Psoriasis is a chronic non-infectious disease, dermatosis, which mainly affects the skin.The autoimmune nature of this disease is currently presumed.Typically, psoriasis is manifested by the formation of red, excessively dry and raised spots above the surface of the skin - the so-called papules, which merge with each other to form plaques.These papules are by nature sites of chronic inflammation and excessive proliferation of lymphocytes, macrophages and skin keratinocytes, as well as excessive angiogenesis (formation of new small capillaries).
It occurs with equal frequency in males and females and lasts for years with alternating periods of relapses and remissions.This is one of the most common dermatoses, difficult to treat and often serious.
What is psoriasis?
Psoriasis is a widespread chronic skin disease characterized by a monomorphic eruption of flat papules that tend to converge into large plaques that quickly become covered with silvery-white scales.
Psoriasis is characterized by periods of worsening (relapses) and temporary well-being, when the manifestations of the disease become less severe.This disease is not contagious and the patient is not dangerous to others.Because the appearance of psoriasis is not associated with microorganisms.
The main element of psoriasis is a single pink or red papule, covered with a large number of loose silvery-white scales.
As a rule, psoriasis does not interrupt the patient's usual rhythm of life.The only drawback is peeling and inflammatory processes on the skin.Unfortunately, it is impossible to cure this disease, but it is quite possible to stop its development or prevent relapses.To do this, it is enough to follow all the doctor's prescriptions and undergo systematic treatment in the hospital.
Is psoriasis contagious?
Psoriasis is absolutely not contagious.Not a single case of person-to-person transmission of the disease has been recorded.The causative agents of the disease are not infections and microbes potentially dangerous to others, but leukocytes produced by the patient's body.
It is impossible for a healthy person to contract psoriasis from a patient.Psoriasis is not transmitted:
- In case of contact with the skin, through the use of the same household items with the patient (bed linen, towels, dishes).
- Through saliva, sweat.
- Sexually.
- When taking care of the sick.
- Through the blood.
Classification
Experts distinguish two forms:
Non-pustular form of psoriasis
Things?This form of the disease differs from others in its stable course.The non-pustular form of psoriasis is characterized by damage over almost the entire surface of the body.This typology includes:
- erythrodermic psoriasis
- vulgar, ordinary or tabula.
Ordinary psoriasis occurs quite often;up to 90% of patients suffering from psoriasis are patients suffering from the vulgar form of this disease.
Psoriatic erythroderma is a serious disease that often leads to a fatal outcome - the death of the patient.With the disease, a violation of the thermoregulatory function occurs and the barrier function of the skin is reduced.
Pustular
- Zumbusch pustular background or generalized pustular
- palmoplantar (pustular psoriasis of the extremities, chronic persistent palmoplantar pustulosis)
- Annularly pustular
- palmoplantar
- psoriatic impetigo herpetiformis
| Stage of psoriasis | Damage percentage |
| Light | less than 3% of the skin is affected |
| Average | 3-10% of the skin is covered with psoriatic plaques |
| Heavy | joint lesions are present or more than 10% of the skin is involved. |
How psoriasis begins: first signs
In most cases, identifying psoriasis is quite simple, because the disease is not similar to other skin conditions.Allergic rashes have a smaller calibration than psoriasis spots, and anamnesis shows that patients practically do not suffer from swelling of the skin, as in allergies
The initial symptoms and signs of psoriasis differ in the main characteristics that the doctor will rely on to make the diagnosis:
- the appearance of a limited pink spot of varying intensity;
- skin itching in the area of psoriatic lesions;
- exfoliation of large quantities of epidermis of various sizes;
- characteristic peeling whitish colour;
- the appearance of grouped dirty white or gray crusts that do not extend beyond the borders of the psoriatic patch;
- dry skin.
Psoriasis is characterized by three distinctive features:
- "Stearic stain effect."When scraping the plaque, the small, transparent scales come off easily.
- "Terminal film effect".If you remove the scales, the skin in this area will be thin, shiny and red.
- “The Bloody Dew Effect.”After scraping, tiny droplets of blood appear on the skin.
Causes
Experts are unable to identify the exact and sole culprit of the disease, but repeated studies show that the disease is autoimmune, meaning it depends on the functioning of the immune system.
For some unknown reason, immune cells, designed to protect the body from malignant changes and bacterial and viral damage, penetrate the upper dermal layers and produce substances that trigger the inflammatory process.The result of this activity is proliferation - accelerated division of skin cells.
According to another theory, psoriasis develops due to a disruption in the life cycle of keratinocytes.
Possible causes of psoriasis:
- Inheritance.According to the latest scientific data, psoriasis is classified as a genotypic dermatosis with a dominant type of transmission.
- Violation of lipid, protein and carbohydrate metabolism.When skin psoriasis is suspected, changes in these blood profiles often occur, contributing to the development of cardiovascular disease, endocrine dysfunction, and metabolic syndrome.
- The presence of a chronic infectious focus in the body.When examining psoriatic plaques, streptococcal flora is often detected.The occurrence of genetic abnormalities can be affected by viral and bacterial infections, for example, tonsillitis, influenza.
- Climatic conditions - dry and hot climate can influence the progression of psoriasis, intensify skin manifestations or, on the contrary, weaken them;
- Anxiety or stress: as previously mentioned, excessive strain from stress directly affects the course of the psoriatic disease;
- Skin damage: wounds facilitate infection, and this leads to intoxication of the body due to inflammatory processes, so the appearance of psoriasis can cause minor damage, but provided that there are concomitant diseases;
- Infections - psoriasis epidemics can be caused by the presence of purulent and inflammatory pathogenic areas, especially due to childhood pathologies.
One theory suggests the existence of two variants of the disease:
- Type I psoriasis– it is inherited in the presence of an immune factor, more than 60% of all patients under the age of 30 suffer from this form, the prognosis is good, treatment is carried out throughout life.
- Type II psoriasis– occurs more often after the age of 45, is not associated with malfunctions of the immune system, affects nails and joints more often.
Symptoms of psoriasis
Skin psoriasis can develop at any age.But often the first case of its manifestation occurs in young people and adults from 18 to 40 years old.There are no differences by gender.Men and women suffer from this disease with the same frequency.
| Signs of psoriatic papules | |
| Module | round |
| edges | clear |
| Color | hot pink or red |
| Scale color | silver white |
The first rashes, as a rule, are formed on the site of wounds, scratches, frostbite, burns and on areas of the body that are constantly exposed to friction.They may itch, but this is not the main symptom.
Depending on the characteristics of the rash, the following forms of psoriasis are distinguished:
- Punctate psoriasis: the size of the elements is smaller than the head of a pin.
- Teardrop-shaped: The papules are teardrop-shaped and reach the size of a grain of lentil.
- Coin-shaped: the plates grow up to 3-5 mm and have rounded edges.
The shapes of the eruption are also distinguished when its elements look like rings, arches and garlands, geographical maps with jagged edges.
The general clinical picture and symptoms of psoriasis vary significantly depending on the stage of the disease.Dermatologists distinguish 3 phases that develop sequentially:
- Progressive.New skin lesions constantly appear, and there is also an active spread of existing plaques with severe peeling and itching.
- Stationary.The growth of papules on the body stops slightly, new formations do not appear, but on the surface of the skin, near the plaques, thickened folds appear.
- Regress.The spread of the disease and increased peeling are not observed.When the signs of psoriasis fade, areas of significant pigmentation remain on the body.
The alternation of these phases gives rise to the wave nature of relapses and remissions.A patient may have different stages of the disease in different areas of the skin.
Initial psoriasis is manifested by the appearance of papules, which are small scaly nodules.They have a dark pink color, are dense to the touch and protrude slightly above the surface of the skin.
The first sign of psoriasis may be the appearance of a rash on areas of the body that are more likely to be subject to friction, and the skin in these areas is dry.These are the places:
- palms or elbows;
- below the knees;
- shins;
- lateral parts of the lower back;
- inguinal folds;
- scalp.
The initial stage of psoriasis on the skin is barely noticeable and does not cause discomfort to the patient.But it is early treatment that will help avoid severe forms of this disease, in which fingernails, toenails, mucous surfaces, and then human joints are affected.
According to statistics, psoriatic plaques are found most often:
- on the external surface of the joints;
- on the back and stomach;
- on the front of the thighs and forearms.
This is different from eczema, in which the rash affects the insides of the limbs and the creases between the toes.