For many centuries, humanity has been trying to discover all the secrets of this mysterious skin disease, but much remains unknown. According to statistics, psoriasis affects 4 to 7 percent of the population, and men and women are equally susceptible to it. Usually, the first signs of psoriasis appear during puberty and can accompany a person throughout their life, sometimes diminishing and disappearing, sometimes increasing in strength.
Causes and risk factors for psoriasis
Psoriasisis a long-term inflammatory process in the skin, considered an autoimmune disease (associated with an allergic response to its tissues). It is a chronic skin disease that affects the cells of the outer layer of the epidermis. The disease usually manifests as red and silvery scaly skin on the feet, knees, back, chest, etc. In most cases, psoriasis starts with small areas of 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 several theories explain its occurrence.
Autoimmune cause
Some studies suggest that psoriasis can occur due to a combination of genetic and environmental factors such as infections, trauma, stress and certain medications. These factors can trigger a response from the immune system, which begins to fight body tissues, including the skin.
However, the processes underlying psoriasis are not yet fully understood. It is important to note that psoriasis is a multiple disease that manifests itself differently in each patient. Studying the mechanisms underlying psoriasis could help develop more effective treatments, reduce the risk of complications and improve patients' quality of life.
Impact of metabolism
Metabolic disorders significantly affect the skin condition and immunity of patients with psoriasis. Increased metabolism leads to the formation of toxins and free radicals, which contribute to inflammatory reactions. There is an imbalance in various metabolisms.
- In case of disturbances in protein metabolism in patients with psoriasis, the content of albumin in the blood decreases and the content of globulins 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 foods can reduce the activity of psoriatic inflammation.
- Disturbances almost always occur in carbohydrate metabolism.
- Vitamin and mineral metabolism is also impaired, 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 thought that psoriasis could be caused by certain bacteria (streptococci), fungi and viruses, but these hypotheses have not been scientifically confirmed. However, dermatologists emphasize that any acute infectious process or chronic infection can cause psoriasis to recur. Particular attention is paid to the viral theory. Recent research shows that RNA viruses, such as HIV and other retroviruses, can influence the genetic apparatus and cause the appearance of genes predisposing to the development of psoriasis.
Genetic predisposition
Inheriting a predisposition to autoimmune reactions is a risk factor for psoriasis. If a person's loved ones suffer from this disease, the risk of developing it increases. Several genes may be associated with psoriasis, including the PSORS1-PSORS9 complexes, with PSORS1 considered particularly active. It contains the genes HLA-C, HLA-Cw6, CCHCR1 and CDSN, which could contribute to the development of the disease. Genes influence 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 provoked by other factors.
Neurogenic cause
Excessive stress on the nervous system, prolonged stress and imbalance in the autonomic nervous system, which provides innervation to 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 disturbances in the immunological response, increased irritability or depression, constant fatigue, drowsiness and apathy, which in turn can lead to psoriasis.
Endocrine
Endocrine disorders associated with 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 glands. Women may have problems with the menstrual cycle and men with sexual function.
Symptoms and characteristics of psoriasis
Psoriasis manifests itself not only in rashes, but also in other symptoms. It often begins in childhood or adolescence and is associated with hormonal disorders, vegetative-vascular dystonia and stress.
The first signs arefatigueAndmood changing. The main symptom is small pinkish bumps on the skin called papules, covered with whitish scales. The papules are surrounded by a brighter edge.
Over time, parts of the rash may combine into large, unusually shaped patches. The base of each papule isinflammatory infiltrate. The following types of skin rashes are distinguished:
- point (no more than 1 mm in diameter);
- teardrop-shaped – (droplet papules up to 2 mm);
- Coin-shaped – (round-coin papules up to 5 mm).
The rash also has its own characteristics:
- stearic spot - if you scratch the surface of the papule;
- terminal film - after cleaning the papules from scales, you can see a transparent film;
- bloody dew (Auspitz phenomenon) – if the integrity of the film is damaged, small bloody droplets may appear.
Is psoriasis contagious?
Many people believe that psoriasis is contagious, so they try to avoid contact with people who have it. This can make the patient want to withdraw from others and lead to serious psychological problems. However, studies have shown that psoriasis is not spread through patient contact. If all family members suffer from this disease, this only indicates the presence of a genetic factor in the development of pathology.
Classification and stages of development of psoriasis
Currently, there are three main stages in the development of psoriasis:
- A progressive stage, characterized by the constant formation of new rashes, accompanied by severe itching.
- The stationary stage, at which new formations stop appearing and existing ones begin to heal.
- Regressive stage in which edges appear around the rash and the skin affected by the rash becomes darker 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 degree, characterized by 3-10% damage to the skin.
- Severe degree, in which the disease affects more than 10%.
Types of psoriasis
Psoriasisis a chronic skin disease that can manifest in a variety of ways. Rashes, their localization and damage to other systems and organs may differ. Depending on these characteristics, various forms of psoriasis are distinguished.
Simple (vulgar, plate)
Plaque psoriasis is the most common form of this disease. Its symptoms include the appearance of bright pink papules covered with white scales.
Elbow psoriasis
This is a typical manifestation of mild plaque psoriasis. A characteristic feature of elbow psoriasis is the presence of one or more permanent "duty" plaques on the extensor side of the elbow joints. If these elements are exposed to trauma, an exacerbation occurs.
Guttate psoriasis
Associated with bacterial (most often streptococcal) and viral infections, this type of psoriasis can cause inflammation. This condition often occurs in children and begins with the appearance of small, tear-shaped red 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 may develop rapidly or gradually become chronic, followed by periods of exacerbation and alleviation of symptoms. In rare cases, psoriasis can be more serious.
Palmoplantar psoriasis
This type of psoriasis often develops in people involved in manual work and is often accompanied by severe itching and can lead to nail complications. Several subtypes of this type of psoriasis include:
- Fan-shaped patches: large elements on the palmar and plantar surfaces with white scales that coalesce into fan-shaped patches. This subtype is most often found on the hands.
- Circular: ring-shaped scaly elements on the palmar and plantar surfaces.
- Callous: growth of a rough epithelium with formation of calluses.
- Pustular: This is a distinct subtype of psoriasis on the palms and soles of Barber. In the areas under the big toes, blisters and pustules with pus appear, which cause severe itching. The ulcers coalesce, then dry out and form crusts. Characteristic elements of psoriasis also appear in other parts of the body.
Leg psoriasis can be associated with varicose veins and mainly occurs in 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 dimples on the nail plate, which have different depths. These dimples are generally more visible and painful when squeezed than other types of dermatitis. Additionally, symptoms include spontaneous separation of the nail, subungual hemorrhages (especially when wearing tight shoes), changes in the color and surface of the nail, such as trachyonychia and koilonychia.
Scalp psoriasis
It can manifest itself as an independent disease or as part of a general pathological process. One of the characteristic features is oozing and crusting on part or all of the surface of the head. In this case, hair growth is not impaired, because the function of the hair roots is not impaired. However, humidity creates a risk of infection, which can damage hair follicles.
Seborrheic psoriasis
This occurs as a result of disruption of the skin glands, which produce viscous sebum, causing skin irritation and promoting inflammation - dermatitis. This condition quickly spreads throughout the head, covering it in the form of a cap and is accompanied by severe itching. In the areas behind the ears, crying sometimes develops and an infection may develop. A scalp covered in dandruff and scabs can resemble a psoriatic crown.
Psoriasis on the face
Usually appears in the nasolabial triangle area, eyelids, above the eyebrows and in the areas behind the ears. The rashes may coalesce, forming large areas of redness and swelling. If the functioning of the sebaceous glands is impaired, the process can be accompanied by oozing, crusting and an increased risk of infection.
Psoriasis on the genitals
Psoriasis affecting the genitals is a concomitant process that is usually accompanied by characteristic psoriasis rashes all over the body, which facilitates diagnosis.
Psoriatic rashes on the penis in men, labia majora in women, and surrounding skin areas are oval in shape and slightly raised above the surface of the skin. They are pink and flaky. Virtually not accompanied by itching. Sometimes the lesion process extends to the mucous membranes and can take the form of vulvovaginitis in women and balanoposthitis in men.
In obese people, atypical psoriatic rashes can be observed in the folds located near the genitals (inguinal, intergluteal). In these areas appear areas of intense red color, which have a mirror-like surface and do not peel off due to constant humidity.
Why is psoriasis dangerous?
Psoriasis can become very serious when the rash covers more than 10% of the skin. This condition is difficult and prone to recurrence, and the rash may become clammy, wet, and susceptible to infection. Only rapid 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 arthritis, 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.
Ignoring timely treatment of psoriasis can lead to complications, such as psoriatic erythroderma, which may occur due to improper treatment of psoriasis or exposure to various irritating factors on the skin. In psoriatic erythroderma, the skin turns dark pink with a clear distinction between affected and healthy areas, as well as small and large scaling. This condition requires emergency medical attention.
Complications of psoriasis
Failure to provide timely and adequate treatment for psoriasis can seriously harm the body's vital organs and systems, such as the joints, heart, kidneys, and nervous system. These consequences can lead to disability or even death.
Diagnostic
Generally, the diagnosis of psoriasis is made on the basis of typical symptoms of skin lesions and their location. In certain complex cases, additional examinations may be necessary to exclude other skin diseases.
Laboratory tests may include:
- Complete blood count, which helps detect 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 may be elevated in psoriasis, which can be confused with gout.
- Antibodies against the human immunodeficiency virus (HIV) may be detected with the sudden onset of psoriasis.
Other tests, such as joint X-rays and skin biopsies, may be used in more complex cases to assess the severity of joint damage and distinguish 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 aggravating the disease. The choice of treatment method depends on the type and severity of psoriasis. Treatment may include:
- external preparations (external ointments, petroleum jelly, paraffin, vegetable oils and creams with anti-inflammatory effect, the quantity of which depends on the nature of the lesion and is used daily);
- lotions and shampoos based on salicylic acid, as well as photosensitizers;
- medications for oral administration (retinoids, vitamin D preparations and others);
- physiotherapeutic procedures;
- Daily baths with bath oil, oatmeal tea, or sea salt can help soften the skin and reduce inflammation associated with psoriasis. It is important to avoid hot water and scrubs, and to use a moisturizer after bathing;
- light therapy, which involves exposing the skin to ultraviolet light, can also be useful (avoid burns);
- photochemotherapy using medium-wave radiation;
- compliance with a special diet and a general diet.
When developing a treatment program, the gender and age of the patient, the presence of concomitant diseases, general health and the impact of external factors are taken into account. Sometimes, to cure it, it is enough to change your lifestyle, and in other cases, several cures are prescribed.
In addition to traditional methods, the treatment of psoriasis may include the use of modern laser technologies. Laser therapy can reduce the symptoms of pathology, achieve long-term remission and relieve the patient of unpleasant rashes and associated problems. A special feature of laser therapy is that a special excimer laser acts only on affected areas of the skin, without affecting healthy areas, which guarantees rapid 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 restrictions.
The effectiveness of treatment depends on many factors, including hereditary predisposition, provoking factors, stage of the disease and the specific nature of the lesion. It is therefore 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 a timely manner and receive qualified help. In the simple form of psoriasis, the patient can work without any restrictions, with the exception of work in chemical factories, where presence in the workplace can be dangerous.
However, psoriasis can cause complications, such as psoriatic arthritis, which can limit work performance and lead to disability.
Preventing psoriasis is an important part of treatment. After recovery, patients need to reconsider their lifestyle, get rid of bad habits, take care of the treatment of other chronic diseases, monitor their diet and increase physical activity, spend more time outdoors and exercise. sport.
Nutrition for psoriasis
The diet for psoriasis is not strict, but proper nutrition plays an important role in complex treatment. When making nutritional recommendations, patients are advised to:
- Avoid foods to which the body is hypersensitive and exclude them from the diet.
- Prefer fresh fruits, vegetables, berries, baked or boiled lean 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.