Psoriasis (translated from the Greek "psora" - "skin disease, scabs") is a chronic pathology of a non-infectious nature, also known as scaly lichen, which mainly affects the skin of the knee and elbow joints, lower back and lower back. lead. There is also psoriasis of the joints, bones, nails, external genitals and internal organs, but these forms are rarely diagnosed. The pathology is difficult to cure, therefore, when the first symptoms appear, red rashes appear, an urgent need to consult a doctor.
Symptoms
Stearin stain
The first sign of psoriasis, which is part of the triad of pathology symptoms. It is characterized by increased peeling after scratching the affected surface with a spatula. Over time, there is a separation of the papules of silvery white scales. Their removal is not difficult, as they break off and weakly adhere to the psoriatic papule. The surface of neoplasms (rashes) turns white, and the particles crumble and look like chips.
The first phenomenon of the triad is explained by the development of parakeratosis (malfunction of the epithelium, which leads to a violation of the formation of the stratum corneum). To combat the deviations at the initial stage, local non-hormonal agents (creams, ointments) are used.
Final film
It is characterized by the removal of a thin layer of tissue from the papules, which has a shiny structure and resembles polyethylene. It easily separates from any impact (pressure, friction, etc. ) after removing the dried flakes.
The terminal film is the last layer removed from the skin. Further scratching leads to the last stage of the triad - drip bleeding.
At this stage, herbal baths, drugs with antiallergic effect, ointments on a natural basis (without corticosteroids and hormones) are used.
Point bleeding
After removing the terminal film, drip bleeding occurs on the affected area of the skin (symptom of auspits or "bloody dew") and accelerated growth of neoplasms is noted, which sometimes reach the size of a pea andare called lenticulars. In some cases, the papules grow to the diameter of a small coin and differentiate as nummulars. With the progression of the disease, their growth increases, and when combined, psoriatic plaques are formed.
For treatment, retinoids, immunomodulators, anti-inflammatory drugs and physiotherapy are used.
Other
The disease can be recognized by other characteristic signs, the main ones of which are 4:
- The border is red, not covered with scales, which form around the papules.
- On a clean area of the skin, small rashes are visible (usually appear before the progressive stage of psoriasis).
- A symptom that helps distinguish psoriasis from seborrheic dermatitis is characteristic of the active stage of the pathology. It is accompanied by the appearance of papules with clear boundaries on the scalp; this does not happen with seborrheic dermatitis.
- A light and shiny skin edge appears around the formation. The symptom is typical of the regression stage of the disease and appears when the papules disappear.
What does it look like
In most cases, the appearance of the pathology is imperceptible: at an early stage, psoriasis affects small areas of the skin, mainly in the folds of the limbs, head and along the hairline.
Warning!The first manifestations occur at the site of constant mechanical irritation of the skin, for example, where clothes rub and squeeze.
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 vague edge. In the center of the papules, the skin peels off, giving the formations a white color. At this point, the rash may appear at the site of scratches, skin injuries, bites, cuts, punctures, or burns.
- Stationary.It begins 1 to 4 weeks after the onset of the disease. New patches do not appear, the old ones acquire a light color, the intensity of the coat decreases.
- Regressive.The color of plaques and papules fades, their infiltration decreases, and the formations dissolve. The average length of the decomposition period is 2-6-8 months.
Symptoms of the disease according to the types:
- Plate(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 tint appear, covered with silvery-white scales on top.
- Seborrheic.This mainly occurs on the scalp. It manifests as peeling and itching, spreads to the area behind the ears and to the skin along the hairline.
- Pustularthe type is considered the most severe form, grows rapidly and affects large areas of the skin. Painful rashes appear on the body, which is accompanied by a local increase in temperature, weakness, headache, diarrhea. Vesicles filled with exudate quickly form in the lesions. In the future, the spots progress, merge with each other, forming large lesions on the body.
- Intertriginous.Typical for children, accompanied by the appearance of bright red papules, with slight peeling (it may not be there).
- Exudative.The affected areas of the skin not only peel off, but also become moist, yellowish crusts form on the surface of the plaques.
- Psoriatic erythroderma.Red plaques with silvery, yellow or white scales are seen throughout 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, which cause irritation and itching.
- Psoriatic arthritis.It is accompanied by "joint syndrome", in which the skin at the joints (on the wrists, phalanges of the fingers, the spine, etc. ) is affected, and if measures are not taken in timetimely manner, the disease affects the joints.
- Tearaccompanied by profuse rashes, consisting of many small patches. In this case, the papules are in the form of drops, their color ranges from bright red to purple.
- Indicate.It is characterized by the formation of small spots on various areas of the body, resembling dots, and there may be no peeling of the dermis.
- Rupioid.One of the types of chronic psoriasis. Crusts appear on the formations, they become higher, taking the form of a cone.
- Oldis manifested by large papules that do not pass for a long time, sometimes papillomas and warts form on them.
- Psoriatic onychialeads to deformation of the nails, the appearance of yellow-brown spots under them.
- Palmar-plantar.Appears on the palms and soles of the feet. The main symptoms are thickening of the skin, dryness, cracks.
- Psoriasis of the mucous membranesaffects the oral cavity and causes the appearance of plaques on the mucous membrane.
Localization of psoriasis
Hands
In most cases, a rash appears on the surface of the elbows or between the toes. Less commonly, papules are noted on the forearm.
Warning!The hands are characterized by a form of pathology plaque, but others are also found. Its sign is small spots of red tint, quickly covered with white scales, the affected skin grows in size.
Legs
Psoriatic formations mainly occur on the legs in the knee area, but it is possible that they form on other parts of the legs.
The first rash is simple and small with a clear outline, but loose, inflamed, and heavily scaly. These point papules spread quickly to form conglomerates.
Lead
Often develops against the background of seborrhea, affects the hairline, forming the so-called psoriatic crown. Skin formations gradually develop and spread over the entire surface, resembling dandruff. This localization occurs quite often, less often a rash appears on the ears or behind them.
Nails
The nail plate can be affected by the type:
- Of- occasional form of psoriasis. Small pits appear on the nails, which look like needle stick marks.
- Onychomycosis- the nail changes color, becomes dull, thickens noticeably and begins to flake. Through the plaque, a psoriatic papule surrounded by a reddish rim is visible, similar to an oil stain.
Body
Usually manifested by characteristic papules that merge with each other. Psoriasis is more common on the back, less often on the neck, abdomen, hips, formations can be teardrop, spike and plaque.
Confront
It is rarely affected, the rash is located in the nasolabial folds, at the temples and eyebrows, around the eyes. Rarely, the pathology affects the edge of the lips, the rash resembles herpes.
Palms and feet
Both areas are affected simultaneously, but there were cases when the pathology developed only on the feet or palms. On the soles, the disease is often associated with fungal pathology, which significantly complicates the diagnosis and treatment.
This type of psoriasis is divided into 3 types:
- Papular plaque- the formations are dense, do not protrude from the skin, it is difficult to separate the scales from the plaque. The rash occurs in marginal areas, accompanied by edema and keratosis.
- Psoriatic calluses- dense round papules, made up of keratinized epidermis. The layer of skin gradually thickens and gets bigger. As a result, he is easily injured, cracks appear. There is practically no redness, the size of the growths is 2-3 millimeters to 2-3 centimeters.
- Vesicular-pustular- manifests itself in the form of serous-purulent papules. The bubbles reach 2 millimeters in diameter and tend to meet.
Joints
Pathology can affect a person's joints, which leads to a change in the structure of their tissues, which, with progression, leads to pain and deformity. External symptoms: A reddish rash appears on the skin. Internal signs - joint pain, especially during sleep, stiffness of movement, swelling is felt.
Important!First, psoriasis affects the small joints of the feet and hands, then spreads to the knee and elbow, and in an advanced stage the intervertebral joints are already in pain.
Itching or not
In most cases, psoriatic disease is accompanied by itching of varying intensity, sometimes not only spots, but also itching all over the body. At the initial stage, the itching is mild, gradually increasing.
The degree of intensity also depends on the localization of the pathology. For example, psoriasis on the head is very itchy, while the skin peels and falls off in large flakes, larger than normal dandruff. At the stationary stage, the itching decreases, often giving way to a burning sensation. During remission, all major symptoms are mild.
The itching gets worse with:
- relapse;
- climate change;
- general intoxication;
- diseases of the digestive tract;
- appearance of scabies, allergies;
- HIV infections.
The skin is very itchy after drinking coffee, alcoholic beverages, spicy and spicy foods, chocolate, and other allergens.
How to distinguish
For eczema
- The nature of the rash.With eczema, blisters or blisters are filled with fluid that periodically oozes out. Psoriasis is characterized by the appearance of dry scaly papules, when removed, blood appears.
- The itchy skin.From eczema the body itches more than with psoriatic pathology.
- Color.In psoriasis, the scales have a silvery tint, and in eczema, the affected areas turn bright red or scarlet.
- Painful areas.Eczema affects the soft and sensitive areas of the skin, armpits and groin. Psoriasis is characterized by a rash on rough, hard, and thick layers of skin (knees, elbows, head, and others).
- The causes of the disease.Psoriasis is often caused by neurogenic factors, and eczema is caused by allergies and body dysfunction.
- Features for rashes on the hands.With psoriasis, pits form on the nail plate, and eczema is similar to a fungal infection.
For seborrheic dermatitis
The clinical manifestations of diseases are similar, but there are several features that can be used to distinguish them:
- for psoriasis, unhealthy skin and bloody cracks are characteristic, which is not observed with seborrheic dermatitis;
- dermatitis, unlike psoriasis, is not accompanied by enlargement of the skin and its severe dryness;
- with psoriasis, the scales are silvery, and seborrhea is yellow or white;
- seborrheic scales are easy to remove, but psoriatics are not;
- dermatitis is more often observed in places of accumulation of sebaceous glands, and scaly disease - throughout the body;
- scalp psoriasis noticeably exceeds the area of hair growth, and seborrheic pathology does not cross this line;
- the lesion area with scaly lichen is much larger than that with dermatitis.
Mushroom
- Psoriasis occurs in the presence of several provoking factors, for example, heredity, mechanical damage to the skin, dysfunction of the immune system, etc. The causative agent of the second disease is only the spores of parasitic fungi.
- Psoriatic pathology is not contagious, it is not transmitted by droplets in suspension, nor by sexual route, nor by touch.
Warning!The fungus (onychomycosis) affects any contact, including in public places - a sauna, swimming pool, gyms, etc. It is transmitted by animals and humans.
- With psoriasis of the head, the structure of the hair does not change, while fungal diseases lead to brittleness, dryness and hair loss.
- Unlike scaly lichen, onychomycosis of the legs and feet is accompanied by an unpleasant odor.
- With the defeat of scaly nails, their structure changes already at the initial stage, and with a fungus for a long time the structure and color of the nail plates do not change.
Pink lichen
The hallmark of psoriasis is the "psoriatic triad". The disease develops gradually and goes through 3 stages. Tinea rosea (pityriasis) grows rapidly and progresses steadily. In addition, pityriasis is a contagious disease, but scaly lichen is not.
Neurodermatitis
- Atopic dermatitis (neurodermatitis) is allergic in 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, psychosomatic, mechanical damage to the skin, etc. ).
- With neurodermatitis, the skin dries up and becomes rough, and with psoriasis, it becomes scaly and bleeds.
- Patches with dermatitis are made up of small, separate parts. In the case of shingles, the papules are uniform and covered with silvery scales.
- The color of the rash with psoriasis is much brighter than with neurodermatitis.
For gout
The difference between gouty and psoriatic arthritis is in the cause of the development. Gout occurs when uric acid crystals are deposited in the cartilage of the joints. Deviation from the norm can be caused by: high blood pressure, obesity, taking diuretics, drinking alcohol, etc.
The symptoms of psoriasis and gout are similar - severe pain at night, stiffness in movement, redness and swelling in the affected area. However, with psoriasis, in most cases, characteristic red rashes appear first, followed by pain.
Other distinctive symptoms of gouty arthritis include:
- the presence of white nodules in the area of the affected joint;
- signs of kidney stones (back pain, blood in the urine and others).