Psoriasis- one of the most common diseases, the frequency of which in the population is constantly increasing every year. And if we consider that absolutely all age categories are susceptible to this pathology, and its simple form quickly turns into a more complex one, then the question of correct therapy and prevention is indeed very acute.
According to statistics, about every 30 inhabitants of the planet suffer from this ailment in one way or another. What to do for psoriasis sufferers? What drugs and folk remedies can be treated? How to properly organize your meals? Let's finally put all the points.
Psoriasis and its causes
Psoriasis is an autoimmune disease with a rather vague etiology: the exact cause, despite numerous studies in this area, is still unknown. It is believed that this pathology is a consequence of genetically determined changes in the immune system, as a result of which chronic inflammation of the skin develops. However, its multifactorial nature is also not excluded, in other words, involvement, together with heredity and the influence of the external environment.
Interestingly, the predisposing factors, according to scientists, are quite different for different age groups: for example, if various types of bacterial infections, including, in particular, streptococcal infections, are considered triggers in children, then for adults, stress stimuli and nicotine abuse are paramount, and alcohol, obesity, and the use of certain drugs (eg, adrenaline receptor blockers).
It is impossible to completely cure psoriasis, however, modern medicine is quite capable of significantly alleviating the course of the disease and maintaining a long-term remission in the patient.
There are several theories to explain the onset of psoriasis:
- infectious and parasitic;
- theory of molecular mimicry.
As with many other conditions, the cause of skin problems should be found in the gut. Its length ranges from 4 to 6 meters and the internal surface is covered with villi, the total surface of which is comparable to the size of a tennis court: this allows the absorption processes to proceed much more efficiently. It is noteworthy that the cells of the mucous membrane of the small intestine are completely renewed every 3-5 days. In addition, up to 70% of human immunocytes are concentrated here. Hence, one of the most common causes of psoriasis is considered to be leaky gut syndrome (LEPS).
Deviation from the normal functioning of the intestinal mucosa is fraught with malabsorption, that is, a violation of the assimilation of basic nutrients (proteins, fats, carbohydrates, vitamins, minerals). In addition, the negative impact on the body of toxins and allergens increases: in such conditions, it is much easier for them to enter the bloodstream. The direct link between psoriasis and inflammatory bowel disease has been shown in numerous studies.
Other works of scientists confirm that a special microflora is formed on the skin of a patient with psoriasis, which is significantly different from the microbiome of healthy skin.
In the area of psoriatic lesions, a mass of various bacteria is concentrated, the stability of which is significantly lower than that of normal skin - in particular, colonization by Staphylococcus aureus is observed, which has an extremely negative effect on the course of the inflammatory process.
Types of psoriasis
- Plaque psoriasis. . . In 90% of cases, dermatologists are faced with this particular form of the disease, also known as simple or ordinary. First, small separate areas appear on the skin, raised above the level of the healthy dermis. These inflamed areas are called psoriatic plaques. Gradually, they grow, merging with neighboring points into one whole.
- Inverse psoriasis.This diagnosis is given to patients who develop smooth red spots in the skin folds and inside the folds - in the groin area, on the inside of the thighs, under the breasts. Unlike simple psoriasis, foci of inflammation are practically not covered with scales, but due to their location and constant friction, they cause severe inconvenience to patients. In addition, there is a danger of streptococcal or fungal reinfection, since in the places where the spots are located, due to high humidity and temperature, ideal conditions are created for the reproduction of microorganisms.
- Guttate psoriasis.This type of disease gets its name from the shape of the formations. The lesions are in the shape of a drop, raised above the level of healthy skin. A common trigger for this form of psoriasis is a previous strep infection, as previously mentioned. The fact is that the patient's immunity, affected during the fight against infection, is seriously weakened - his resources are not unlimited and, like all living things, it takes time to recover - and it is against this background that onemanifests an activated autoimmune disease.
- Pustular psoriasis.It is considered the most severe form, accompanied by the formation of blisters filled with a clear liquid. Skin inflammation begins around the foci, swelling and thickening appear. With a secondary exacerbation, the probability of which is quite high, the blisters fill with pus. Localized foci of pustular psoriasis on the arms and legs. In difficult cases, there is a ubiquitous location of blisters on the body, their rapid growth and the danger of infection of the entire surface of the skin.
- Psoriasis on the nails.This type of disease changes the appearance and structure of the fingernails and toenails. Nails thicken, lose their natural color, emit an unpleasant smell. The skin around the nail bed swells, thick ridges are formed. In advanced cases, the nails may disappear without subsequent regrowth.
- Psoriatic arthritis.In this case, the disease affects the joints and connective tissues. Most often, inflammation affects the distal phalanges of the extremities. There is psoriatic dactylitis - swelling of the fingers. The hip and knee joints are also exposed to the devastating effects of the ongoing disease. Cases of disability with loss of the ability to move independently are frequent.
- Psoriatic erythroderma.Flaky spots appear on the skin, while peeling of the affected layer is observed. Patients experience extreme discomfort due to constant itching and swelling. Most often, this diagnosis is made in patients who have already been treated for simple psoriasis but have not completed therapy or changed medication.
Symptoms of the disease
The first manifestation of psoriasis is a small rash. Papules grow rapidly, growing to spots with a diameter of 4 to 8 cm, become more and more, and dry scales are formed on the surface. In advanced cases, the individual spots merge with each other and the lesion affects large areas of the body. Psoriatic papules can be distinguished from other skin diseases by their round shape with clear edges, bright red or pink color, and silvery white scales. They first appear on those areas of the skin, the integrity of which is violated due to abrasions, wounds, frostbite, constant friction. There are three characteristic signs that confirm the onset of psoriasis development:
- Stearin stain phenomenon- dry particles easily separate from the affected surface, revealing an area that looks like a drop of wax or sterol.
- Psoriatic phenomenon(terminal) film. Further cleaning of papules from scales allows you to see a transparent, moist film, the skin under which is inflamed.
- Auspitz phenomenon. . . Removal of the terminal film leads to the appearance of the smallest drops of blood on the surface of the stain.
This triad of psoriasis is unique: its presence allows you to make the correct diagnosis unequivocally. However, different parts of the body have their own characteristics of the manifestation of the disease.
- Psoriasis on the body.The back, neck, abdomen, thighs and lower legs are most often affected by guttate psoriasis. Small papules, which resemble drops in shape, gradually grow, rising above the surface of the skin. This form of the disease is often diagnosed in people who have had a staph infection.
- Psoriasis on the hands.The most common places for the appearance of psoriatic papules on the hands are the elbows and interdigital spaces - while, as a rule, a plaque form is observed, in which individual small fragments merge into a single area of the lesion covered with dry scales. The forearms are much less likely to be affected.
- Psoriasis on the legs.The disease begins with single rashes in the knee area. Inflamed areas disturb patients with severe peeling and itching, rapidly increase in size and merge with neighboring ones.
- On the palms and feet.In most cases, the simultaneous defeat of both palms and feet is recorded, but in some patients the ailment affects the stratum corneum of the purely upper or lower limbs. As a result of the growth of psoriatic papules, thickening, swelling of the skin occurs with further cracking.
- Scalp psoriasis.First of all, rashes appear on the forehead, behind the head and even behind the ears. First, patients themselves notice individual scaly formations that grow, merge with those located nearby and, over time, can affect the entire scalp. The papules are very itchy, thus causing a constant need to scratch the skin - the resulting wounds and cracks are likely to become the gateway to infection. Dry particles are separated from harmful formations: first small, somewhat similar to dandruff, and then larger flakes.
- On the face, ears, neck.Localization of psoriatic papules on the face is rather an exception in the usual clinical picture. In rare cases, when this happens, the disorder affects the areas around the eyes and eyelids, as well as the cheeks and tongue. Formations on the neck quickly spread further - to the back or head. The ears are the site of development of seborrheic psoriasis. Papules can appear both inside the cartilage shell and outside. When making a diagnosis, it is important not to confuse the disease with seborrheic eczema, which has similar symptoms.
- On the nails.There are three options for the initial manifestation of psoriasis on the nails. The first is the emergence of small dotted depressions. The second is a thickening of the nails, a change in their natural color to gray or yellow. With the further development of nail psoriasis, the plaque exfoliates, the upper particles are easily separated. And, finally, the third is a deformation of the nail, accompanied by a loss of smoothness by the plaque and the appearance of depressed areas.
- Symptoms of psoriasis in children.At an early age, the disease proceeds differently: the main localization of red scaly rashes are skin folds: inguinal, in the elbow and popliteal folds, on the neck. Papules itch a lot, children experience constant torment, become irritable and restless. In general, all clinical variants seen in children are similar to those seen in adults. The differences concern purely manifestations, the location of the pathological process and the course of the disease itself.
4 stages of psoriasis
Clinical dermatology, based on the differences in symptoms, degree of skin lesions and duration, distinguishes three stages in the course of psoriasis. However, it is believed that the initial stage should be recognized as another full-fledged stage in the development of the disease.
- Initial state.The first sign of psoriatic lesions are small rashes. The places of their appearance can be different and depend on the type of disease. Primary papules are no more than 3 mm in size, painted a pale pink color, which after 3-4 days is replaced by a gray bloom - dead dermis particles are formed on the spot. This process is accompanied by itching and burning, and overall health worsens. In general, the formation of plaques in the initial stage takes up to three weeks, and at this time a person has the opportunity to slow down the development of the pathology.
- Progressive.At this stage, the ailment affects significant areas of the skin: for example, with normal psoriasis, plaques are formed, with other forms, characteristic papules of them. In the process of developing the disease, the individual spots merge with each other, covered with gray scales. The symptom with which the progressive stage is determined is the Köbner phenomenon (isomorphic reaction). Any damage to the skin after a while is accompanied by the appearance of a psoriasis rash in this place. Another confirmation that the disease is actively developing is the appearance of drops of blood, similar to dew, after the removal of plaque. The duration of this phase depends on the type of injury. On average, it takes from two weeks to two months.
- Stationary phase.During this time, a thick grayish-white or gray crust forms. The pink circles disappear. The skin becomes rough, dry particles are constantly exfoliated from it. The itching and burning sensation becomes less bothersome, but does not completely disappear. No new papules are formed. This phase can be quite long.
- Regressive phase.The final stage of the development of the disease, during which a gradual reduction and reabsorption of plaques occurs. The itch no longer bothers. A clear sign of regression is Voronov's symptom, when the papules are surrounded by white rings. Fading of spots occurs from the center to the periphery, as a result of which bizarre patterns are formed on the skin. At the end of the regressive phase, only slightly different skin areas in the shade from healthy areas are reminiscent of psoriasis. There is no need to talk about full recovery for psoriasis. The end of the regressive phase indicates that the disease cycle is complete, which can recur at any time. In order for remission to continue, it is necessary to pay attention to health: avoid provoking factors, follow a diet, be observed by a dermatologist.
Examination plan for psoriasis
- General clinical blood analysis.
- Research on the content of vitamins D, B12, folic acid in the blood.
- Blood test for ALT (alanine aminotransferase), AST (aspartate aminotransferase), direct bilirubin, alkaline phosphatase, gamma-glutamyl transferase, cholesterol with lipid profile, creatinine, glucose, insulin, total protein.
- Blood for rheumatoid factor, c-reactive protein, uric acid, ASLO.
- Ferritin, transferrin, serum iron are indicators of anemia (especially chronic diseases).
- Thyroid panel: TSH, T4 sv, TK sv.
- KhMS according to Osipov.
- Ultrasound of the abdominal organs.
Traditional treatments for psoriasis
The sooner a person who has discovered the first signs of skin lesions sees a doctor, the greater the chances of taking timely measures that will prevent the rapid development of the disease and its transition to a chronic form - and, therefore, significantly improve the standard of living. general.
One of the most commonly prescribed drugs at the onset of the disease is salicylic ointment. It has an anti-inflammatory and antimicrobial effect, has a keratolytic effect, thanks to which the plaques are eliminated from the keratinized particles. To reduce itching, naphthalane ointment is also used.
Therapy in a progressive phase.
At this stage, an integrated approach to treatment is required and only an experienced specialist can provide it. Treatment aims to relieve symptoms by ridding the body of toxins. To normalize metabolic processes, intramuscular injections of calcium gluconate are often prescribed. Sodium thiosulfate relieves inflammation and eliminates the manifestations of intoxication.
To moisturize inflamed skin, special emulsions and salicylic ointment are used. Tar-containing means are contraindicated in a progressive stage: they act irritatingly and increase the patient's suffering.
When the intensity of inflammation decreases, physiotherapy procedures can be connected. Patients with psoriasis are shown ultraviolet irradiation, PUVA therapy and paraffin applications. Corticosteroids and cytostatics are not used unnecessarily, these powerful drugs are only needed in difficult and advanced cases.
To reduce allergic manifestations, antihistamines are prescribed and sedatives are prescribed to reduce nervousness. Diuretics help reduce swelling of inflamed skin and remove toxins from the body.
At this stage, the inflammation subsides, the plaques become covered with a dry crust, so funds are needed that will relieve discomfort from the appearance of scales. These are tar shampoos, oil-based emulsions.
In many patients, ultraviolet irradiation and the PUVA technique have a good effect. If there is no improvement, doctors prescribe cytostatics.
Therapy in a regressive phase.
In the final period of the disease cycle, constant correction of treatment methods is required, depending on the current condition of the patient. Prevention is replacing active therapeutic actions.
The patient receives recommendations for changing the diet and lifestyle in general. To avoid the return of the skin lesion it is necessary to avoid stressful situations that trigger the formation of psoriatic plaques.
Typically, doctors give patients the following advice:
- reconsider your lifestyle: make changes to your diet, get enough sleep, move more;
- ensure normal vitamin levelsD, iron, B vitamins, proteins in the body;
- normalize the digestive tract: exclude hypoacidity, impaired outflow of bile, SIBO and CIGR (syndromes of bacterial and, consequently, fungal overgrowth);
- get rid of chronic infection foci: sanitize the oral cavity, undergo treatment with an otolaryngologist;
- cope with concomitant somatic pathology: hypothyroidism, insulin resistance, metabolic syndrome, etc.
Traditional methods of getting rid of psoriasis
- Initial state.At the first sign of skin breakdown, juniper and lavender oils are effective. They soothe the irritated areas of the dermis, promote the healing of minor injuries, relieve the feeling of oppression. A few drops of oil are added to a cream of neutral composition, for example for children, and applied to the rash that appears. Another popular method of dealing with the initial manifestations of psoriasis is the use of 3% hydrogen peroxide. Any measures, even the most harmless at first glance, can be applied after consulting a dermatologist. Dietary changes, avoiding unhealthy foods and alcohol are also common recommendations from traditional healers.
- Progressive phase. At the stage of the rapid development of the disease, an infusion of celandine is added to the healing oils and hydrogen peroxide. To prepare it, you will need fresh or dried plant stems and salt water. Alcohol tinctures are contraindicated, they can worsen the condition of the affected skin. It is necessary to insist on celandine for at least several hours, and before applying the healing solution to the plaques, treat them with birch tar.
- Stationary phase.At the stage of stopping the formation of new papules, it is possible to use proven folk methods that will definitely not harm the patient. These include the use of sulfuric ointment, salicylic solution.
- Regressive phase.In the final stage of the course of the disease, hirudotherapy (leech therapy) is often used. Although this method is not officially recognized by traditional medicine, many experts do not rule out its effectiveness. The procedures are carried out within 3-10 days, depending on the patient's state of health.
Psoriasis prevention: how to prevent the development of the disease
- Skin care.To minimize the likelihood of psoriatic damage in the presence of a genetic predisposition, simple ways to maintain skin health will help: water and hardening procedures (baths in the sea, baths with extracts of herbs and salts, contrast showers, bathing withfresh water in the air, etc. ); use soft sponges and avoid hard wipes that can damage the skin; the use of detergents, of natural composition, free of aggressive chemical components.
- Ultraviolet rays.Several studies have shown the beneficial effect of sun exposure on skin prone to psoriatic plaque formation. Moderate doses of ultraviolet light help accelerate tissue regeneration and reduce inflammation. You should not abuse sunbathing - an excess of rays can provoke an exacerbation of the disease.
- Clothing.Synthetic fabrics, tight styles, an abundance of belts and fasteners - all this is contraindicated for patients with psoriasis, even in remission. Clothing should be natural, hypoallergenic, loose, not cause any inconvenience that can lead to the return of pronounced symptoms. Dark tones should be avoided for aesthetic reasons; the silvery white scales are less visible on light colored garments.
- Injuries.For patients with psoriasis, any small wound, scratch, abrasion can cause the progressive stage to return and a secondary skin infection. They should be extremely careful to avoid injury.
- Cosmetic and household products.Not all remedies are suitable for maintaining cleanliness for people with such diagnoses. When choosing shower gels, soaps, shampoos, it is important to pay attention to their composition, giving priority to those that contain natural ingredients. It is best to purchase a therapeutic range of care products that are sold in pharmacies. Solid particle scrubs are absolutely contraindicated - they are able to restart the disease process due to the smallest lesions on the skin. Household chemicals should also be selected based on health safety, do not use aggressive cleaning powders based on chlorine and alkali. Gloves must be worn when cleaning to avoid adverse effects on the skin of the hands.
- Vitamin therapy.Maintaining the vitamin balance is indicated for everyone and especially for people with chronic dermatitis. Complex preparations keep the body in good condition, help it resist viruses and prevent metabolic disorders.
Psoriasis- this is not a death sentence, but a very serious reason to reconsider the rules you lived by before. Your allies on the path to taming the disease should be competent professionals: dermatologists, nutritionists, therapists. With their help, as well as through a deliberate approach to treatment, you can learn to live comfortably, despite your diagnosis.