Psoriasis

Psoriasis (scaly lichen) is a chronic non-infectious autoimmune skin disease of unknown origin.Its most common manifestations are peeling of the skin (including the scalp) and the presence of rashes.Psoriasis can cause pathological changes in other organs: nails, spine, joints and kidneys are most often affected.

The disease causes severe psychological discomfort in the patient;due to the presence of defects in appearance, it becomes difficult for a person to adapt to the team and communicate with people.Severe forms of psoriasis can lead to disability.It is impossible to completely cure the pathology.However, proper treatment makes it possible to achieve a stable remission and return to the previous quality of life.

What is psoriasis

The main symptom of the disease is the presence of psoriatic plaques - scaly pink spots of various sizes, which are accompanied by itching.They are most often found on the scalp (they can also be along the hairline, behind the ears), elbows, knees, and can also appear on the genitals, buttocks, lower back and other parts of the body.Sometimes plaques appear on old scars.The pink color of the rash is due to the fact that the veins in the affected areas are expanding.

Psoriasis develops due to a malfunction of the immune system.In each layer of the epidermis (there are 5 of them in total - basal, spinous, granular, shiny and horny) there are keratinocytes (about 90% of them in the entire epidermis).Depending on the layer in which they are located, keratinocytes perform different functions (regeneration, synthesis of keratin or other proteins, prevention of dehydration of the skin, protection of the lower layers of the skin).

Keratinocytes are constantly renewed.Their synthesis takes place in the basal layer.Then they move higher, where each time they perform a new function.After reaching the stratum corneum, they lose their nucleus and turn into corneocytes (special bags containing keratin).Now their function is a barrier.After outliving their life, corneocytes slough off the surface of the skin.Keratinocytes live for about 2-4 weeks and are then replaced by new ones.

In psoriasis, under the influence of a malfunction of the immune system, keratinocytes begin to divide much faster, and their lifespan decreases.Peeling occurs, followed by inflammation of the epidermis and dermis.

Psoriasis can develop in a person of any age (in total, about 4% of the world's population suffers from it).However, the disease most often occurs in people younger than 20 and older than 55 years.Fair-skinned people suffer from psoriasis quite often;among representatives of the Negroid race, the pathology is detected much less often.

Causes of psoriasis

The exact causes of psoriasis have not yet been identified.However, the most common are 2 theories about the origin of this disease:

1. Hereditary disease – it is believed that the tendency to develop psoriasis is passed down genetically.
2. The result of immune disorders caused by infections, bad lifestyle, climatic conditions and bad habits.

Reference!In 40% of patients suffering from this pathology, relatives also suffered from psoriasis.Also, close relatives of patients often had a latent form of psoriasis, which was manifested by changes in the structure of capillaries.

The most common "push" for the beginning of the development of psoriasis is emotional overload (in 50% of cases), focal infections, metabolic disorders, diabetes mellitus, liver diseases, and the use of certain drugs (most often glucocorticosteroids, beta-blockers, lithium salts).

There are other factors that "trigger" the disease or cause it to worsen:

• Injuries, fractures.
• Frostbite.
• Sunburn.
• Smoking tobacco.
• Alcohol abuse.
• Obesity.
• Chemical damage to the skin.
• Food allergies.
• Parasitic infestations.
• Pregnancy and childbirth.
• Other skin diseases - eczema, dermatitis.

Reference!It is absolutely known that psoriasis is not contagious.The development of pathology in people whose close relatives suffer from this disease is explained by genetic predisposition.Psoriasis is not transmitted from person to person.

Types and stages of psoriasis

There are many forms of psoriasis, but some of the most common are:

1. Common psoriasismost often develops.It is characterized by the presence of itchy plaques with a scaly surface on the skin.Also, with this form, a change in the color of the nails and the appearance of small white spots on them is often observed.In some cases (at an advanced stage), the nails move away from the nails.
2. Guttate psoriasismanifests itself as a small rash, localized mainly on the chest and back.The rash is accompanied by itching in places where the skin is affected.Usually, the symptoms of the disease disappear after 4-6 months and do not appear again.However, the patient may subsequently develop another form of psoriasis.This happens about half the time.Guttate psoriasis usually occurs in children and adolescents.It often develops as a result of an infection, most often after a bacterial throat infection.
3. Reversible psoriasisresponds well to treatment, sometimes it is possible to achieve a stable remission without relapse.Weeping red plaques appear only on some parts of the body, in folds, and do not spread further.Typically, the rash appears in the groin area or under the mammary glands, also in the armpit.Reversible psoriasis most often develops in elderly patients.
4. Pustular psoriasisis a difficult and dangerous form.In some cases, it develops quickly and suddenly.It is characterized by the appearance of blisters with purulent content on the soles and palms, then the affected skin thickens and begins to actively peel.Later, the rash spreads to large areas.In advanced cases, the skin of the entire body may be affected.Pustular psoriasis can be life-threatening.It mainly affects adults.

Psoriasis develops in 3 stages:

1. Progressive.
2. Stationary.
3. Regressive.

Progressive phasecharacterized by the appearance of multiple nodular rashes and their spread to new areas of the body.Plaques gradually increase in size.

In the stationary phasethe appearance of the rash stops.Existing plaques stop increasing, but active peeling begins on the entire affected surface.

In the regression phaseplaques become denser, their elements dissolve, peeling decreases.Then spots without pigment remain at the site of the rash.

Reference! Psoriasis can also be classified according to seasonality: there are summer and winter forms, according to the development of exacerbations.Most often, relapses occur more often in the autumn-winter period than in the spring-summer period.

Symptoms of psoriasis

Symptoms of psoriasis are:

• A pink rash or white patches covered with scales.
• Itching in the affected areas.
• Vascular changes.
• Signs of inflammation in the affected tissues.
• Deterioration of the appearance and condition of the nails.

Reference!About 1 in 10 patients develop arthritis as a result of psoriasis.Therefore, it is necessary to start treatment as soon as possible to prevent the development of complications.

Diagnostics

Psoriasis has a very characteristic clinical picture, so the diagnosis is usually not difficult.If you scrape the papules (plaques), 3 main phenomena are observed:

1. Stearin stain - with gentle scraping, the peeling intensifies, and the rash becomes similar to a crushed drop of stearin.
2. Terminal film - if you remove the scales from the surface of the plaque, it has a shiny, moist surface.
3. Blood Dew - if you scratch the ending film, precise drops of blood appear on it.

In some cases, a piece of dead skin is taken for analysis for differential diagnosis.

Treatment of psoriasis

The main goal of medical measures is not to cure the patient (since this is impossible), but to achieve a stable remission.A comprehensive treatment is carried out, the plan of which is developed in accordance with the course of the disease in a particular person.Includes:

• Local drug therapy - ointments, creams, shampoos, aerosols, lotions.
• General drug therapy - injections of antihistamines, sedatives, vitamins, treatment with immunosuppressants, cytostatics, retinoids, corticosteroid hormones.
• Maintenance therapy - the patient is prescribed ultraviolet radiation while taking a dermatotropic agent.
• The use of detoxification methods - the appointment of immunomodulators, procedures that clean the blood.
• In some cases, taking non-steroidal anti-inflammatory drugs.

If concomitant diseases are diagnosed, they are also treated.

Lifestyle with psoriasis

The patient must take into account that the treatment of the disease will last a lifetime.In many ways, the duration of remission depends on it.It is important to give up bad habits (smoking, drinking alcohol).It is also necessary to follow a diet.Exclude citrus fruits, whole milk, chocolate, honey, eggs, foods containing red pigment (strawberries, watermelons) and other foods that can cause allergic reactions from your diet.It is also advisable to avoid spicy, fatty, fried, smoked food, rich meat and fish broths.Condiments are excluded: ketchup, mayonnaise, mustard, etc.Sugar and salt intake should be limited.You should pay attention to products containing fiber, omega acids, vitamins A, E, C, group B, as well as zinc and calcium.

The following simple measures will help alleviate the condition:

• Refusing to stay in the water for a long time - swim and bathe less often, a short shower is recommended.
• Hard washcloths should be replaced with a soft sponge or cotton cloth, and ordinary soap with a pH neutral product.
• After showering, you should not wipe yourself, but pat the skin with a towel - this way you will avoid damage to the plaques and increased itching.
• After water procedures, the skin should be moistened with cream.
• It is necessary to give preference to roomy, light clothes made of soft natural fabrics, because the pressure of clothes on the skin can cause the development of new rashes.
• Itching often forces the patient to scratch, which can cause skin damage - to avoid new damage, it is better to keep the nails short.
• Drying of the skin should be avoided, so avoiding air conditioning will be beneficial, as well as humidifying the air indoors.
• Although sunbathing can be beneficial for psoriasis, excessive exposure to ultraviolet light can make the disease worse – you should consult your doctor about your sun exposure regimen.
• Any risk of skin irritation should be avoided.
• Cuts and wounds can cause new rashes to appear, so you need to protect yourself from them.
• Stress is a frequent trigger for disease exacerbation, so it is necessary to avoid traumatic situations whenever possible.
• It is necessary to avoid physical inactivity (inactivity) - moderate physical activity will have a good effect on the condition of the whole organism.

If you feel worse, contact your doctor immediately to prevent the disease from progressing to a more severe stage or developing complications.