Psoriasis

Psoriasis (scaly lichen) is a chronic non-infectious autoimmune skin disease of unknown origin.Its most common manifestations are peeling of the skin (including the scalp) and the presence of rashes.Psoriasis can cause pathological changes in other organs: nails, spine, joints and kidneys are most often affected.

The disease causes strong psychological distress in the patient;due to the presence of defects in appearance, it becomes difficult for a person to adapt to the team and communicate with people.Severe forms of psoriasis can lead to disability.It is impossible to completely cure the pathology.However, adequate treatment allows you to achieve a stable remission and restore your previous quality of life.

What is psoriasis

The main symptom of the disease is the presence of psoriatic plaques: flaky pinkish spots of different sizes, accompanied by itching.Most often they are located on the scalp (they can also be present along the hairline, behind the ears), on the elbows, on the knees and can also occur on the genitals, buttocks, lower back and other parts of the body.Sometimes plaques appear on old scars.The pink color of the rash is due to the fact that the vessels in the affected areas dilate.

Psoriasis develops due to a malfunction of the immune system.In each layer of the epidermis (there are 5 of them in total: basal, spinous, granular, lucid and horny) there are keratinocytes (about 90% of them in the entire epidermis).Depending on the layer in which they are located, keratinocytes perform different functions (regeneration, synthesis of keratin or other proteins, prevention of skin dehydration, protection of the lower layers of the skin).

Keratinocytes are constantly renewed.Their synthesis occurs in the basal layer.Then they move higher, where each time they perform a new function.Once they reach the stratum corneum they lose their nucleus and transform into corneocytes (particular sacs containing keratin).Now their function is barrier.After surviving their lives, corneocytes exfoliate from the surface of the skin.Keratinocytes live for about 2-4 weeks, then are replaced by new ones.

With psoriasis, under the influence of a malfunction of the immune system, keratinocytes begin to divide much faster and their lifespan is reduced.Peeling occurs, accompanied by inflammation of the epidermis and dermis.

Psoriasis can develop in a person of any age (in total about 4% of the world's population suffers from it).However, the disease occurs more often in people under 20 years of age and over 55 years of age.Fair-skinned people suffer from psoriasis quite often;among representatives of the Negroid race, pathology is detected much less frequently.

Causes of psoriasis

The exact causes of psoriasis have not yet been identified.However, the most common are 2 theories about the origin of this disease:

1. Hereditary disease: The tendency to develop psoriasis is believed to be transmitted genetically.
2. A consequence of immune disorders caused by infections, inadequate lifestyle, climatic conditions and bad habits.

Reference!In 40% of patients suffering from this pathology, relatives also suffered from psoriasis.In addition, close relatives of patients often experience a latent form of psoriasis, manifested by changes in the structure of capillaries.

Most often, the "push" to start the development of psoriasis is emotional overload (in 50% of cases), focal infections, metabolic disorders, diabetes mellitus, liver disease and the use of certain drugs (most often glucocorticosteroids, beta-blockers, lithium salts).

There are other factors that "trigger" the disease or cause its exacerbation:

• Injuries, fractures.
• Freezing.
• Sunburn.
• Smoking tobacco.
• Alcohol abuse.
• Obesity.
• Skin damage caused by chemicals.
• Food allergies.
• Parasitic infestations.
• Pregnancy and childbirth.
• Other skin diseases: eczema, dermatitis.

Reference!It is absolutely known that psoriasis is not contagious.The development of pathology in people whose close relatives suffer from this disease is explained by genetic predisposition.Psoriasis is not spread from person to person.

Types and stages of psoriasis

There are many forms of psoriasis, but some are the most common:

1. Common psoriasisdevelops more often.It is characterized by the presence of itchy plaques with a scaly surface on the skin.Also, with this form, discoloration of the nails and the appearance of small white spots on them is often observed.In some cases (in advanced stages), the nails move away from the nail bed.
2. Guttate psoriasisit manifests itself as a small skin rash, located mainly on the chest and back.The rash is accompanied by itching in the areas where the skin is affected.Usually the symptoms of the disease disappear after 4-6 months and do not appear again.However, the patient may later develop another form of psoriasis.This happens about half the time.Guttate psoriasis is usually found in children and adolescents.It often develops following an infection, most often after a bacterial throat infection.
3. Reversible psoriasisresponds well to treatment, sometimes it is possible to achieve stable remission without relapse.The red, weeping plaques appear only in some parts of the body, in the folds, and do not spread further.Rashes usually appear in the groin area or under the mammary glands, even in the armpits.Reversible psoriasis develops more often in elderly patients.
4. Pustular psoriasisit is a serious and dangerous form.In some cases it develops quickly and suddenly.It is characterized by the appearance of blisters with purulent contents on the soles of the feet and palms, then the affected skin thickens and begins to actively peel off.Subsequently, the rash spreads over large areas.In advanced cases, the skin all over the body may be affected.Pustular psoriasis can threaten the patient's life.It mainly affects adults.

Psoriasis develops in 3 stages:

1. Progressive.
2. Stationary.
3. Regressive.

Progressive phasecharacterized by the appearance of multiple nodular eruptions and their spread to new areas of the body.The plaques gradually increase in size.

In stationary phasethe appearance of rashes stops.Existing plaques stop increasing in size, but active peeling begins on the entire affected surface.

In a regressive phaseplaques become denser, their elements dissolve, peeling decreases.Thus, pigmentless spots remain at the site of the rash.

Reference! Psoriasis can also be classified based on seasonality: there are summer and winter forms, depending on the development of flare-ups.Most often, relapses occur even more often in the autumn-winter period than in the spring-summer period.

Symptoms of psoriasis

The symptoms of psoriasis are:

• Pink rashes or white patches covered with scales.
• Itching in the affected areas.
• Vascular changes.
• Signs of inflammation in the affected tissues.
• Deterioration of the appearance and condition of the nails.

Reference!About 1 in 10 patients develop arthritis due to psoriasis.Therefore, it is necessary to start treatment as soon as possible to prevent the development of complications.

Diagnostics

Psoriasis has a very characteristic clinical picture, so the diagnosis is usually not difficult.If you scrape off the papules (plaques), 3 main phenomena are observed:

1. Stearin stain: with light scraping, the peeling intensifies and the rash becomes similar to a drop of crushed stearin.
2. Terminal film: If you remove scales from the surface of the plaque, it will have a shiny, moist surface.
3. Bloody Dew: If you scratch the terminal film, pinpoint drops of blood appear on it.

In some cases, a piece of dead skin is taken for analysis for differential diagnosis.

Treatment of psoriasis

The main goal of medical measures is not to cure the patient (since this is impossible), but to achieve stable remission.A comprehensive treatment is carried out, the plan of which is developed based on the course of the disease in a particular person.Includes:

• Local drug therapy: ointments, creams, shampoos, aerosols, lotions.
• General drug therapy: injections of antihistamines, sedatives, vitamins, treatment with immunosuppressants, cytostatics, retinoids, corticosteroid hormones.
• Maintenance therapy: the patient is prescribed ultraviolet irradiation along with taking a dermatotropic agent.
• The use of detoxification methods: the appointment of immunomodulators, procedures that purify the blood.
• In some cases, taking non-steroidal anti-inflammatory drugs.

If concomitant diseases are diagnosed, they are also treated.

Lifestyle with psoriasis

The patient must take into account that the treatment of the disease will last a lifetime.In many ways, the duration of remission depends on this.It is important to abandon bad habits (smoking, drinking alcohol).You also need to follow a diet.Exclude from the diet citrus fruits, whole milk, chocolate, honey, eggs, foods containing red pigment (strawberries, watermelons) and other foods that can provoke the development of allergic reactions.It is also advisable to avoid spicy, fatty, fried, smoked foods, broths rich in meat and fish.Condiments are excluded: ketchup, mayonnaise, mustard, etc.You should limit your intake of sugar and salt.You should pay attention to products containing fiber, Omega acids, vitamins A, E, C, group B, as well as zinc and calcium.

The following simple measures will help alleviate the condition:

• Refusal to stay in the water for a long time: you should swim and bathe less often, it is recommended to take a short shower.
• Hard wipes should be replaced with a soft sponge or cotton cloth and regular soap with a neutral pH product.
• After the shower, you should not dry yourself, but pat your skin with a towel - this will avoid damaging the plaques and increasing itching.
• After water procedures, the skin should be moisturized with cream.
• It is necessary to give preference to spacious and light clothes made of soft natural fabrics, since the pressure of clothing on the skin can provoke the development of new rashes.
• Itching often forces the patient to scratch, which can cause skin lesions: to avoid new damage, it is best to cut nails short.
• Drying out the skin should be avoided, so avoiding air conditioning will be helpful, as will humidifying the indoor air.
• While sunbathing can be beneficial for psoriasis, excessive exposure to ultraviolet light can aggravate the disease—you should consult your doctor about your sun exposure regimen.
• Any risk of skin irritation must be avoided.
• Cuts and wounds can cause new rashes to appear, so you need to protect yourself from them.
• Stress is a common trigger for disease exacerbation, so traumatic situations should be avoided whenever possible.
• It is necessary to avoid physical inactivity (inactivity): moderate physical activity will benefit the condition of the entire organism.

If you feel worse, you should see a doctor immediately to prevent the disease from progressing to a more serious stage or complications from occurring.