Psoriasis is one of the most common skin diseases, every cent suffers from it.
Psoriasis is a developmental disease of which several factors are important at once: from hereditary predisposition (psoriasis in relatives) to disturbances in the functioning of the nervous, endocrine, immune and other factors.
The reasons
The causes of psoriasis are not fully understood.
The principle of the mechanism of the disease is to stop the division of skin cells, which causes an autoimmune reaction (autoimmune reaction - occurs inside the body, does not depend on external threats).
The upper layer of the skin (epidermis) is mainly composed of keratinocytes, cells that produce keratin. Keratin is a protein, its properties allow it to perform the protective function of the skin. Keratinocytes are formed in the deep layers of the epidermis and slowly move to its surface, during movement they mature and acquire new properties.
At the end of their "maturation", the keratinocytes form a stratum corneum on the surface of the skin. Then the keratinized cells die and exfoliate from the living ones, then the life path of the keratinocytes comes to an end. This ensures a continuous renewal of the skin.
The normal path of keratinocytes from the deep layer to the surface takes a month. With psoriasis, their lifespan is reduced to several days, this leads to the appearance of scaly and psoriatic foci, since the skin does not have time to get rid of keratinized cells.
When psoriatic plaques appear, they are usually accompanied by itching and redness. This indicates an autoimmune reaction in the deep layers of the skin, resulting in swelling of the thick layer of the skin (dermis). The dermis contains blood and lymphatic vessels.
It is not certain why the keratinocyte formation process is accelerated, but a hereditary factor is known to play a significant role.
The development of common psoriasis can begin due to:
- mental trauma and constant stressful conditions;
- damage to the skin;
- transferred infectious disease;
- taking certain medications;
- hormonal disorders;
- allergic reactions (typical allergens: citrus fruits, eggs, chocolate);
- alcohol intoxication;
- climate change.
The psoriatic triad is a characteristic symptom of the disease that occurs when the skin is scraped.
Stearin stain(increased peeling after scraping, which gives the surface of the papules a resemblance to a crushed drop of stearin).
Thermal film(the appearance after complete removal of the scales of a wet, thin, shiny and translucent surface).
Identify the bleeding(the appearance of droplets of blood that do not merge with each other).
What happens to the skin in psoriasis?
In psoriasis, the skin structure is disturbed, the epidermis becomes thinner, the processes of keratinization of the skin (accumulation of the keratin protein) are disrupted, and some layers of the normal epidermis disappear. In the next stage of the disease, the groups of cells responsible for inflammation are found in the protective superficial horny layer of the epidermis and in the area of parakeratosis, around the dilated vessels of the skin.
Characteristic plaques and scales appear on the surface of the skin.
Psoriasis is not only a common disease, it has many manifestations and also disguises itself as other diseases.
Psoriasis localization sites:
- elbows and knees;
- sacrum and loin;
- scalp (seborrheic psoriasis);
- flexion surfaces and skin folds: the inner surface of the elbow and knee joints, the groin and armpits, the area under the breast (inverse psoriasis);
- palms and surfaces of the feet (palmar-plantar psoriasis);
- nail psoriasis.
Common symptoms of psoriasis
The main symptoms of psoriasis are:
- psoriatic plaques;
- tightness of the affected skin area;
- itch.
Symptoms by type of psoriasis:
- exudative psoriasis (the affected areas of the skin peel off and become wet, a yellow crust forms on the surface of the rash);
- intertriginous psoriasis (more common in children, foci of onset are red, with slight peeling, sometimes wet ones can be confused with diaper rash);
- old psoriasis (it is characterized by large plaques that do not go away for a long time);
- rupioid psoriasis (another form of chronic psoriasis, characterized by a cone-shaped plaque);
- guttate psoriasis (profuse rash of small papules).
Types of psoriasis
- Ordinary psoriasis (vulgar, plaque);
- Generalized (diffuse, postulate) psoriasis;
- Teardrop-shaped psoriasis (from the type of rash);
- Arthropathic psoriasis (with joint damage);
- Other types of psoriasis (seborrheic and others).
Psoriasis vulgaris is the most common form of the disease.
Psoriasis begins with the appearance of skin rashes, often few, in typical places: on the elbows and knees. In addition, the characteristic localization of the rash is the area of the scalp and trunk. There is usually a clear connection between the appearance of rashes and the action of the provoking factor.
Factors that cause psoriasis can be stress, skin trauma, a recent infectious disease, and regular alcohol consumption.
Usually, the exacerbation of the disease occurs in the cold season - this is the winter type of psoriasis. The summer type is rarer. Mixed forms of psoriasis are now noted. Over time, the number of rashes increases. They form characteristic psoriatic plaques. The Kebner phenomenon is observed: the appearance of new plaques in places of skin trauma. As a rule, patients have plaques that remain on the skin even without exacerbations.
The disease flows cyclically:
- Progressive stage (increase in the number of rashes);
- Stationary stage (no new rashes appear);
- Regressive phase (regression of rashes, appearance in their place of skin areas without pigment).
Psoriasis vulgaris, photo
Diagnostics
When diagnosing psoriasis, first of all a detailed skin examination is required.
Thin skin, bleeding in places, loose plaques are signs of psoriasis. In the presence of these symptoms, the doctor performs a series of diagnostic measures to exclude the presence of other events with similar manifestations. For the final diagnosis, blood tests, smears, and skin biopsies are done as needed. If the joints are affected, magnetic resonance imaging (MRI) is prescribed and X-rays are done to identify lesions.
Vulgar psoriasis, treatment
Psoriasis is a systemic disease with skin manifestations and complex treatment is required: both local and systemic therapy. The disease is chronic and treatment aims to reduce the number and severity of flare-ups and to achieve an acceptable skin condition for the patient.
In the progressive stage of psoriasis, all aggressive procedures are canceled: ultraviolet irradiation, baths. It is important that patients with psoriasis carefully and carefully handle the skin, do not injure it in order to avoid exacerbation and the appearance of new plaques.
Diet for psoriasis
Psoriasis is often accompanied by liver disease, so avoiding alcohol, fatty, fried and smoked foods is important. It is equally important to be moderate in your carbohydrate intake, as this changes the pH of the skin and increases the risk of infection of the rash.
Prophylaxis
Psoriasis prevention is all about maintaining a healthy lifestyle. This helps prevent other diseases from occurring, as the body's immune system is protected from stress and can withstand threats from the outside.
Psoriasis prevention measures include:
- suitable skin care;
- relaxing massage to improve blood circulation;
- proper nutrition, it is recommended to avoid allergenic foods and exclude (limit) the intake of spicy, fatty, pickled, smoked, salty, as well as citrus foods;
- vegetable and dairy diet;
- a sufficient amount of moisture in the body;
- elimination of alcohol, smoking and other bad habits;
- increased physical activity;
- walks in the fresh air;
- avoid stressful situations;
- take vitamins of groups A, B, C, D, E;
- choice of loose clothing of natural materials that will not rub and will not cause irritation.
Means for the treatment of psoriasis
Systemic therapy for psoriasis aims to reduce the proliferation of the skin epithelium, stabilizing the keratinization of skin cells and cell membranes. For this, preparations based on vitamin A (retinoids), cytostatics are used. Among the most modern treatments, so-called biologicals are used, which neutralize the substances that cause inflammation.
For many years, UFOs have been used - treatment with ultraviolet rays of group B (in tanning beds, rays of group A), which reduce inflammation and contribute to the death of altered cells. PUVA therapy is the simultaneous use of ultraviolet radiation and a special substance that increases the sensitivity of the skin to it.
An effective remedy for psoriasis
Local treatment is no less important than systemic treatment. Helps reduce skin inflammation. Medicines are prescribed depending on the stage of psoriasis.
Progressive phase
- exfoliating ointments and lotions;
- anti-inflammatory hormonal ointments with calcitriol;
- emollients to relieve itching and dry skin.
Stationary phase
- UVB therapy;
- concentrated exfoliating ointments;
- emollients to restore the skin and reduce dryness.
Regressive phase
- concentrated exfoliating ointments;
- emollients to restore the skin and reduce dryness.
Psoriasis cream
Psoriasis creams and ointments have different purposes and are used in different stages of the disease. Hormonal anti-inflammatory ointments and creams are used to stop the inflammatory processes of the skin. There are several classes of hormonal drugs. They have different absorption capacities and different activities. When used in children, they try to avoid applying hormonal drugs to the face and neck area, the area of the skin folds - places where the skin is thinnest. Local preparations based on calcipotriol (a derivative of vitamin D) also have an anti-inflammatory effect. This is a later generation of drugs. They are not currently used during pregnancy and breastfeeding.
Salicylic Ointment and Salicylic Acid Lotion are designed to remove skin scales with severe flaking. Salicylic acid not only has an exfoliating effect, but also increases the effectiveness of local hormonal drugs. In the stationary and regressive phase, when the inflammation has become less active, salicylic acid-based agents are used at a higher concentration.
Means for restoring the structure of the skin and eliminating dryness are used throughout the entire treatment period, as well as in combination with ultraviolet irradiation to reduce skin itching. Once the flare-ups have subsided, these products help maintain the skin's protective properties and reduce the risk of new breakouts.
An effective cream for psoriasis
The modern approach to the care and assistance of dry skin is based on saturating the epidermis with moisture and is called corneotherapy (derived from the "corneum" - corneal, or horny, layer of the epidermis.
Corneotherapy is aimed at restoring the horny layer of the epidermis and its protective functions, which allows to improve the condition of the skin as a whole. The works of the founder of corneotherapy Albert Kligman made it possible to create special means - emollients.
How do emollients work?
within 1 hour of applying the emollients: - the condition of the skin improves, thanks to the fact that the emollients "retain" the moisture in it.
6 hours after the application of the emollients: - the skin structure is restored thanks to the content of special natural restorative lipids (ceramides and other useful fats).
24 hours after the application of emollients: - the clinical improvement of the skin condition occurs thanks to the penetration of moisturizing components into the deep layers of the epidermis and the restoration of the superficial layers of the skin (up to 24 hours from the start of application).