasis is divided into 3 types:
- Papular plaque- formations are dense, do not protrude above the skin, it is difficult to separate the scales from the plaque. The rash occurs on the marginal areas, followed by edema and keratosis.
- Psoriatic callus- round dense papules, consisting of keratinized epidermis. The skin layer gradually thickens and roughens. As a result, he is easily injured, cracks appear. There is practically no redness, the size of the growth is from 2-3 millimeters to 2-3 centimeters.
- Vesicular-pustular- manifests itself in the form of serous-purulent papules. The bubbles reach a diameter of 2 millimeters and tend to coalesce.
Joints
Pathology can affect a person’s joints, leading to a change in the structure of their tissues, which with progress entails pain and deformities. External symptoms: A reddish rash appears on the skin. Internal signs - joint pain, especially during sleep, you feel stiffness of movement, swelling.
Bitan!First, psoriasis affects the small joints of the feet and hands, then spreads to the knee and elbow, and in the advanced stage, the intervertebral joints already suffer.
Itching or not
In most cases, psoriatic disease is accompanied by itching of varying degrees of intensity, sometimes itching not only the spots, but the whole body. In the initial phase, the itching is mild, gradually increasing.
The degree of intensity also depends on the site of pathology. For example, psoriasis on the head is very itchy, while the skin peels and falls off in large scales, larger than normal dandruff. In the stationary phase, the itching decreases, often turning into a burning sensation. During remission, all major symptoms are mild.
Itching worsens with:
- relapse;
- climate change;
- general intoxication;
- diseases of the digestive tract;
- joining scabies, allergies;
- HIV infections.
Your skin itches a lot after drinking coffee, alcoholic beverages, spicy and spicy foods, chocolate and other allergens.
How to differentiate
In eczema
- The nature of the rash.In eczema, blisters or blisters fill with fluid that occasionally leaks. Psoriasis is characterized by the appearance of dry scaly papules, when removed, blood appears.
- Itchy skin.From eczema, the body itches more than in psoriatic pathology.
- Color.In psoriasis, the scales have a silvery tinge, and in eczema, the affected areas become bright red or crimson.
- Painful areas.Eczema affects the soft, sensitive areas of the skin, armpits and groin. Psoriasis is characterized by a rash on the rough, hard and thick layers of the skin (knees, elbows, head and others).
- Causes of disease.Psoriasis is often caused by neurogenic factors, and eczema by allergies and improper functioning of the body.
- Characteristics of rash on the hands.In psoriasis, pits form on the nail plate, and eczema is similar to a fungal infection.
For seborrheic dermatitis
The clinical manifestations of the disease are similar, but there are several characteristics by which you can distinguish them:
- psoriasis is characterized by an unhealthy glow of the skin and bloody cracks, and this is not observed in seborrheic dermatitis;
- dermatitis, unlike psoriasis, is not accompanied by roughness of the skin and its severe dryness;
- in psoriasis, the scales are silvery and the seborrhea is yellow or white;
- seborrheic scales are easily removed, but psoriatic ones are not;
- dermatitis is more often observed at the sites of accumulation of sebaceous glands and scaly diseases - throughout the body;
- scalp psoriasis noticeably protrudes beyond the area of hair growth, and seborrheic pathology does not exceed this limit;
- the area of the squamous lichen lesion is much larger than the area of dermatitis.
From fungi
- Psoriasis occurs in the presence of several provoking factors, for example, heredity, mechanical damage to the skin, malfunction of the immune system, etc. The cause of other diseases are only the spores of parasitic fungi.
- Psoriatic pathology is not contagious, it is not transmitted by droplets in the air, sexually or by touch.
Attention!The fungus (onychomycosis) affects any contact, including public places - sauna, swimming pool, gyms and so on. It is transmitted from animals and humans.
- In psoriasis of the head, the structure of the hair does not change, while the fungal disease leads to brittleness, dryness and hair loss.
- Unlike scaly lichen, onychomycosis of the feet and legs is accompanied by an unpleasant odor.
- With the defeat of scaly nails, their structure changes already in the initial phase, and with fungi, the structure and color of nail plates do not change for a long time.
From pink lichen
A feature of psoriasis is the "psoriatic triad". The disease grows gradually and goes through 3 stages. Pityriasis rosea (pityriasis) develops rapidly and progresses steadily. In addition, pityriasis is a contagious disease, but scaly lichen is not.
From neurodermatitis
- Atopic dermatitis (neurodermatitis) is of allergic origin and is triggered by a certain substance, for example, plant pollen, food, animal hair, etc. The causes of psoriasis are different (heredity, reduced immunity, psychosomatics, mechanical damage to the skin, etc. ).
- In neurodermatitis, the skin dries out and becomes rough, and in psoriasis it flakes and bleeds.
- Plaques with dermatitis consist of separate small elements, in the case of shingles, the papules are uniform and covered with silvery scales.
- The color of the rash in psoriasis is much lighter than in neurodermatitis.
For gout
The difference between gout and psoriatic arthritis lies in the cause of the development. Gout occurs when uric acid crystals settle in the cartilage of the joints. Deviations from the norm can be caused by: arterial hypertension, obesity, taking diuretics, drinking alcohol and so on.
The symptoms of psoriasis and gout are similar - severe pain at night, stiffness in movement, redness and swelling in the affected area. However, in most cases of psoriasis, the characteristic red rashes appear first, followed by pain.
Other recognizable symptoms of gout arthritis include:
- the presence of white nodules in the area of the affected joint;
- signs of kidney stones (back pain, blood in urine and others).