Psoriasis is a severe systemic dermatological disease.The disease is characterized by a chronic course, with a complex course, with periods of exacerbation followed by remission.Psoriasis can take on various forms, requires an integrated approach to treatment and is dangerous with a number of complications.
What is psoriasis?
Psoriasis is a dermatological disease that can occur in adults and children.
Psoriasis is a non-infectious inflammatory disease of the epidermis.The pathology is characterized by changes in the skin, which manifests itself in the form of peeling and nodular formations.
The peculiarity of psoriasis is its chronic wave-like course.The disease cannot be completely cured; therapy is aimed at reducing symptoms and visible manifestations of the disease.Periods of exacerbations are followed by periods of remission, which can last from several months to several years.It is the duration of remission that is the criterion for assessing the effectiveness of the chosen treatment regimen.
Psoriasis first appears at a young age.The disease can progress, causing complications in the joints.According to statistics, psoriasis shortens life expectancy by an average of 7 years.
Despite the fact that it is impossible to cure the pathology, the disease cannot be left to chance.If alarming symptoms appear, you should consult a dermatologist.A correctly selected treatment regimen will allow you to live life to the fullest, without worrying about inflammation of the epidermis.
Reasons for the development of psoriasis
The exact reasons for the onset of the pathological process have not been established.There are several theories about the occurrence of this pathology.
- Autoimmune nature of the development of the disease.This theory is quite widespread.Many doctors are inclined to believe that inflammation of the epidermis is a consequence of an immunopathological malfunction in the body, as a result of which the human immune system begins to chaotically attack epidermal cells in different parts of the body.In response to such an attack, skin inflammation occurs.This theory is also supported by one of the most common complications of psoriasis – psoriatic arthritis.In this case, the pathological process spreads from the skin to the connective tissue of the joints.
- Genetic theory.This theory explains why people with psoriasis can have children with the same diagnosis.In this case, genetic characteristics only indicate the chance of developing the disease, but do not predetermine psoriasis.For example, if parents are prone to various dermatitis, they are diagnosed with psoriasis or severe forms of eczema, there is a risk that children will also develop chronic inflammation of the epidermis.Nevertheless, quite often, patients with psoriasis give birth to completely healthy children, who may never encounter any dermatological diseases in their entire lives, not to mention psoriasis.
- Neurogenic theory.Another fairly common explanation for the causes of the development of the disease is neuropsychic stress.In studies conducted back in the middle of the last century, it was found that patients with psoriasis have increased levels of the neurotransmitter acetylcholine in the nerve endings of internal organs and the epidermis.In response to neuropsychic stress, this neurotransmitter can theoretically provoke the development of inflammation in the epidermis.In addition, dysfunctions in the brain stem and autonomic vascular disorders were also identified in patients with psoriasis.All this indicates the neurosis-like nature of the disease.
- Exchange theory.Presumably, psoriasis may be a consequence of a general metabolic disorder.Lack or impaired absorption of certain vitamins and minerals can lead to changes in the structure of the epidermis and make it susceptible to negative influences that cause inflammation.
Provoking factors
Having understood the probable causes of the development of the disease, you should pay attention to factors that could potentially lead to the onset of inflammation.Here we are talking about unique triggers or triggering mechanisms, under the influence of which either the primary manifestation of psoriasis occurs or an exacerbation after remission.Such triggers include:
- infectious diseases;
- parasite infection;
- hormonal changes;
- stress;
- allergic reactions;
- immunodeficiency;
- skin damage;
- aggressive external influences on the epidermis.
Infectious diseases lead to disruption of the immune system.Often, after severe infections, adolescents and young adults experience a primary manifestation of psoriasis.From this moment on, a person is given a diagnosis that remains with him for life.Infections are not the direct cause of the disease, but provoke its manifestations.Also, parasitic infestations in the liver can trigger the onset of inflammation.
The primary manifestation of psoriasis due to hormonal imbalances is more often encountered by young women or adolescents.Puberty is associated with pronounced changes in the functioning of the body and rapid growth, which leads to disruption of the immune system and theoretically can act as a trigger for the onset of skin inflammation.
Given the increased amount of acetylcholine, stress is one of the most obvious triggers.
Severe stress causes the primary manifestation of psoriasis in 65% of cases.The same condition can lead to interruption of remission and the onset of exacerbation.
Symptoms of psoriasis can also appear in areas of severe skin damage.Thermal effects, burns, deep wounds - all this is potentially dangerous for a person with a tendency to this disease.Damage to the epidermis can lead to the onset of exacerbation and is especially dangerous in the early stages of the disease, since plaque-like neoplasms form at the sites of injury.In some patients, exacerbations occur due to ultraviolet exposure.
Is psoriasis contagious?
The photo describes the peculiarity of the symptoms of psoriasis disease very clearly.If the inflammation is localized in open areas of the body that are visible to others (forearms, hands and palms, face and neck), patients may encounter misunderstanding and disgust.However, despite the specific symptoms, psoriasis is not an infectious disease, which means it is not at all contagious.
Contact with the skin of a patient with psoriasis is absolutely safe for a stranger.The disease is not transmitted by airborne droplets, hematogenous or sexual contact, as it is a consequence of internal disorders in the body, but not exposure to pathogenic microbes.
Many people are intimidated by the appearance of psoriasis-affected skin.This can have a negative impact on the patient's sense of self, which often leads to psychological problems such as complexes and dissatisfaction with oneself.A person who is diagnosed for the first time will face problems in society.In some cases, doctors recommend a course of psychotherapy to accept your illness and social adaptation.
The mechanism of development of psoriasis
The mechanism of development of the disease psoriasis is the excessive proliferation of the main cells of the epidermis, keratinocytes.This process entails the development of inflammation, which is manifested by the infiltration of the skin by lymphocytes and macrophages.Visually, this is expressed in a change in the structure of the epidermis.It becomes dense, keratinization appears.The skin with psoriasis is very flaky.
The inflammatory process leads to changes in blood microcirculation in the affected area.Due to the thickening of the epidermis, severe fragility of the capillaries is observed, as a result of which the affected areas acquire a purplish-purple color.
Flaky skin particles on the surface of the plaques lead to the formation of a grayish tint.Psoriasis is also characterized by severe dryness of the epidermis.
The process of formation of new foci of the disease is called progressive psoriasis.This stage takes a certain period of time and then gives way to the stationary stage.It is characterized by the absence of any changes in the nature of the rash or the number of skin lesions.
The stationary stage is eventually replaced by a regressive stage.At the same time, the plaques decrease in size, gradually heal and become almost invisible.Clearing the skin of inflammation is the beginning of remission.It is impossible to predict in advance how long it will last, but sooner or later remission is again replaced by a progressive stage of the disease.
Characteristic signs of psoriasis:
- chronic undulating course;
- specificity of foci of skin inflammation;
- progression with each exacerbation;
- changes in the epidermis and capillaries in the affected area.
The specific treatment methods for psoriasis depend on the form of the disease.In total, several clinical forms are distinguished, with characteristic symptoms and course features.
Classification of psoriasis - clinical forms and features of symptoms
Symptoms of psoriasis depend on the form of the disease.This pathology is characterized by a wide variety of forms and symptoms, which makes self-diagnosis difficult.
Based on the type of inflammation, there are three main forms of the disease:
- plaque-like or vulgar;
- pustular;
- teardrop-shaped.
The plaque or vulgar form of the disease is the most common type of psoriasis, diagnosed in 80% of cases.This pathology can affect any part of the body.The disease is characterized by the formation of a dense nodular rash.The skin in the area of the rash becomes inflamed and red.Over time, the nodules merge into fairly large lesions that rise above the skin.
As a rule, with plaque psoriasis there is no itching.There may be discomfort due to dry skin.Itching is usually observed with additional exposure to allergens.
Pustular psoriasis of the skin is characterized by the formation of small blisters filled with light exudate.The disease begins with the formation of dense nodules under the skin, which, increasing in size, take on the appearance of a blistering rash.In this case, the bubbles are located deep in the epidermis, hurt when pressed and are easily damaged.The skin around the pustules swells, turns red, and over time begins to peel with easily detachable scales.Most often, the disease affects the skin of the feet, arms, and back, but can also spread to the body.
Guttate psoriasis gets its name from the characteristic appearance of the rash.It is shaped like a drop, with a pronounced border.The skin around the elements of the rash swells, turns red, and may itch and hurt.In the center of the rash, the epidermis does not change.The teardrop form of the disease occurs in a generalized form, that is, the pathology spreads to the entire body.
Psoriasis can affect any area of the body.Additionally, the following forms of the disease are distinguished according to the localization of the rash:
- psoriasis of the flexor surfaces;
- psoriatic onychodystrophy;
- arthropathic psoriasis;
- psoriatic erythroderma.
Psoriasis of the flexural surfaces affects only the skin folds.The rash does not look like plaques, but appears as small red spots with a smooth and shiny surface.The areas where the disease spreads are the inguinal folds, armpits, and the area under the mammary glands in women.The pathology occurs in a fairly mild form, but is dangerous due to the addition of a secondary infection due to damage to the spots.Most often, this form of the disease is aggravated by mycoses.
Onychodystrophy due to psoriasis is a lesion of the nail plates.Pathology rarely acts as an independent disease, most often being a complication of plaque psoriasis on the feet and hands.The disease manifests itself as a change in the color and structure of the nail plates.They turn pale and become brittle.In advanced forms, this leads to complete irreversible destruction of the nails.
Arthropathic psoriasis also rarely acts as an independent disease.This is a systemic pathology that affects connective tissue.This form of the disease is characterized by inflammation of the epidermis and joints.Psoriatic arthritis affects the small joints of the fingers and toes, causing them to become deformed.In severe cases, this is dangerous due to the development of disability due to loss of motor function in diseased joints.
What the symptoms of psoriatic arthritis look like is clear from the photo - this is swelling and thickening of the fingers, deformation of the joints, and limitation of mobility
How psoriasis begins: initial stage symptoms
In severe cases of pathology, the affected areas can merge, forming extensive symptoms.
What exactly psoriasis looks like at the initial stage depends on the form of the disease.Psoriasis vulgaris begins with the formation of dense nodules under the skin.They rise above the epidermis, are easily palpable, but do not cause discomfort.The skin around the nodules quickly begins to peel off.After some time, the nodules merge into large foci of the rash, and a plaque forms.
Pustular psoriasis begins with lumps deep under the skin, which are outwardly invisible, but can be easily felt.The skin around the elements of the rash swells and hurts when pressed or mechanically damaged.
Guttate psoriasis is the formation of small rash elements on large areas of the skin.The most common localization areas are hips, chest, and back.The rash looks like drops with a pronounced border.
To understand what psoriasis looks like at the initial stage, you should know the specifics of skin changes during inflammation - nodules appear earlier, later they merge, and only then large plaques form.
In the initial stages of the disease, peeling is moderate, regardless of the form of the disease.As it progresses, the skin changes, becomes dense, and large areas of peeling appear.
Symptoms and characteristics of different forms of the disease
What psoriasis looks like on the body depends on the form of the disease.Each type of pathology has its own characteristics.
Features of vulgar psoriasis:
- localization: legs, arms, forearms, back, chest, neck;
- forms of rash: large dense plaques with abundant peeling;
- There is no discomfort other than a feeling of tightness;
- After the plaques heal, spots remain on the skin.
Psoriasis vulgaris leads to disruption of pigment production in the affected area.After the plaques resolve, when they completely heal and disappear, age spots resemble psoriasis.In place of the plaques, there may be brown spots, light areas due to insufficient pigmentation, or purple spots that look like scars.
Specifics of symptoms of pustular psoriasis:
- localization: distal ends of the limbs;
- form of rash: dense blisters with uninfected (non-purulent) exudate;
- secondary symptoms: pain and itching, general malaise, fever;
- there is a risk of infection of the rash elements.
Pustular psoriasis is the most severe form of the disease.In rare cases, it acquires a generalized form, affecting the skin of the entire body.In this case, the bubbles can merge into large formations.After their resolution, scars may remain on the skin.
Guttate psoriasis is characterized by the following features:
- localization: legs, thighs, shoulders, neck, hairy areas of the skin of the body;
- rash shape: small dots, drops or circles, with swollen skin around the rash;
- there is no pain or itching;
- There may be an increase in body temperature when a rash appears.
Guttate psoriasis quite often develops against the background of decreased immunity after infectious diseases, despite the fact that the disease itself is autoimmune and not infectious.This form of the disease often first appears in adolescence after a streptococcal infection.
Diagnostics
An experienced doctor can easily identify the symptoms of psoriatic diseases through a visual examination.
Plaque psoriasis is diagnosed quite simply.An experienced dermatologist needs only a visual examination to make a preliminary diagnosis.Additionally, a test for the so-called psoriatic triad is performed.This is a specific skin reaction that occurs in response to plaque scraping.
Guttate psoriasis is also diagnosed based on visual examination.For pustular psoriasis, differential diagnosis is carried out with bacterial skin diseases.
In case of psoriasis of the flexor surfaces, it is necessary to conduct an additional examination to exclude the fungal nature of the skin inflammation.Specific laboratory tests are not required, since psoriasis does not lead to changes in the composition of the blood.
How to treat psoriasis?
How psoriasis can be cured depends on the form and severity of the symptoms.The pathology cannot be completely cured; therapy is aimed at achieving stable remission.The peculiarity of psoriasis is that there is no universal treatment regimen.For psoriasis, treatment includes:
- drug therapy;
- nutrition adjustments;
- physiotherapy;
- spa treatment.
There are a number of basic drugs, but they are not suitable for all patients.The doctor's first priority is to determine the types of medications that are appropriate for a particular patient.Moreover, in some cases it is necessary to try a dozen different drug treatment regimens before the optimal direction of drug therapy is selected.
Ointments and creams for skin
How can psoriasis be cured? Scientists and doctors have been struggling with this question for decades, but there are still no drugs that effectively relieve the disease.Conservative therapy suggests using ointments and creams for the skin.
Agents for external use are divided into indifferent and hormonal.
Hormonal ointments are unsafe and in some cases cause worsening of symptoms, so dermatologists are increasingly abandoning this method of treatment, opting for indifferent ointments and physical therapy.
Indifferent ointments are preparations with a natural composition, enriched with various vitamins and microelements.They are aimed at reducing inflammation, reducing peeling, and softening the skin.
In the treatment of psoriasis, ointments based on medicinal herbs with anti-inflammatory properties can be used.In the absence of allergies, it is allowed to use preparations with propolis.Ointments containing petroleum products are widely used, which effectively soften the skin.
For severe inflammation, hormonal therapy is used.These are ointments with corticosteroids.In severe cases, injections of such drugs may be prescribed.
Preparations for internal use
In addition to external use, for psoriasis it is necessary to take tablets.If the production of vitamin D is impaired, taking this substance is indicated.Hepatoprotectors must be prescribed, since inflammation of the epidermis negatively affects liver function, especially with long-term psoriasis.
The disease worsens due to stress.Neuroses and other mental disorders lead to a worsening of the disease.In this regard, traditional therapy is necessarily supplemented with sedatives.For psoriasis, sedative medications are prescribed to combat stress.For long-term use, valerian officinalis, motherwort or peony root tincture can be prescribed.
The newest methods of treating psoriasis are methods aimed at suppressing excessive proliferation of skin cells.In severe forms of the disease, immunosuppressants and antitumor drugs may be prescribed.
Physiotherapy
Treatment must be supplemented with physiotherapy.For psoriasis use:
- PUVA therapy;
- ultraviolet irradiation (UVR);
- laser therapy;
- selective phototherapy;
- electrosleep.
Each method has its own characteristics, but all methods of influencing the inflamed epidermis stimulate metabolic processes and stop excessive cell proliferation.
When psoriasis worsens in the summer under the influence of UV rays, it is necessary to carefully approach the issue of physiotherapy.Methods involving ultraviolet irradiation may have the opposite effect and cause symptoms to worsen.
Electrosleep is indicated for severe mental problems and severe stress.This method shows fairly good results in the treatment of psoriasis.
Folk remedies
Therapy with folk remedies for psoriasis includes the use of homemade emollient ointments and medicinal plants with sedative properties.
To reduce swelling of the skin, baths with spruce branches and rubbing the skin with chamomile decoction are recommended.Ointments are prepared on the basis of yolks, butter, lard.Their main goal is to soften the skin, so psoriasis cannot be cured using these methods.
For internal use, decoctions of lemon balm, St. John's wort, and chamomile are recommended.At home, you can prepare sedative tinctures from valerian or motherwort root.
Nutrition for psoriasis
Diet plays an important role in treatment.When psoriasis worsens, it is recommended to exclude allergenic foods from the diet.Since the disease negatively affects the functioning of the liver, you should avoid alcohol, fatty and fried foods.Smoked and pickled foods, processed foods, carbonated drinks and coffee are prohibited.
Preference should be given to vegetables and fruits, lean meat, and fish.For psoriasis, it is useful to eat nuts, as they are rich in B vitamins, which are necessary for the normal functioning of the nervous system.
Spa treatment
Sanatorium-resort treatment is medical care that is provided for preventive and rehabilitation purposes for psoriasis.
Treatment with mineral waters is widely used for psoriasis.Thermal springs of the Carpathians, Bulgaria, and Turkey are recommended for patients.A good result is achieved by visiting sanatoriums and health resorts, where hydrotherapy is carried out with the help of fish that eat dead skin particles.
For psoriasis, sea air and sea salt, medicinal mud are useful.Sanatorium-resort treatment is recommended annually.Together with drug treatment and physiotherapy, this method helps to achieve sustainable remission.
Psoriasis and the army
A mild form of psoriasis does not in all cases exempt you from military service.With widespread psoriasis on the skin, which often worsens, a man can be assigned category “B”, but he must undergo a full medical examination and submit certificates about the results of treatment every six months.
In case of a generalized form of the disease with complications in the joints and the ineffectiveness of immunosuppressive treatment, the man can be assigned category “D”.
Quality of life and prognosis
Psoriasis significantly worsens the quality of life, primarily due to problems of social adaptation in the generalized form of the disease.Complicated psoriasis negatively affects general well-being and impairs the functioning of internal organs, primarily the liver.
Complications of psoriasis extend to the joints.In severe cases, this can lead to deformation, impaired motor activity and disability.
At the same time, properly selected therapy allows the patient to live a full life.Despite the fact that the prognosis for psoriasis is conditionally unfavorable, since the disease is incurable, a person can learn to coexist with his diagnosis.