Psoriasis (translated from the Greek "psora" - "skin disease, scabs") is a chronic disease of a non-infectious nature, also known as squamous lichen, which mainly affects the skin of the knee and elbow joints, the lower part of theback and head. There is also psoriasis of the joints, bones, nails, external genitalia and internal organs, but these forms are rarely diagnosed. The pathology is difficult to cure, therefore, when the first symptoms appear, red rashes, it is urgent to consult a doctor.
The first sign of psoriasis, which is part of the triad of pathological symptoms. It is characterized by increased peeling after scraping the affected surface with a spatula. Over time, there is a separation from the silvery-white scale papules. Their removal is not difficult, as they loosen and weakly adhere to the psoriatic papule. The surface of the neoplasms (rashes) turns white and the particles crumble and resemble shavings.
The first phenomenon of the triad is explained by the development of parakeratosis (improper functioning of the epithelium, which leads to a violation of the formation of the stratum corneum). To combat deviations at the initial stage, local non-hormonal agents (creams, ointments) are used.
It is characterized by the removal of a thin layer of tissue from the papules, which has a shiny structure and resembles polyethylene. It is easily separable from any impact (pressure, friction, etc. ) after removing the dried flakes.
The terminal film is the last layer that is removed from the skin. Further scraping leads to the last stage of the triad: drip bleeding.
At this stage, medicinal herbal baths, drugs with antiallergic effect, ointments on a natural basis (without corticosteroids and hormones) are used.
Identify the bleeding
After removing the terminal film, dripping bleeding occurs on the affected area of the skin (auspicious symptom or "bloody dew") and accelerated growth of neoplasms is noted, which sometimes reach the size of a pea and are called lenticular. In some cases, the papules grow to the diameter of a small coin and differ as nummular. With the progression of the disease, their growth increases, and when combined, psoriatic plaques are formed.
For treatment, retinoids, immunomodulators, anti-inflammatory drugs, physiotherapy are used.
The disease can be recognized by other characteristic signs, the main of which are 4:
- The border is red, not covered with scales, which forms around the papules.
- Small rashes are visible on a clean area of the skin (they 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 clear, shiny skin border appears around the formation. The symptom is typical of the regression stage of the disease and appears when the papules disappear.
What it looks like
In most cases, the onset of the pathology is unnoticeable: at an early stage, psoriasis affects small areas of the skin, mainly on the folds of the limbs, on the head and along the hairline.
Warning!Initial manifestations occur at the site of constant mechanical irritation of the skin, for example, where clothing rubs and presses.
- 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 and slightly vague border. In the center of the papules, the skin peels off, giving the formations a white color. At this stage, the rash may appear at the site of scratches, skin lesions, bites, cuts, punctures, or burns.
- Stationary.It begins 1-4 weeks after the onset of the disease. New plaques do not appear, old ones acquire a light color, the intensity of peeling decreases.
- Regressive.The color of plaques and papules fades, their infiltration decreases, and the formations dissolve. The average duration of the decay period ranges from 2 to 6-8 months.
Symptoms of the disease depending on the types:
- Plate(common or vulgar). The most common type of pathology. On various parts of the body (most often on the elbows, knees, head), oval or round plates of red color appear, covered with silvery-white scales on top.
- Seborrheic.It occurs mainly on the scalp. It manifests itself as flaking and itching, spreads to the area behind the ears and to the skin along the hairline.
- Pustularthe type is considered the most severe form, develops rapidly and affects large areas of the skin. Painful rashes appear on the body, which are accompanied by a local increase in temperature, weakness, headache, diarrhea. Blisters filled with exudate soon form in the lesions. In the future, the spots progress, merge with each other, forming large lesions on the body.
- Intertriginal.Typical for children, accompanied by the appearance of bright red papules, with slight peeling (may not be there).
- Exudative.The affected areas of the skin not only peel off, but become wet, yellowish crusts form on the surface of the plaques.
- Psoriatic erythroderma.Red plaques with silvery, yellow or white scales are observed throughout the body. It is accompanied by an increase in the lymph nodes, an increase in body temperature. In the future, the formations merge into large spots that cause irritation and itching.
- Psoriatic arthritis.It is accompanied by "joint syndrome", in which the skin in the area of the joints (on the wrists, phalanges of the fingers, on the spine, etc. ) is affected and if measures are not taken in a timely manner, the disease affects thejoints.
- Tearaccompanied by abundant rashes, consisting of many small plaques. In this case, the papules are in the form of drops, their color is from bright red to purple.
- Point.It is characterized by the formation of small spots on various areas of the body, similar to dots, and there may be no peeling of the dermis.
- Rupioid.One of the types of chronic psoriasis. Crusts appear on the formations, become higher, taking the shape of a cone.
- Oldmanifests itself in large papules that do not pass for a long time, sometimes papillomas and warts are formed.
- Psoriatic onychialeads to deformation of the nails, the appearance of yellow-brown spots under them.
- Palm-plantar.It appears on the palms and soles of the feet. The main symptoms are thickening of the skin, dryness, cracking.
- Mucosal psoriasisaffects the oral cavity and provokes the appearance of plaques on the mucous membrane.
Localization of psoriasis
In most cases, rashes appear on the surface of the elbows or between the toes. Less commonly, papules are seen on the forearm.
Warning!The hands are characterized by one form of plaque pathology, but others are also found. His sign are small specks of a red hue, quickly covered with white scales, the affected skin swells.
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 single and small with a clear, but loose, inflamed, and severely flaky outline. These pinpoint papules spread rapidly to form conglomerates.
Often develops against the background of seborrhea, affects the hairline, forming the so-called psoriatic crown. Skin formations gradually grow and spread over the entire surface, resembling dandruff. This localization occurs quite often, less often a rash appears on the ears or behind them.
The nail plate can be affected by the type:
- Thimble- point form of psoriasis. Small pits appear on the nails, which resemble needle prick marks.
- Onychomycosis- the nail changes color, becomes dull, thickens noticeably and begins to flake off. A psoriatic papule surrounded by a reddish border, similar to an oil stain, is visible through the plaque.
It usually manifests as characteristic papules that merge with each other. Psoriasis is more common on the back, less often on the neck, abdomen, hips, formations can be drop-shaped, pointed and plaque-shaped.
It is rarely affected, the rash is found in the nasolabial folds, in the area of 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 at the same time, but there have been cases when the pathology has developed only on the feet or palms. On the sole of the foot, the disease is often combined with fungal pathology, which greatly complicates the diagnosis and therapy.
This type of psoriasis is divided into 3 types:
- Papular plaque- the formations are dense, do not protrude above the skin, it is difficult to separate the scales from the plaque. The rash occurs in the marginal areas, accompanied by edema and keratosis.
- Psoriatic callus- round and dense papules, consisting of keratinized epidermis. The layer of skin gradually thickens and swells. As a result, it is easily injured, cracks appear. There is practically no redness, the size of the growths is from 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 stick together.
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 deformation. External symptoms: a reddish rash appears on the skin. Internal signs: pain in the joints, especially during sleep, stiffness of movements, swelling.
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 already suffer.
Itchy or not
In most cases, psoriatic disease is accompanied by itching of varying degrees of intensity, sometimes not just spots, but itching of the whole body. In the initial stage, itching is mild, gradually increasing.
The degree of intensity also depends on the location of the pathology. For example, psoriasis on the head itches a lot, while the skin peels and falls off in large flakes, larger than normal dandruff. In the stationary phase, the itching decreases, often giving way to the burning sensation. During remission, all major symptoms are mild.
Itching gets worse with:
- climate change;
- general intoxication;
- diseases of the digestive system;
- accession of scabies, allergies;
- HIV infections.
The skin is itchy a lot after drinking coffee, alcoholic beverages, hot and spicy foods, chocolate and other allergens.
How to distinguish
- The nature of the rash.With eczema, the blisters or blisters are filled with fluid that periodically oozes. Psoriasis is characterized by the appearance of dry scaly papules, when it is removed, blood appears.
- 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 malfunctions in the body.
- 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 the diseases are similar, but there are several features by which you can distinguish them:
- for psoriasis, an unhealthy sheen of the skin and bleeding cracks are characteristic, and this is not observed with seborrheic dermatitis;
- dermatitis, unlike psoriasis, is not accompanied by skin enlargement and its severe dryness;
- with psoriasis, the scales are silvery, and the seborrhea is yellow or white;
- seborrheic scales are easily removed, but psoriatic scales are not;
- dermatitis is most often observed in the places of accumulation of the sebaceous glands, and squamous diseases - throughout the body;
- scalp psoriasis protrudes significantly beyond the hair growth area and seborrheic pathology does not cross this line;
- the area of the lesion with scaly lichen is much larger than that of dermatitis.
From the mushroom
- Psoriasis appears in the presence of several provoking factors, for example, heredity, mechanical damage to the skin, malfunction of the immune system, and so on. The causative agent of the second disease is only the spores of parasitic fungi.
- Psoriatic pathology is not contagious, it is not transmitted either by airborne droplets, nor sexually, nor through touch.
Warning!Fungus (onychomycosis) affects any contact, even in public places: saunas, swimming pools, gyms, and so on. It is transmitted by animals and people.
- 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 nails do not change.
From the pink lichen
The hallmark of psoriasis is the "psoriatic triad". The disease gradually grows and goes through 3 stages. Pityriasis rosea (pityriasis) develops rapidly and progresses steadily. Also, pityriasis is a contagious disease, but squamous lichen is not.
- Atopic dermatitis (neurodermatitis) is of allergic origin and is triggered by a certain substance, such as plant pollen, food, animal hair, and so on. The causes of psoriasis are different (heredity, reduced immunity, psychosomatic, mechanical damage to the skin, and so on).
- With neurodermatitis, the skin dries up and becomes rough and with psoriasis it becomes scaly and bleeds.
- Plaques with dermatitis consist of small separate elements, 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.
The difference between gouty and psoriatic arthritis lies in the cause of development. Gout occurs when uric acid crystals are deposited in the cartilage of the joints. Deviation from the norm can be provoked by: arterial hypertension, obesity, taking diuretics, alcohol consumption, and so on.
The symptoms of psoriasis and gout are similar: severe night pain, stiffness in movement, redness and swelling in the affected area. However, with psoriasis, in most cases, characteristic red rashes appear first and then 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).