All about psoriasis - how to treat, causes and symptoms, types

For more than two thousand years, humanity has been trying to solve all the puzzles of this severe skin disease, but much remains unknown. According to statistics, this disease affects 4-7% of the population, women and men are equally susceptible. The first signs of psoriasis usually appear during puberty and stay with a person for the rest of their life, then subside and go away completely, then intensify.

Can Psoriasis Be Cured?Modern medicine has achieved a great deal in the treatment of this chronic dermatosis and is able to provide the patient with a decent standard of quality of life.

Causes of psoriasis

Psoriasis is a chronic inflammatory process of the skin, which modern medicine calls autoimmune (associated with an allergy to its own tissues). There are many causes of psoriasis and predisposing factors for the development of this dermatosis, about which a number of theories about its origin have been put forward.

Autoimmune

This is the main theory, as it is well established that the immune system actively responds to certain types of skin exposure. The skin of people with psoriasis is very sensitive to mechanical, physical and chemical influences. Not only the epithelial cells respond to such influences, but the entire immune system.

Cellular immunity is impaired: the ratio of the individual subtypes of lymphocytes responsible for the formation of a normal immune response. Thus, in psoriasis, the number of Aids T cells increases - aids regulating immunity, while the number of suppressor T cells, suppressing an overly strong immune response, decreases. Lymphocytes and some other cells produce cytokines - active substances that stimulate the immune response. Humoral immunity also suffers, an imbalance of antibodies (immunoglobulins) in the blood serum develops, antibodies to the tissues of the patient's body appear.

Inflammation begins against the background of the activation of T lymphocytes, but the reason why they are activated has not been established. In the research process also arises the question of how to suppress the autoimmune response without harming the patient.

Exchange

An imbalance in metabolism has a significant effect on the skin and immunity. In patients with psoriasis, there is an acceleration of metabolism, the appearance of a large amount of toxic free radicals and other toxins that support the inflammatory response. The metabolism is disturbed:

• protein- the CDSN predisposition gene stimulates the synthesis of the corneodesmosine protein, which sensitizes (allergen) the body; the protein content of albumin in the blood decreases and the content of globulins increases; this condition is called dysproteinemia and further enhances awareness;
• fat- the content of lipids and cholesterol in the blood increases; the use of predominantly vegetable foods and a general decrease in the calorie content of the daily diet can reduce the activity of psoriatic inflammation;
• carbohydrates- almost always violated;
• exchange of vitamins and minerals- the content of vitamin C in the skin increases, the content of vitamins C, A, B6, B12, iron, copper and zinc in the blood decreases.

Infectious

This theory was relevant at the beginning and in the middle of the last century. Certain bacteria (streptococci), fungi and viruses were considered to be the causative agents of psoriasis. These theories have not been confirmed. But dermatologists note that any acute infectious process or the presence of a permanent focus of infection can cause relapses. Viral theory occupies a special place. Recent studies have revealed the effect of retroviruses (RNA-containing viruses - HIV, etc. ) on the genetic apparatus with the formation of psoriasis predisposition genes.

Genetic

The predisposition to autoimmune reactions is hereditary. If relatives of a person suffer from psoriasis, the likelihood of developing this disease increases several times. There are psoriasis sensitivity genes (the local PSORS1 - PSORS9, PSORS1 complexes are particularly active, they contain the HLA-C, HLA-Cw6, CCHCR1 and CDSN genes, responsible for the development of the disease). Genes affect metabolism, immunity, and the development of autoimmune processes. But the presence of such genes does not at all guarantee the development of the disease. Of great importance is the influence of provoking factors.

Neurogenic

Prolonged stress, high neuropsychic stress, disorders of the autonomic nervous system (innervating the walls of blood vessels and internal organs) can provoke the development of psoriasis, causing imbalance in the endocrine system, impaired metabolic and immunological processes.

Endocrine

Endocrine disorders of psoriasis are common and mainly play the role of provoking factor. A clear link between the two has not been proven. Dermatologists note that patients often have dysfunctions of the thyroid gland, adrenal glands, and pituitary gland. There are menstrual irregularities in women and sexual function in men.

Symptoms of psoriasis

The main symptoms of psoriasis are rashes. But there are other signs as well. The very first manifestations usually appear in adolescence or childhood against a background of hormonal disorders, vegetative-vascular dystonia and prolonged stress.

The disease begins with a feeling of constant fatigue, mood disorders. Characterized by small pinkish formations (papules) rising above the surface, powdery from above with a whitish coat. They are surrounded by a brighter and more imposing edge.

The elements of the rash grow and combine into large, oddly shaped patches. The base of the papule is an inflammatory infiltrate. By the nature of the rash, psoriasis is divided into:

• point- items not exceeding 1 mm in diameter;
• tear- papules-droplets up to 2 mm;
• coin shaped- Round papules measuring up to 5 mm.

Characteristic features of the rash:

• stearin stain- if you scratch, the surface of the papules;
• terminal film- Thoroughly cleaning the surface of the papules of the scales, we will see a transparent film;
• dew of blood (Auspitz phenomenon)- after scratching the film and violating its integrity, we will see small bloody droplets protrude to the surface.

Stages of psoriasis

There are three stages of the disease:

1. progressive- the first elements of the rash appear, their number increases, all new areas are captured; rashes also appear when scratching the itchy skin or exposure to certain external irritating factors (Kebner's phenomenon); at the initial stage of psoriasis, the papules begin to merge into large plaques;
2. Stationary- there are no new elements, and those that appeared earlier are not regressing;
3. regressive- the rash becomes pale, its base becomes less dense; the rash gradually subsides, the process often begins from the central part, so the plaques can have the form of rings; if the plaques of psoriasis dissolve from the periphery to the center, they simply gradually decrease in size and a white ring forms around them - the pseudoatrophic rim of Voronov; where there was a rash, white pigmented areas remain - psoriatic leukoderma.

Sometimes papules are present on the skin at all three stages of development simultaneously. There are also summer and winter forms with a predominance of exacerbations in summer or winter.

Is psoriasis contagious?

Numerous studies have confirmed that it is not a contagious disease. If infectious pathogens participate in its development, then this is only through a general effect on metabolism, immunity and the genetic apparatus.

Patients often ask:

• How is psoriasis spread?

  Psoriasis is not passed from person to person.

• Is Psoriasis Hereditary?

  The answer is again negative, but there is a hereditary predisposition in the form of metabolic characteristics and the functioning of the immune system, which is transmitted to close relatives.

Types of psoriasis

The nature of the rash, its location, damage to other organs and systems in this chronic dermatosis may be different. According to these signs, several types of diseases are distinguished.

Simple (vulgar, plaque)

The most common. Its symptoms are papules of a characteristic bright pink color, covered with white scales. Downstream, plaque psoriasis divides into the following forms:

• easy- if the lesion does not cover more than 3% of the skin; in the progressive phase, the papules increase, but then they quickly undergo a reverse development;
• moderate- the rash takes from 3 to 10%; papules are large, merge into plaques;
• heavy- the defeat captures more than 10%; rashes are numerous, merge, forming a wide variety of forms.

Common psoriasis proceeds as relapses, alternating with remissions, but there is also a continuous course.

Elbow psoriasis

This is one of the manifestations of a mild form of inflammation of the plaque. A distinctive feature of psoriasis on the elbows is the constant presence of one or more "service" plaques on the extensor side of the elbow joints. If these elements are injured, an exacerbation begins.

Guttate psoriasis

In the development of guttate psoriasis, bacterial (most often streptococcal) and viral infections are of great importance. Occurs in childhood. Inflammation begins after infection. Streptococci secrete toxins (antigens - substances foreign to the human body) that bind to tissue proteins. Antibodies are produced to them and autoimmune inflammation develops.

The onset is acute. On the skin of the extremities (less often of the body and face), small red tear papules appear on the scaly surface. With wounds in the area of the rash, small erosions and sores are formed, the risk of infection increases.

Psoriasis quickly takes on a subacute and chronic course. Relapses are replaced by remissions, independent healing or transition to the adult form of the disease is possible.

Palmoplantar psoriasis

It develops in those who are engaged in physical labor, is accompanied by severe itching and almost always complicates the nails. There are subspecies:

• fan-shaped- with large elements on the palmar and plantar surfaces, covered with white scales, merging into fan-shaped plates; such psoriasis on the hands is more common;
• circular- ring-shaped scaly elements on the palmar and plantar surfaces;
• horn- characterized by the growth of a coarse epithelium with the formation of corns;

A separate subspecies is pustular psoriasis on the palms and soles of Barber's feet. The areas under the thumbs of the extremities are covered with vesicles and pustules (with purulent contents), severe itching appears. The abscesses merge, then dry up, forming scabs. Elsewhere on the body, characteristic psoriatic elements develop. The disease often spreads to the fingernails.

Psoriasis on the legs is maintained and made worse by varicose veins, in which case the rash will mostly be in the leg area.

Psoriasis of the nails

Damage to the nails can be either independent or a complication. Typical symptoms:

• small dimples of different depths appear on the nail plate; similar nail lesions are found in other dermatitis, but in psoriatic lesions they are deeper and slightly painful when pressed;
• slow and painless spontaneous separation of the nail (onycholysis);
• subungual hemorrhages on the toenails, especially if the patient wears tight shoes;
• trachyonychia - clouding and irregularities on the nail plate; a depression forms in the middle of the nail and the nail becomes like a spoon (koilonychia).

Sometimes the periungual roller is affected by the transition of inflammation to other tissues (psoriatic paronychia).

Scalp psoriasis

Here the disease proceeds independently or as part of a general pathological process. Characterized by oozing, the formation of scabs on parts or the entire surface of the head. Hair growth is not affected at the same time: psoriasis on the head does not impair the function of the hair roots. But the oozing creates the threat of infection with subsequent damage to the hair follicles.

It flows in waves, then subsides with the disappearance of the scabs, then again worsening and accompanied by severe itching, often leading patients to neurosis.

Seborrheic psoriasis

Seborrhea is a condition caused by dysfunction of the sebum-producing glands in the skin. A viscous oil is produced, irritating the skin and contributing to the development of inflammation - dermatitis.

Seborrheic psoriasis quickly spreads to the whole head, covering it in the form of a cap and accompanied by severe itching. In the areas behind the ear, crying sometimes develops and an infection joins. The head covered with dandruff and solid scabs sometimes looks like a psoriatic crown.

Psoriasis on the face

Usually psoriasis on the face is localized in the area of the nasolabial triangle, the eyelids, above the eyebrows, in the areas behind the ear. The fused elements of the rash form large areas of redness and swelling. With dysfunction of the sebaceous glands, the process is often accompanied by crying, scabs and an increased risk of infection.

Psoriasis on the genitals

It is not an isolated process. Simultaneously with the defeat of the genitals, there are characteristic psoriatic rashes all over the body, so it is not difficult to identify the disease.

Psoriasis on the penis in men and the labia majora in women, as well as adjacent skin areas, manifests as pink, scaly, oval papules rising slightly above the skin. There is hardly any itching. Sometimes the process spreads to the mucous membranes and looks like vulvovaginitis in women and balanoposthitis in men.

Atypical psoriatic rashes can be observed in obese people in folds located next to the genitals (inguinal, intergluteal). Here, areas of intense red color with a mirror-like surface are formed with no signs of peeling due to constant wetting.

What is the danger of psoriasis and if it needs to be treated

The danger is that psoriasis can take a severe generalized form, the rashes will occupy more than 10% of the integument. This stage of the disease is difficult, relapses, the elements of the rash are injured and get wet, infection often joins. Only prescribed treatment for psoriasis can stop the process of its spread.

Sometimes the disease is complicated by inflammation of the joints with the formation of psoriatic arthritis, against which the function of the joints can be significantly impaired.

Against the background of a systemic autoimmune process, which has a significant effect on the patient's condition, other autoimmune diseases often develop (rheumatoid arthritis, certain types of osteoarthritis, Crohn's disease, etc. ), as well as severe cardiovascular pathologies, diseases of the digestive system, neurological reactions.

If you do not start treatment for psoriasis in time, the patient's condition will significantly worsen and lead to disability.

There is also a complication such as psoriatic erythroderma, which develops with improper or insufficient treatment of psoriasis, as well as when various irritating factors are exposed to the inflamed skin. The skin acquires a bright pink color with a clear delineation of the affected areas of healthy areas, small and large lamellar peel. Such a patient requires urgent medical attention.

Is psoriasis treated?

Yes, and successfully, but full recovery cannot be guaranteed.

Processing methods

Autoimmune inflammation requires individually selected complex therapy, lifestyle changes, nutrition and the elimination of all bad habits. Modern medicine has proposed three basic principles for the successful treatment of psoriasis:

• strict adherence to the algorithms of prescribed therapy;
• regular monitoring of the effectiveness of therapy;
• timely correction of the prescribed treatment with its insufficient effectiveness.

Nutrition for psoriasis

There is no special diet for psoriasis, but nutrition is of great importance. Therefore, when prescribing a complex treatment, nutritional recommendations are necessarily given:

• identify increased sensitivity of the body to certain foods and exclude them from the diet;
• give preference to fresh vegetables, non-acidic fruits and berries, boiled and baked lean meat, drink more;
• what not to eat with psoriasis:
  1. products containing essential oils - onions, garlic, radish;
  2. drinks containing caffeine (concentrated tea, coffee), alcohol;
  3. everything is more salty, sour and sweet, rich;
  4. products that promote sensitization (allergization) of the body - orange fruits, honey, nuts, cocoa, eggs;
  5. do not eat fatty animal products.

Pegano diet for psoriasis

This diet was developed by American physician John Pegano, but has not found official medical recognition. The principle of building the Pegano diet for psoriasis is associated with alkalizing the body by selecting the right diet. According to this principle, all products are divided into:

• forming alkalis (two-thirds of the daily diet) - mixtures and juices of non-acidic fruits and berries, vegetables (excluding those that cause increased gas formation);
• acidifier (one-third of the diet) - meat, fish, dairy products, beans, peas, potatoes, cereals, sweets and pastries.

Patients are advised to drink mineral water without gas, drinking water up to 1. 5 liters per day, as well as other liquids drunk (compotes, fruit juices, etc. )

Drug therapy

Mild psoriasis is treated with topical medications. The severe and rapidly progressive forms of the disease are treated mainly in hospitals with the prescription of general (systemic) drugs.

Treatment of external psoriasis

The drug is selected by a dermatologist. For vulgar psoriasis with dry, constricting plaques, ointments are suitable, if oozing develops (with seborrheic), creams and medicinal solutions are used. In order to avoid the body's resistance (resistance) to a certain drug, this is changed over time.

In the acute (progressive) stage, the following external treatment is carried out:

• agents that have a softening effect - boric petroleum jelly, 2% salicylic ointment;
• effective non-hormonal ointments for psoriasis containing activated zinc pyrithionate; they suppress infection and have a cytostatic effect (suppress tissue proliferation);
• external agents containing glucocorticosteroid hormones (GCS);
• a combined agent with calcipotriol (a vitamin D3 analogue) and the corticosteroids betamethasone; perfectly suppresses the inflammatory process.

External treatment of stationary stage psoriasis:

• ointments that dissolve scales (keratolytics) and have an anti-inflammatory effect - 5% naphthalan, boron-naphthalan, tar-naphthalan;
• corticosteroid drugs.

External treatment of psoriasis in the resolving phase:

• the same keratolytic ointments, but at a higher concentration: 10% tar-naphthalan ointments;
• ointments based on analogues of vitamin D3 - within 6-8 weeks; removes the inflammatory process and peeling of the rash.

For the treatment of psoriasis of the nails, special varnishes are used to suppress the development of the pathological process. It is recommended to treat the periungual phalanges with moisturizing gels.

Systemic treatment of psoriasis

• drugs that relieve inflammation and intoxication - calcium chloride, sodium thiosulfate, unitiol in the form of injections;
• tablets for psoriasis, which suppress the processes of proliferation (multiplication of epithelial cells) - cytostatics that suppress the activity of the immune system, analogues of vitamin A, corticosteroid hormones;
• biological agents containing human monoclonal antibodies of the IgG class, acting on certain links of inflammation by suppressing the synthesis of cytokines; it is a very effective modern drug that is given by injection;
• vitamins for psoriasis help restore metabolism and keratinization of epithelial cells; doctors prescribe vitamins A, E, D3, group B.

Folk remedies for psoriasis

Any treatment for psoriasis, including with the use of folk remedies, can only be prescribed by a doctor. Self-treatment can lead to the opposite effect: the spread of the disease.

As part of complex therapy, the following methods can be used:

• fat- product from the treatment of industrial oils; to prepare the ointment, you need to buy a medical solid oil at a pharmacy; recipe: in 0, 5 kg of solid oil add 50 g of honey and half a packet of baby cream; procedures are performed daily; in the pharmacy you can buy ready-made preparations based on solidol.
• baking soda- a folk remedy for psoriasis, which helps to cleanse scabs, relieves itching; recipe for soda applications: take 60 g of soda, dissolve in 0, 5 liters of water, soak a gauze cloth in the solution, fold in several layers and apply to the lesion for 20 minutes; after the procedure, blot the skin and apply emollient ointment on it; treatment of psoriasis with soda is carried out once a day;
• Mummy- has a pronounced anti-inflammatory effect, well relieves itching; can be taken orally once a day, 0, 2 g for two weeks; external therapy is carried out with a mummy solution; it is applied to dry itchy patches twice a day; treatment of psoriasis on the head is carried out by rinsing the scalp with a mummy solution after washing;
• sea salt- relieves inflammation, itching well; sea salt baths: take 1 kg of salt, dilute in two liters of water and add to the bath; take a bath for 15 minutes, then rinse the solution in a hot shower, blot the body with a towel and apply an emollient ointment; treat psoriasis with baths no more than twice a week;
• clay- has a pronounced cleaning effect, adsorbing to its surface toxins formed as a result of inflammation and improper metabolism; helps to dry, remove scabs and itching; you can take any clay, but it is better to buy blue clay in a pharmacy; pieces of clay should be dried well, broken with a hammer, diluted with water and left to stand for several hours; put the resulting plaque-shaped clay on a napkin (up to 3 cm thick) and apply to the foci of inflammation for three hours; treat psoriasis with clay every other day.

Important: treatment of psoriasis at home with folk remedies should be carried out with caution and strictly according to the doctor's prescription. Such treatment will help one patient, while in another it can cause an exacerbation and rapid spread of inflammation. Therefore, if against the background of therapy the patient's condition worsened, it is necessary to immediately stop it and consult a doctor.

Home treatment for psoriasis

When treating psoriasis at home, it is important to follow dietary recommendations, lead a healthy lifestyle, exclude bad habits and strictly follow all prescriptions of a dermatologist.

How to treat psoriasis at home? Some patients try to cleanse themselves of toxins and toxins using all kinds of unconventional methods (enemas, etc. ). It can give exactly the opposite result: the work of the digestive tract will be disturbed, and an exacerbation will begin. Modern medicine recognizes cleansing the body in the form of good nutrition and getting rid of bad habits.

It is important to follow all the doctor's prescriptions and to pay attention to how the prescribed treatment works. If it is not effective enough, the doctor will replace the treatment, thereby achieving the maximum therapeutic effect.