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 appearance defects, it becomes difficult for a person to adapt to the team and communicate with people.Severe forms of psoriasis can cause disability.It is impossible to completely cure the pathology.However, proper treatment allows you to achieve stable remission and restore your previous quality of life.

What is psoriasis

The main symptom of the disease is the presence of psoriatic plaques - scaly pinkish spots of various sizes, accompanied by itching.Most commonly, they are located on the scalp (they can also be present along the hairline, behind the ears), elbows, knees, and can also occur 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 vessels in the affected areas are dilating.

Psoriasis develops due to a dysfunction of the immune system.In each layer of the epidermis (there are 5 of them in total - basal, spiny, 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 skin dehydration, protection of the lower layers of the skin).

Keratinocytes are constantly renewing themselves.Their synthesis takes place in the basal layer.Then they rise higher, where each time they perform a new function.Having reached the stratum corneum, they lose their nucleus and transform into corneocytes (special bags containing keratin).From now on, their function is barrier.After surviving their life, corneocytes exfoliate from the surface of the skin.Keratinocytes live for about 2 to 4 weeks, then are replaced by new ones.

With psoriasis, under the influence of a dysfunction of the immune system, keratinocytes begin to divide much faster and their lifespan is reduced.Peeling occurs, accompanied 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.Fair-skinned people suffer from psoriasis quite often;in representatives of the Negroid race, pathology is detected much less frequently.

Causes of psoriasis

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

1. Hereditary disease – the tendency to develop psoriasis is thought to be passed down genetically.
2. A consequence of immune disorders caused by infections, poor lifestyle, climatic conditions and bad habits.

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

Most often, the “push” to trigger the development of psoriasis is emotional overload (in 50% of cases), focal infections, metabolic disorders, diabetes mellitus, liver disease and the use of certain medications (most often glucocorticoids, beta-blockers, lithium salts).

There are other factors that “trigger” the disease or cause its exacerbation:

• Wounds, fractures.
• Frostbite.
• Sunburn.
• Smoking tobacco.
• Alcohol abuse.
• Obesity.
• Damage to the skin from chemicals.
• Food allergies.
• Parasitic infestations.
• Pregnancy and childbirth.
• Other skin diseases – eczema, dermatitis.

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

Types and stages of psoriasis

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

1. Common psoriasisdevelops most often.It is characterized by the presence of itchy patches with a scaly surface on the skin.In addition, with this form, discoloration of the nails and the appearance of small white spots on them is often observed.In some cases (in advanced stages), the nails move away from the nail bed.
2. Guttate psoriasismanifests itself as a small rash, located mainly on the chest and back.The rash is accompanied by itching in the areas where the skin is affected.Usually, the symptoms of the disease disappear after 4-6 months and no longer appear.However, the patient may subsequently develop another form of psoriasis.This happens about half the time.Guttate psoriasis is usually seen in children and adolescents.It often develops following an infection, most often after a bacterial infection of the throat.
3. Reversible psoriasisresponds well to treatment, it is sometimes possible to achieve stable remission without relapse.Red, oozing patches appear only in certain parts of the body, in folds, and do not spread further.Typically, rashes appear in the groin or under the mammary glands, as well as in the armpits.Reversible psoriasis most often develops in elderly patients.
4. Pustular psoriasisis a serious and dangerous form.In some cases, it develops quickly and suddenly.It is characterized by the appearance of blisters with purulent contents on the soles of the feet and palms, then the affected skin thickens and begins to actively peel off.Later, the rash spreads over large areas.In advanced cases, the skin all over the body may be affected.Pustular psoriasis can be life-threatening.Mainly affects adults.

Psoriasis develops in 3 stages:

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

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

At the stationary stagethe appearance of rashes stops.The existing plaques stop increasing in size, but active peeling begins over the entire affected surface.

In a regressive phasethe plates become denser, their elements dissolve, the coat decreases.Then, at the site of the rash, spots devoid of pigment remain.

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

Symptoms of psoriasis

The symptoms of psoriasis are:

• Pink rashes or white spots covered with scales.
• Itching in affected areas.
• Vascular changes.
• Signs of inflammation in the affected tissues.
• Deterioration in the appearance and condition of the nails.

Reference!About 1 in 10 patients develop arthritis from psoriasis.It is therefore necessary to start treatment as early as possible to avoid the development of complications.

Diagnosis

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

1. Stearin stain - with light scratching, the peeling intensifies and the rash resembles a crushed drop of stearin.
2. Terminal film - if you remove the scales from the surface of the plate, it has a shiny, wet surface.
3. Bloody dew - if you scratch the terminal film, droplets of blood appear on it.

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

Treatment of psoriasis

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

• Local drug therapy - ointments, creams, shampoos, sprays, lotions.
• General drug therapy - injections of antihistamines, sedatives, vitamins, treatment with immunosuppressants, cytostatics, retinoids, corticosteroid hormones.
• Maintenance therapy - the patient is prescribed ultraviolet irradiation combined with taking a dermatotropic agent.
• The use of detoxification methods - the appointment of immunomodulators, procedures that cleanse 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 throughout his life.In many ways, the duration of remission depends on this.It is important to give up bad habits (smoking, alcohol consumption).It is also necessary to follow a diet.Exclude from the diet citrus fruits, whole milk, chocolate, honey, eggs, foods containing red pigment (strawberries, watermelons) and other foods that can provoke the development of allergic reactions.It is also advisable to avoid spicy, fatty, fried, smoked foods, rich meat and fish broths.Seasonings are excluded: ketchup, mayonnaise, mustard, etc.You should limit your sugar and salt intake.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 situation:

• Refusal to stay in water for a long time - you should swim and bathe less often, it is recommended to take a short shower.
• Hard washcloths should be replaced with a soft sponge or cotton cloth, and regular soap with a pH-neutral product.
• After showering, you should not dry yourself, but pat your skin with a towel - this will avoid damaging the plaques and increasing itching.
• After water procedures, the skin should be moisturized with cream.
• It is necessary to give preference to spacious and light clothing made from soft natural fabrics, since the pressure of clothing on the skin can provoke the development of new rashes.
• Itching often causes the patient to scratch, which can cause injury to the skin.To avoid further damage, it is best to cut your nails short.
• Drying of the skin should be avoided, so avoiding air conditioning will be beneficial, as will humidifying indoor air.
• Although sunbathing can be beneficial for psoriasis, excessive exposure to ultraviolet rays can make the condition worse.You should consult your doctor about your sun exposure regimen.
• Any risk of skin irritation must be avoided.
• Cuts and wounds can cause new rashes to appear, so you need to protect yourself from them.
• Stress is a common trigger for exacerbation of the disease, so it is necessary to avoid traumatic situations as much as possible.
• It is necessary to avoid physical inactivity (inactivity) - moderate physical activity will benefit the condition of the whole organism.

If you feel worse, you should immediately see a doctor to prevent the disease from progressing to a more serious stage or complications from occurring.