Psoriasis is a chronic dermatological disease, the basis whose pathogenesis is an abnormally rapid growth in skin cells, which leads to the appearance on the surface of the skin of compact areas of various colors.
Today, psoriasis has become the most common non -infectious dermatological disease.Psoriasis does not have a gender predisposition: both men and women suffer equally often.You can get this pathology at any age, but more often the first signs of the disease appear up to 20 years.
Psoriasis is rather scarce in therapy, partly due to the fact that so far the etiology and pathogenesis of this pathology are not yet clear.Furthermore, there is no specific means of prevention of psoriasis, since it is impossible to determine if a person has a predisposition to the disease.
The reasons for development
At the moment, scientists cannot unequivocally answer the question "Why is psoriasis develop?".Two main factors of the development of the disease are distinguished: this is a genetic predisposition and hyperreactivity of the immunity system.
Until now it has been establishedThe predisposition to the development of psoriasis is inherited.But the difficulty lies in the fact that it is extremely difficult to trace how exactly this predisposition is inherited and after the influence of which factors psoriasis can develop.
It is believed that the following factors can induce the development of psoriasis:
- Frequent hypothermia of the skin, as well as the effect of the dry climate on it;
- Infectious processes;
- Frequent stress;
- The use of some groups of pharmaceutical products: non -pounded anti -inflammatory drugs (especially aspirin), some hypotonic and psychotropic drugs;
Pathogenesis
At the moment, the pathogenesis of psoriasis has not been clarified.Two main connections of the pathogenesis can be distinguished:
- Violation of skin keratinization.
- Interruption of the immunity system.
Together, the above factors lead to the fact that the cells of the lower layers of the epidermis for an unknown reason begin to share very quickly.This process leads to a reactive increase in the rate of drying of the upper layer of epidermal cells, which is externally manifested peeling of the skin.
Symptoms
The disease always begins acutely, without any push to the development of the pathological process.As a rule, the first elements of the rash are located in the place where the skin has been damaged.
At the beginning of the symptoms of psoriasis, papules of pink or red colors appear on the skin.This process is accompanied by itching.The size of the elements varies from some millimeters to 1.5 centimeters (in some cases, the elements also reach large dimensions).So the elements of the rash are covered with easily separated silver stairs.
Sometimes psoriasis damages the nail plates.This pathology externally recalls the damage to the nails and manifests itself from the following symptoms:
- There are many small recesses on the surface of the nail;
- The edge of the nail plate thickens and acquires an opaque and yellowish color;
Another characteristic manifestation of psoriasis is psoriatic arthritis (symmetrical damage to the joints and periarticular tissues).Very often, the pathological process develops in the interfaced joints of the feet and hands.Initially, the disease manifests itself from pain and swelling, and therefore the deformation of the articulation concerned develops, which can even lead to the patient's disability.It should be noted that in rare cases, damage is also possible.Sometimes psoriatic arthritis also develops in the joints of the spinal column.
Types
The following types of psoriasis are distinguished according to the severity and characteristics of the clinical manifestations:
- Plaquaper.This type is the most common: it is diagnosed in almost 90% of people suffering from psoriasis.The elements of the skin eruption, theoretically, can occur on any skin area.However, the most typical locations are the lower back, the scalp and the extensors of the upper and lower ends (the area of the elbows and knees).It should be noted that with this form of psoriasis, the pathological elements do not appear on the face, the palms and the soles remain intact.Externally, this form looks like an inflamed plaque covered with silver with stairs.When the plates are displayed from under the stairs, the lymph is released.With further injuries, the plaque begins to bleed.The shape of psoriasis plate is also characterized by the appearance of the "paraffin lakes" so called - the confluence of different plates in an element.
- Reverse psoriasis (psoriasis of flexion surfaces or interstigonic).This form is rather rare.The elements of the rash have the shape of red spots without peeling, which do not protrude over the surface of the intact skin.Typical location of this form of psoriasis - skin folds (axillary cavities, inguinal folds, skin under the chest in women).Furthermore, due to the characteristics of the location, a fungal infection often joins in reverse psoriasis.
- Genital psoriasis.This form develops more often in girls, mainly in adolescence (up to 16 years).Often the development of the pathological process is preceded by Streptococcus infection (for example Angina).Roccious psoriasis with a rocky psoriasis resemble an ordinary allergic eruption: small points that have a lilac gray color, does not protrude over the surface of the skin.These skin eruptions may appear on any skin area.The skin on which rash eruptions are normally has an inflamed appearance.
- Pustulenia psoriasis.It is a more serious form than above.With pustular psoriasis, small painful pusions filled with pus appear on the patient's body.This form can occur both locally and in general.With pustular psoriasis, the general condition of patients often worsen, body temperature increases.With the generalized form of pustular psoriasis, hospitalization is necessary.
- Erytroderma is the most serious form of psoriasis.With it, almost all the patient's skin is damaged.This form is accompanied by creepy, an increase in body temperature to a large number, a strong deterioration of the patient's condition.This disease requires urgent medical intervention, in the absence of which a fatal result can also occur.
Severity
There are many different gradations of psoriasis in terms of gravity.However, in routine clinical practice, the simplest of them is used, which does not require special research methods.
Therefore, distinguishThree degrees of gravity of psoriasisDepending on the prevalence of the pathological process:
- Form of light.This form is set in cases where the patient is influenced by psoriasis of less than 3% of the skin.
- Moderate form.This diagnosis is done with damage to psoriasis from 3 to 10% of the patient's skin.
- Heavy form.This form is exposed taking into account the lesion of the skin and clinical manifestations.Therefore, this form is exhibited with an injury of over 10% of the skin or with a significant deterioration of the patient's well -being.It should be noted that psoriasis is considered serious in the presence of psoriatic arthritis, regardless of the degree of prevalence of the pathological process.
The course of the disease and prognosis
Psoriasis is a disease with a path similar to waves, that is, it has periods of remission (when the symptoms disappear practically) and the exacerbation.As a rule, the process is aggravated during the off -season periods.
The prognosis for psoriasis depends on the shape of the disease and gravity.As a rule, with classic psoriasis forms, the prognosis is favorable, but disability and even death is possible in serious forms.
Despite the favorable prognosis in most forms of psoriasis, do not forget the social aspect of this disease.In the acute period of the disease, the skin and the hairy part of the human head are covered by plates peeling, which are often perceived by others as a manifestation of any contagious disease.For this reason, those around them begin to avoid the patient, which makes him close and often depression.
Diagnostics
The basis for diagnosis are the clinical manifestations of the disease, the characteristics of his current, as well as the data of the objective inspection.There are numerous characteristic symptoms that are determined for the diagnosis of psoriasis:
- "Psoriatic film" - if you purify the surface of the papulian peeling, then it becomes smooth and shiny.
- "Stearin Stain" - When the psorial elements are displayed, their surface becomes whitish, stirin films appear.
- "Blood Dew" - If, after the manifestation of the above symptoms, they do not stop the harness of the elements, their surface is covered with blood droplets (capillary bleeding appears).
Three symptoms described above are called "psoriatic triad" and are the main method of diagnosis of psoriasis.However, there are many other signs that are determined in a certain phase of the disease:
- In the acute phase of psoriasis, they are caused by the symptoms of Pilnov (the psorial elements are surrounded by a red edge) and Kebner (new skin eruptions actively appear in damaged areas of the skin).
- The regression phases also determine the symptom of Voronov (around the elements a bright luminous edge of a small rough skin is determined).
Of the laboratory and instrumental methods, the following are used:
- Microscopy of stairs and dough with potassium hydroxide (for differential diagnosis with damage to fungal skin).
- In complex clinical cases, with an atypical path, pathological elements resort to conducting a biopsy.
- With psoriatic arthritis, blood test indicators are examined (mainly ESR and rheumatoid factor) and lead a ray x of the joints concerned (for the differential diagnosis with arthritis of another etiology).
Treatment
The treatment of psoriasis is a long and complex process.Unfortunately, since psoriasis is a chronic disease, the purpose of therapy is not patient care, but the achievement of prolonged remission and the prevention of exacerbations.The treatment depends on the stadium, the shape and gravity of psoriasis.It should be noted that a set of medical measures must be prescribed by a dermatologist and only after an in -depth examination of the patient and the verification of the diagnosis.
Diet.The treatment of psoriasis should begin with the correction of the patient's daily diet.If we talk about general recommendations, people with psoriasis should reduce the amount of protein in the diet and increase the amount of carbohydrates due to the consumption of vegetables and fruit.It is also necessary to exclude those products that can cause exacerbation of psoriasis: alcohol, chocolate, various spicy spices and limit the use of garlic and onions.It is also worth limiting the consumption of fried meat and fish, smoked meat.
Furthermore, when filling in an optimal diet, the patient's preparation to allergies to any product and, if possible, exclude it should be taken into consideration.The optimal diet is the use of a large amount of fresh and vegetables and lean varieties of meat and fish in boiled form.
Pharmacological treatment.For the treatment of psoriasis, pharmaceutical products are used in various forms of release: ointments, tablets, injections, etc.
In addition to local drugs, system therapy is also used, when drugs are prescribed in the form of tablets or injections.The following drugs are often prescribed:
- Immunosuppressors.They have an overwhelming effect on the immunity system.It is prescribed only in serious cases that are not susceptible to other therapy methods, as it has a large number of side effects and is difficult to transfer.
- Cytostatic.Its action aims to reduce the cell division rate, which leads to a decrease in the development rate of psoriasis and a decrease in peeling.It is used only in very serious cases, with resistance to other therapy methods.
- Various homeopathic drugs.Unfortunately, these drugs are not suitable for all patients and do not always have the necessary effect.
Photochemotherapy.Lighting is one of the main psoriasis therapy methods.
In conclusion, it is worth noting that psoriasis is a complex and not completely studied disease.A qualified doctor must be done via treatment.Remember that no miraculous method praised on the internet will help you get rid of psoriasis alone.
The same can be said about popular medicine: all its methods will benefit only in combination with the general remedies prescribed by the attending physician.
Therefore, we can conclude that to achieve success in the treatment, the patient should only use those methods he has agreed with his doctor, as well as observing all his recommendations.This is the only way to achieve good success in the treatment and prolonged remission of psoriasis.