Psoriasis

Psoriasis is a chronic skin disease characterized by the presence of a monomorphic rash in the form of pink-red nodules with a loose silvery-white scaly surface.The disease lasts for years, alternating periods of relapse and remission are observed.

Typically, this disease causes the appearance of dry, red spots raised above the skin surface, but some people with psoriasis do not have visible skin lesions.These spots are called psoriatic plaques.

However, they can also be located and occur on other areas of the skin, including the palmar surface of the hands, the scalp, the external genital organs, and the plantar surface of the feet.

The fingernails or toenails are also often affected.Nail lesions can occur in the absence of skin lesions and be isolated.

Statistics

The prevalence of psoriasis in the world is estimated at about 1-3% of the population.According to the international organization Europso, in 2010 there were 125 million patients with psoriasis registered on the planet.

Classification

In general, the classification is as follows:

• Pustular psoriasis
  • generalized psoriasis;
  • anular psoriasis (anular pustulosis);
  • palmoplantar psoriasis (extremity psoriasis, palmoplantar persistent chronic pustulosis, Barbera pustular psoriasis);
  • chronic form of persistent acrodermatitis (psoriasis of the soles and palms, palmoplantar psoriasis);
  • psoriatic impetigo herpetiformis.
• Nonpustular psoriasis
  • vulgar psoriasis or psoriasis vulgaris, simple psoriasis (plaque-like, stable psoriasis in chronic form);
  • psoriatic erythroderma (erythrodermatic psoriasis).

Causes

Doctors have not been able to compile a list of the exact causes of psoriasis.I propose to consider the reasons depending on the character.

1. Viral.Viruses that negatively affect the functioning of lymph nodes.It is extremely problematic to identify these microorganisms and determine their habitat.It is noteworthy that the blood of a sick person after transfusion to a healthy patient does not infect.Therefore, this cause of psoriasis is considered unproven.
2. Immune.A generally accepted reason.The trigger mechanism is a gene process in which the immune system is disrupted.
3. Infectious.Initially, scientists were of the opinion that spirochetes, streptococci and even epidermophytons were to blame.The research results did not confirm this theory.New hypotheses indicate that the development of psoriasis is caused by infectious diseases, including tonsillitis and influenza.
4. Genetic.We are talking about the inheritance of a predisposition to the disease.

Predisposing and provoking factors

The key pathological manifestation of psoriasis is the excessive proliferation of defective epidermal cells.Therefore, the fundamental point in elucidating the mechanism of development of the disease and deciding how to treat psoriasis is to establish trigger factors.The main ones:

1. Psychological - the influence of short-term severe stress, as well as unexpressed, but long-term or frequently repeated negative psychological effects, moral dissatisfaction, sleep disturbances, depressive states.
2. Metabolic disorders in the body, dysfunction of the digestive organs, especially the liver and exocrine function of the pancreas.
3. Disease or dysfunction of the endocrine glands (hypothalamus, thyroid, parathyroid and thymus glands, endocrine activity of the pancreas).
4. Immune system disorders (allergic reactions and immune diseases).
5. The presence of chronic foci of infection in the body.
6. Mechanical and chemical damage to the skin, long-term use of antibiotics or glucocorticoids for any diseases, hyperinsolation, smoking and alcohol abuse, acute infectious diseases.

Course of the disease

Psoriasis is a chronic disease, usually characterized by a wave-like course, with periods of spontaneous or caused by certain therapeutic effects of remission or improvement and periods of spontaneous or provoked by adverse external influences (alcohol consumption, intercurrent infections, stress) relapses or exacerbations.The severity of the disease can vary in different patients and even in the same patient during periods of remission and exacerbation within a very wide range, from small local lesions to complete coverage of the entire body with psoriatic plaques.

What are the most common myths about the disease?

• Psoriasis is contagious.No, psoriasis is a chronic, non-infectious skin disease that is not transmitted from person to person and does not migrate from one part of the body to another.
• Climate affects the incidence and if you move to warm countries there will be no psoriasis.No, climate does not affect the prevalence of psoriasis.
• Psoriasis can be prevented.Factors that cause exacerbation, neither by themselves nor in various combinations, are the cause of the disease.Today it is unknown what serves as the initial impetus for the development of psoriasis, and therefore it is impossible to take preventive measures.
• Psoriasis can be treated using so-called traditional medicine.Patients should be extremely careful when approaching such methods.On the one hand, we know that there is no “cure” for psoriasis, but the desire to get rid of the disease at any cost pushes patients to various dubious actions (turning to healers, healers), and this is wasted money.On the other hand, these “healers” offer patients “their own developments” as, for example, external remedies, which, as a rule, contain hormones, but in this case the regimen and, especially, their dosage cannot be controlled in any way.

Severity

Psoriasis is usually classified by severity as mild (involving less than 3 percent of the skin surface), moderate (involving 3 to 10 percent of the skin surface), and severe (involving more than 10 percent of the skin surface).Psoriatic joint damage is regarded as a severe form of psoriasis, regardless of the area of skin damage.

Symptoms of psoriasis

In patients with psoriasis, due to the intensive growth of skin cells, dense areas appear on the skin, which are white, red or silver in color.In a healthy person, the development of skin cells occurs gradually, their exfoliation occurs approximately once a month.Consequently, new cells gradually move to replace old cells in the upper layer of the skin.

In patients with psoriasis, the development of new cells occurs much faster: they are formed not in a few weeks, but in a few days.Accordingly, during this time the upper skin cells do not have time to die, and as a result, the manifestation of the main symptoms of psoriasis occurs - layering and the formation of plaques on the skin.Such plaques in patients with psoriasis vary in size.Their manifestation is observed on different parts of the body - on the scalp, knees, hands, elbows, and lower back.Symptoms of psoriasis most often occur in older people, but the disease can appear in children and adolescents.

Irritated psoriasis

It develops against the background of active exposure to certain irritants on the skin with existing progressive psoriasis, in particular sun rays or specific ointments, as well as other types of irritants that affect plaques.

Exudative psoriasis

This form of psoriasis is characterized by excessive exudate during the inflammatory reaction; it appears as part of the progressive period of psoriasis.

Guttate psoriasis

Guttate psoriasis, the symptoms of which appear suddenly, is characterized by the formation of multiple spots within the skin.

Patchy psoriasis

This form of the disease manifests itself in the form of mild infiltration (in the general definition, infiltration is the impregnation of tissues with one or another substance) from the elements of the rash.They, in turn, look like spots (not papules).Patchy psoriasis develops, as a rule, acutely, and it is also characterized by similarities with toxicerma.

Old psoriasis

This form of the disease can be considered in terms of symptoms in the form of pronounced infiltration from the plaques, their general cyanosis, with a hyperkeratotic or warty surface.

Seborrheic psoriasis

This form of psoriasis, as its name suggests, develops in patients with seborrhea that is already relevant to them.The disease manifests itself on the scalp, in the area behind the ears, on the chest, in the area of the nasolabial folds, in the subscapular and scapular parts of the back.

Palmoplantar psoriasis

The disease can manifest itself either in the form of ordinary psoriatic plaques and papules, or in the form of hyperkeratotic formations simulating calluses and calluses.

Diagnostics

The process of diagnosing psoriasis does not present any particular difficulties and is based on studying the characteristic appearance of the patient’s skin.Laboratory tests or specific studies for psoriasis are not usually performed.However, in some cases with progressive severe psoriasis, a blood test is still necessary to identify inflammatory, autoimmune, and rheumatic processes.

What psoriasis looks like: photos in the initial stage

The primary element of psoriasis is a single pink or red papule, which is covered with a large number of loose silvery-white scales.An important diagnostic sign is the triad of psoriasis: the phenomenon of stearin spots, terminal film and pinpoint bleeding when scraping off the scales.

Quality of life of patients with psoriasis

It has been shown that psoriasis can impair the quality of life of patients to the same extent as other severe chronic diseases.Depending on the severity and location of psoriatic lesions, patients with psoriasis may experience significant physical and/or psychological discomfort, difficulties with social and professional adaptation, and even require disability.

Patients with psoriasis can also be (and often are) overly concerned with their appearance, attach too much importance to it (sometimes to the point of obsessive fixation on this, almost dysmorphophobia), suffer from low self-esteem, which is associated with fear of social rejection and rejection, or with fears of not finding a sexual partner due to appearance problems.

Treatment of psoriasis at home

Psoriasis is a chronic disease.The goal of treatment is positive results so that skin rashes disappear and do not appear for as long as possible.In some cases, psoriasis does not require any treatment.

The question of how to treat psoriasis at home should be divided into 3 main categories: internal use of drugs, mainly medications, external use (ointments) and physiotherapy.Secondary ones are used more often as adjuncts in the treatment of psoriasis.

Regardless of what methods of treating psoriasis the dermatologist chooses, the maximum effect comes from an integrated approach to solving this problem, which involves:

• use of external means;
• internal use of medications, vitamins, dietary supplements;
• connection of physiotherapeutic procedures;
• treatment in sanatoriums with mineral waters, mud, leeches;
• prescription of diet, therapeutic fasting.

Comprehensive treatment of psoriasis recurrence initiated in a timely manner allows for rapid clearing of the skin from the rash and long-term prevention of its reappearance.

Medicines

Drug treatment of psoriasis includes taking various medications orally, using ointments and other remedies.

Taken orally:

• antihistamines;
• hepatoprotectors;
• enzymes;
• energy sorbents;
• antibiotics (a number of penicillins, macrolides and cephalosporins);
• non-steroidal anti-inflammatory drugs;
• immunosuppressants;
• biological products.

Hormonal drugs are used for complex stages of the disease.Use only as prescribed by a doctor.In other cases, it is recommended to do without them.Since they are addictive, although they lead to a quick effect, but not for a long period.In addition, hormonal drugs have a lot of side effects.

External therapy involves applying substances to the skin, such as:

1. Retinoids;
2. Creams with the main active ingredient – grease;
3. Petroleum mixtures;
4. Tar medicines;
5. Keratolytic base preparations;
6. Vitamin D3 complexes on a synthetic basis;
7. Corticosteroids.

Ointments for psoriasis

In the case of a mild form of this pathology, it is sometimes possible to get rid of its symptoms through external means alone:

1. Naftalan ointment is used both in stationary and regressive stages of this pathology.With its help, it is possible to get rid of not only inflammation of the skin, but also itching.
2. Glucocorticosteroid drugs make it possible to reduce the inflammatory process, despite this they cannot be used for a long period of time
3. Salicylic ointment helps soften the horny scales of the skin and also quickly remove them.
4. Sulfur-tar ointment five and ten percent helps reduce the inflammatory process of the skin, however, it should never be used by patients with the exudative form of this pathology.
5. Ointments for psoriasis with vitamin D are endowed with a fairly powerful anti-inflammatory effect and help make the treatment of this pathology more effective.

Phytochemotherapy

Phytochemotherapy is one of the methods of treating psoriasis that involves the use of ultraviolet rays.This method is carried out using special installations that allow the exposure of ultraviolet rays not to the entire skin, but only to its affected areas.This method of therapy is usually used along with a drug called Methotrexate.

PUVA therapy

This is the therapeutic effect of long-wave ultraviolet radiation in combination with special medications, which is used for the most severe forms of psoriasis that are difficult to respond to other treatment methods.The peculiarity of PUVA therapy as a method of treatment is that after recovery, that is, cleansing of the skin, constant maintenance treatment is necessary to maintain remissions.

Innovative treatment methods - new in the treatment of psoriasis

Surgical treatment of psoriasis

It has long been proven that when diagnosed with skin psoriasis, treatment with external medications alone does not give the desired result.For several years now, surgeons have been carrying out a unique operation to surgically restore the valve of the small intestine, which protects this part of the intestine from pathogenic bacteria.After the operation, the protective capabilities of the immune system are enhanced, the skin becomes healthier and long-term remission is observed.

Using narrowband UVB therapy with a wavelength of 311 nm

Recently, the use of this method as monotherapy has been practiced.Compared to other UV treatments, this method has minimal side effects, is well tolerated and is a short-acting technique - a few minutes per procedure, the course of treatment is 2.5 months.In such a short period of time, visible clinical improvement and long-term remission occurs for up to 2 years.

Diet for psoriasis

Patients with psoriasis simply must follow a diet and adhere to the basic principles of proper nutrition.

List of products that form alkali in the body:

• Any vegetables except rhubarb, pumpkin and Brussels sprouts.It is important to remember that potatoes, peppers, eggplants and tomatoes are strictly prohibited.
• Don't exclude fruits.The main thing is not to eat prunes, cranberries, currants and blueberries.It is worth noting that bananas, melon and apples should not be consumed at the same time as other foods.
• Be sure to drink fresh vegetable juices from carrots, beets, parsley, celery and spinach.
• You can consume fruit juices of grapes, pineapple, pear, orange, papaya and grapefruit, mango, lemon and apricot daily.It is important to add lecithin and lemon juice to your food.

List of foods that patients with psoriasis should not eat (they form acid):

• The consumption of foods containing starch, fats, sugar and oils should be eliminated completely or reduced to a minimum.Typically, these include the following products: potatoes, beans, cream, cheese, grains, meat, dried peas.Unbalanced daily consumption of these products inevitably leads to the initiation of acid reactions in the blood.The result is a deterioration in health.
• It is important to properly balance food.There are a number of products whose consumption at the same time is prohibited.For example, meat products with products that contain a large amount of sugars, and you should not combine sweets and starch.
• It is important to limit your sugar intake.Preservatives, vinegar, dyes and various food additives should be included in the diet as little as possible.
• The main point is that it is necessary to completely eliminate the consumption of alcohol and alcohol-containing drinks.

Menu for a week for psoriasis

Let's consider a sample menu for a week, which is recommended for exacerbations, relapses and for prevention during dangerous periods.

1st day

• Breakfast: fresh cabbage salad, a slice of whole grain bread, green tea.
• Second breakfast: 2 hard-boiled eggs, toast, dried fruit compote.
• Lunch: cauliflower soup, whole grain bread, for the main course - buckwheat porridge with mushrooms or vegetables, green tea.
• Dinner: a little unsweetened cottage cheese with sour cream, kefir.

2nd day

• Breakfast: cucumber and tomato salad, apple, green tea.
• Second breakfast: a piece of black bread with butter, 1
• hard-boiled egg, green tea.
• Lunch: cabbage soup without meat, a piece of black bread, green tea.Dinner: apple, glass of fermented baked milk.

3rd day

• Breakfast: fruit salad dressed with yogurt, gooseberry compote.
• Second breakfast: vegetable salad, a slice of whole grain bread, green tea.
• Lunch: boiled fish (pike perch, catfish) with a minimum amount of salt, a slice of whole grain bread, gooseberry compote.
• Dinner: yesterday's bun, gooseberry compote.

4th day

• Breakfast: cucumber and egg salad with sour cream, whole grain toast, apple juice.
• Second breakfast: 2 bananas, 1 glass of fermented baked milk or kefir.
• Lunch: a cup of broth, a piece of boiled meat, a salad of cucumbers and tomatoes.
• Dinner: a slice of whole grain bread with butter, a glass of kefir.

5th day

• Breakfast: carrot salad, whole grain toast, green tea.
• Second breakfast: boiled fish (not red).
• Lunch: river fish soup, a slice of whole grain bread, green tea.
• Dinner: yesterday's bun, a glass of kefir.

6th day

• Breakfast: oatmeal with water, a piece of bread with bran, green tea.
• Second breakfast: cottage cheese with fruits (bananas, apples, apricots), kefir.
• Lunch: pea soup without meat, a piece of bread (any kind), an apple.
• Dinner: a glass of kefir.

7th day

• Breakfast: buckwheat porridge with milk, kefir.Second breakfast: a sandwich with butter and a piece of boiled meat, apple juice.
• Lunch: soup with meatballs, green tea.Dinner: 2 apples.

Traditional methods of treating the disease

Cleansing the body with psoriasis is often carried out using folk remedies.For these purposes, various products of natural origin, as well as herbs, are used.So, we’ll figure out how to treat psoriasis using traditional methods later in the article.

Prescription medications for oral use

To cleanse the skin and eliminate the main symptoms of psoriasis, the following recipes are recommended:

1. Using flax seeds.To prepare the product, pour a tablespoon of seeds into a glass of boiling water and mix thoroughly.The product must infuse for at least 12 hours.It is better to leave the medicine overnight.Take the infusion in the morning on an empty stomach.
2. Bay decoction.A decoction of bay leaves has a good effect.To do this, add 10-15 medium-sized leaves to a liter of boiling water and let the product simmer for 15-20 minutes over low heat.At the end, strain the broth and cool.Take 1 tbsp.l.three times a day for 20-30 days.

Products for external use

To get rid of plaques and cleanse the skin, use the following recipes:

1. Treatment of lesions with linseed oil.You can apply the oil 5-6 times a day.
2. Ointment based on tar and propolis.To prepare, you need to take 50 g of tar and 30 g of propolis.The products must be heated in a water bath and mixed thoroughly.After cooling, apply the ointment to the plaques 3-4 times a day.
3. Fish oil in its pure form cleanses the skin very well.It is applied to the affected areas in a thin layer and left for 30-40 minutes.

Treatment of psoriasis: spa therapy

In regressing stages of psoriasis, spa therapy is prescribed.

1. Heliotherapy is most effective in stationary and regressing stages of psoriasis.This type of treatment is contraindicated in the summer form of psoriasis, when the skin is very sensitive to sunlight.Heliotherapy is a treatment using sunlight, of which ultraviolet rays are the most effective.
2. Climatotherapy is the use of climatic factors and natural biostimulants of the body for medicinal purposes.
3. Aerotherapy is a stay prescribed and regulated by a doctor, sleeping in the fresh air, and air baths.
4. Mineral baths are recommended.Carbon dioxide baths are recommended for psoriasis in combination with diseases of the cardiovascular system.Oxygen baths stabilize redox processes and normalize blood pressure.
5. Thermal therapy is a resort therapy technique that includes mud, paraffin, ozokerito and clay therapy, psammo and naphthalan therapy and other methods.
6. Mud therapy (peloid therapy) is one of the most effective methods, the essence of which is to carry out external procedures using various healing mud, peat, and sapropels.
7. For psoriasis in the stationary stage without manifestations of erythroderma and spring-summer with sulfide waters;radon waters;thermal siliceous waters;treatment with brine;healing mud.

Recently, resorts on the Dead Sea have become extremely popular among psoriasis patients.

Prevention

There is no specific prevention of psoriasis, but after the onset of the disease, it is necessary to take sedatives, conduct courses of vitamin therapy and correct diseases that provoke relapses.

What's the forecast?

The prognosis is conditionally unfavorable, since psoriasis is a chronic disease that cannot be completely cured.It progresses slowly, while timely and adequate treatment only improves the quality of life, but does not eliminate the disease itself.

During periods of exacerbation, loss of ability to work is observed.In the absence of adequate medical care, it can lead to disability.