Psoriasis: symptoms, treatment and prevention

Psoriasis- is one of the most common diseases in the population, the frequency of which increases every year. And if we consider that absolutely all age categories are susceptible to this pathology, and the simple form quickly becomes more complex, the question of proper therapy and prevention is really very acute.

According to statistics, about every 30 people on the planet suffer from this disease to one degree or another. What to do for psoriasis patients? What drugs and folk remedies can be treated? How to properly organize your meals? Finally let's put all the dots.

Psoriasis and its causes

Psoriasis is an autoimmune disease of a fairly uncertain etiology - the exact cause is still unknown, despite numerous studies. This pathology is believed to be the result of genetically determined changes in the immune system, resulting in the development of chronic inflammation of the skin. However, its multifactorial nature is not ruled out - in other words, participation along with heredity and the influence of the external environment.

According to scientists, the predisposing factors are very different for different age groups: for example, different types of bacterial infections, including streptococcal infections, are triggers in children, then for adults, stress stimuli and nicotine abuse are more prevalent, and alcohol, obesity and certain medications (e. g. , adrenaline receptor blockers).

Although psoriasis cannot be completely cured, modern medicine is able to significantly alleviate the course of the disease and maintain a long-term remission in the patient.

There are several theories that explain the onset of psoriasis:

• infectious and parasitic;
• neurogenic;
• endocrine;
• metabolic;
• immunology;
• irsi;
• theory of molecular mimicry.

As with many other conditions, the cause of the skin problem must be found in the gut. It is between 4 and 6 meters long, and the inner surface is covered with a villi, the total area of which is comparable to the size of a tennis court - this allows the absorption process to go more efficiently. Interestingly, the cells of the small intestinal mucosa are completely renewed every 3-5 days. In addition, up to 70% of human immunocytes are concentrated here. Thus, one of the most common causes of psoriasis is leaky gut syndrome (LEPS).

Deviation from the normal functioning of the intestinal mucosa is fraught with malabsorption, ie a violation of the assimilation of essential nutrients (proteins, fats, carbohydrates, vitamins, minerals). In addition, the negative effects of toxins and allergens on the body increase: in such conditions, they are very easy to enter the bloodstream. The direct link between psoriasis and inflammatory bowel disease has been proven in numerous studies.

Other studies confirm that a special microflora is formed in the skin of a patient with psoriasis, which is significantly different from the microbiome of healthy skin.

In the area of psoriatic lesions, there is a concentration of various bacteria, the stability of which is significantly lower than in normal skin - especially colonization by Staphylococcus aureus, which has a very negative effect on the course. inflammatory process.

Types of psoriasis

1. Plaque psoriasis. . . At 90% of the time, dermatologists encounter this special form of the disease, also known as simple or ordinary. Initially, there are small areas on the skin that are raised above the level of a healthy dermis. These inflamed areas are called psoriatic plaques. They gradually grow together with the neighboring spots as a whole.
2. Reverse psoriasis.This diagnosis is given to patients who develop smooth red spots in the layers of skin and wrinkles - in the groin, on the inside of the thighs, under the breasts. Unlike simple psoriasis, the foci of inflammation are practically not covered by scales, but they are a serious concern for patients due to their location and constant friction. In addition, there is a risk of re-infection with streptococcus or fungi, because the places where the spots are localized create ideal conditions for the growth of microorganisms due to high humidity and temperature.
3. Guttate psoriasis.This type of disease got its name from the pictures of the form. The lesions are in the form of a drop raised above the level of a healthy skin. A common trigger for this form of psoriasis is a previous streptococcal infection, as mentioned earlier. The problem is that the patient's immunity is severely weakened during the fight against the infection - its sources are not limited and it takes time to recover like all living things - and against this background there is an autoimmune disease. is active.
4. Pustular psoriasis.It is considered to be the most severe form, accompanied by the formation of bubbles filled with a clear liquid. Inflammation of the skin begins around the foci, swelling and thickening appear. Most likely, with a secondary exacerbation, the bubbles fill with pus. Pustular psoriasis localized in the arms and legs. In difficult cases, there is a risk of blisters everywhere, rapid growth and infection of the entire surface of the skin.

5. Psoriasis on the nails.This type of disease changes the appearance and structure of the nail plates on the hands and feet. Nails thicken, lose their natural color, emit an unpleasant odor. The skin around the nail bed becomes rough, forming thick ridges. In advanced cases, the nails may disappear without further growth.
6. Psoriatic arthritis.In this case, the disease affects the joints and connective tissues. Inflammation often affects the distal phalanges of the extremities. There is psoriatic dactylitis - swelling of the fingers. The hip and knee joints are also exposed to the destructive effects of the ongoing disease. There are often cases of disability with loss of ability to move independently.
7. Psoriatic erythroderma.Spots appear on the skin, peeling of the affected layer is observed. Patients experience extreme discomfort due to persistent itching and swelling. Often, this diagnosis is given to patients who have already been treated for simple psoriasis but have not completed treatment or changed their medication.

Symptoms of the disease

The first manifestation of psoriasis is a small rash on the skin. Papules grow rapidly, growing to spots between 4 and 8 cm in diameter, becoming more numerous and dry scales forming on the surface. In advanced cases, individual spots coalesce and the lesion affects large areas of the body. Psoriatic papules can be distinguished from other skin diseases by their round shape with clear borders, red or bright pink color and silver-white scales. It first appears in areas of the skin whose integrity is compromised as a result of abrasions, wounds, frostbite, and constant friction. There are three characteristics that confirm the onset of psoriasis:

1. Stearin stain phenomenon- Dry particles are easily separated from the affected surface and a drop reveals an area such as wax or sterol.
2. Psoriatic phenomenon(terminal) film. Further cleaning of the papules from the scales allows you to see a transparent and moist film on which the skin is inflamed.
3. Auspitz Phenomenon. . . Removal of the terminal film causes the appearance of the smallest drops of blood on the surface of the stain.

This psoriasis triad is unique - its presence allows you to make an accurate diagnosis. However, different parts of the body have their own characteristics of the manifestation of the disease.

• Psoriasis in the body.The back, neck, abdomen, thighs and lower legs are most affected by guttate psoriasis. Small papules, shaped like shaped droplets, gradually grow above the surface of the skin. This form of the disease is often diagnosed in people with staphylococcal infection.

• Psoriasis on the hands.The most common sites for the formation of psoriatic papules on the hands are the elbows and interdigital spaces - as a rule, the form of a plaque where individual small pieces are combined into a single lesion area covered with dry scales. The forearms are unlikely to be affected.
• Psoriasis on the legs.The disease begins with a single rash on the knee. Inflamed areas bother patients with severe peeling and itching, grow rapidly and merge with neighboring ones.
• On the palms and soles.In most cases, simultaneous defeat of both palms and legs is observed, but in some patients the disease completely affects the stratum corneum of the upper or lower extremities. As a result of the growth of psoriatic papules, the skin becomes thicker and coarser with more cracking.
• Psoriasis of the scalp.First of all, rashes appear on the forehead, behind the head and at the same time behind the ears. First, patients report single-paid formations that grow on themselves, merge with those around them, and can affect the entire scalp over time. Papules are very itchy, so it causes a constant urge to scratch the skin - wounds and cracks are more likely to become the gateway to infection. Dry particles are separated from harmful formations - first small, somewhat similar to dandruff, and then larger flakes.

• On the face, ears, neck.Localization of facial psoriatic papules is an exception to the usual clinical picture. Rarely, when this happens, the disease affects the area around the eyes and eyelids, cheeks and tongue. Formations in the neck spread rapidly - back or head. The ears are the site of development of seborrheic psoriasis. Papules can appear both inside and outside the cartilage membrane. When diagnosing, it is important not to confuse the disease with seborrheic eczema with similar symptoms.
• On the nails.There are three options for the initial manifestation of psoriasis on the nail plates. The first is the formation of small dotted depressions. The second is the thickening of the nails, the natural color of which turns gray or yellow. With further development of nail psoriasis erodes the plate, the upper particles are easily separated. And finally, the third is nail deformation, which is accompanied by a loss of smoothness by the plaque and the appearance of depressed areas.

• Symptoms of psoriasis in children.At an early age, the disease progresses differently: the main localization of red scaly rashes are skin wrinkles: inguinal, elbow and popliteal wrinkles, neck. Papules are very itchy, children experience constant pain, become irritable and anxious. In general, all clinical variants observed in children are similar to those observed in adults. The differences relate entirely to the manifestations, the location of the pathological process and the course of the disease.

4 stages of psoriasis

Clinical dermatology, based on differences in symptoms, degree and duration of skin damage, distinguishes three stages in the course of psoriasis. However, there is an opinion that the initial stage should be recognized as another full-fledged stage in the development of the disease.

1. The initial stage.The first sign of psoriatic lesions are small rashes. Appearance may be different and depends on the type of disease. The initial papules are no more than 3 mm, painted a pale pink color, and after 3-4 days are replaced by a gray flower - dead dermis particles are formed in its place. This process is accompanied by itching and burning, and general health deteriorates. In general, the formation of plaques in the first stage lasts up to three weeks, at which time a person has a chance to slow down the pathological development.
2. Progressive.At this stage, the disease affects important areas of the skin: for example, plaques with normal psoriasis, papules, which are characteristic of other forms. During the development of the disease, individual spots merge with each other, covered with gray scales. The symptom that determines the progressive stage is the Köbner phenomenon (isomorphic reaction). After a while, any damage to the skin is accompanied by the formation of a psoriatic rash here. Another confirmation that the disease is actively developing is the appearance of raw blood-like droplets after the plaque is removed. The duration of this stage depends on the type of lesion. On average, it lasts from two weeks to two months.
3. Stationary stage.During this period, a thick gray-white or gray crust is formed. Pink rims disappear. The skin becomes rough, and dry particles are constantly peeled off. Itching and burning are less annoying, but do not disappear completely. New papules do not form. This stage can be quite long.
4. Regressive stage.The final stage of the disease is the gradual reduction and resorption of plaques during this period. Itching no longer worries. An obvious sign of regression is Voronov's symptom when the papules are surrounded by white rings. The fading of the spots occurs from the center to the periphery, resulting in strange patterns on the skin. At the end of the regressive phase, only areas of the skin that are slightly different in shade from healthy areas are reminiscent of psoriasis. There is no need to talk about a full recovery in the case of psoriasis. The end of the regressive phase indicates the end of a period of disease that can return at any time. To prolong remission, you need to pay attention to health: avoid irritants, diet, be observed by a dermatologist.

Examination plan for psoriasis

1. General clinical analysis of blood.
2. Research on the content of vitamins D, B12, folic acid in the blood.
3. Blood test for ALT (alanine aminotransferase), AST (aspartate aminotransferase), direct bilirubin, alkaline phosphatase, gamma-glutamyl transferase, lipid profile cholesterol, creatinine, glucose, insulin, total protein.
4. Blood for rheumatoid factor, c-reactive protein, uric acid, ASLO.
5. Ferritin, transferrin, serum iron are indicators of anemia (especially in chronic diseases).
6. Thyroid panels: TSH, T4 sv, TK sv.
7. Coprogram.
8. According to Osipov, XMS.
9. Ultrasound examination of the abdominal organs.

Traditional treatment for psoriasis

Early therapy.

The sooner a person discovers the first signs of skin damage, the more likely they are to take timely measures to prevent the disease from developing rapidly and becoming chronic - and therefore will significantly improve the disease. overall living standards.

One of the most commonly prescribed medications at the onset of the disease is salicylic ointment. It has anti-inflammatory and antimicrobial effects, has a keratolytic effect, so the plaques are cleaned of keratinized particles. Naphthalene ointment is also used to reduce itching.

Therapy in a progressive stage.

At this stage, an integrated approach to treatment is required and can only be provided by an experienced specialist. The treatment aims to relieve symptoms and cleanse the body of toxins. Intramuscular injections of calcium gluconate are often prescribed to normalize metabolic processes. Sodium thiosulfate eliminates inflammation and eliminates the manifestations of intoxication.

Special emulsions and salicylic ointments are used to moisturize inflamed skin. Antiperspirants are contraindicated in a progressive stage: they act irritating and increase the patient's suffering.

Physiotherapy procedures may be discontinued when the intensity of inflammation decreases. Patients with psoriasis are prescribed ultraviolet radiation, PUVA therapy and paraffin applications. Corticosteroids and cytostatics are not used unnecessarily, these powerful drugs are needed only in difficult and advanced cases.

Antihistamines are prescribed to reduce allergic reactions and sedatives are prescribed to reduce nervousness. Diuretics help reduce the swelling of inflamed skin and remove toxins from the body.

Inpatient therapy.

At this stage, the inflammation is reduced, the plates are covered with a dry crust, so you need funds to reduce the discomfort from the appearance of scales. These are resin shampoos, oil-based emulsions.

Ultraviolet radiation and PUVA technique have a good effect on many patients. If there is no improvement, doctors prescribe cytostatics.

Regressive phase therapy.

In the last period of the disease, depending on the patient's current condition, a continuous adjustment of treatment methods is required. Prevention replaces active therapeutic actions.

The patient receives recommendations for changes in diet and lifestyle in general. In order to prevent the recurrence of skin damage, it is necessary to avoid stressful situations that trigger the formation of psoriatic plaques.

Typically, doctors give patients the following recommendations:

• reconsider your lifestyle: make adjustments in diet, get enough sleep, exercise more;
• maintain normal vitamin levelsD, iron, B vitamins, protein in the body;
• normalize the digestive system: to exclude hypoacidity, bile flow, SIBO and CIGR (excessive bacterial and therefore fungal growth syndromes);
• get rid of chronic infections: clean the oral cavity, be treated by an ENT doctor;
• to deal with the accompanying somatic pathology: hypothyroidism, insulin resistance, metabolic syndrome, etc.

Traditional ways to get rid of psoriasis

• The initial stage.Juniper and lavender oils are effective at the first sign of skin lesions. Soothes irritated areas of the dermis, helps to heal minor injuries, eliminates the feeling of tightness. For children, for example, a cream that is neutral in composition is added a few drops of oil and applied to the visible rash. Another popular method to combat the initial manifestations of psoriasis is the use of 3 percent hydrogen peroxide. Any measure, even the most harmless at first glance, can be applied after consulting a dermatologist. Dietary changes, abstinence from harmful foods and alcohol are also common recommendations of traditional doctors.

• Progressive stage.In the rapid development of the disease, a strawberry infusion of healing oils and hydrogen peroxide is added. You will need fresh or dried plant stems and salt water to prepare. Alcoholic tinctures are contraindicated and may worsen the condition of the affected skin. Strawberries need to insist for at least a few hours and treat them with birch resin before applying the treatment solution to the boards.
• Stationary stage.At the end stage of the formation of new papules, you can use proven folk remedies that will not necessarily harm the patient. These include the use of sulfur ointment, salicylic solution.
• Regressive stage.Hirudotherapy (leech therapy) is often used in the later stages of the disease. Although this method is not officially recognized by traditional medicine, many experts do not rule out its effectiveness. The procedures are performed within 3 to 10 days, depending on the patient's condition.

Prevention of psoriasis: how to prevent the development of the disease

• Skin care.In the presence of a genetic predisposition, simple ways to maintain skin health will help to minimize the likelihood of psoriatic damage: water and firming procedures (bathing in the sea, baths with plant extracts and salts, contrast showers, air doating with cool water, etc. ); use soft sponges and avoid hard clothes that can damage the skin; use of natural detergents without aggressive chemical components.
• Ultraviolet rays.Several studies have proven the beneficial effects of sun exposure on skin prone to psoriatic plaque formation. Moderate UV rays help accelerate tissue regeneration and reduce inflammation. You should not abuse sunbathing: too much radiation can aggravate the disease.

• Clothing.Synthetic fabrics, tight-fitting styles, a large number of belts and fasteners - all this is contraindicated for patients with psoriasis in remission. Clothing should be natural, hypoallergenic, loose, and not cause any discomfort that could lead to the return of obvious symptoms. Dark tones should be avoided for aesthetic reasons; silver-white scales are less visible in light-colored clothes.
• Damage.For psoriasis patients, any small sore, scratch, abrasion, relapse of the progressive stage and secondary infection of the skin can occur. They must be extremely careful not to get injured.
• Cosmetics and household products.Not all means of maintaining cleanliness are appropriate for people with this diagnosis. When choosing shower gels, soaps, shampoos, it is important to pay attention to their composition, preferring natural ingredients. It is better to buy therapeutic series of care products sold in pharmacies. Scrubs with solid particles are the complete opposite: they can resume the course of the disease due to the slightest damage to the skin. Household chemicals should also be selected based on health safety, do not use chlorine and alkaline-based aggressive cleaning powders. Gloves should be worn when cleaning to prevent adverse effects on the skin of the hands.
• Vitamin therapy.Maintaining vitamin balance is indicated for everyone, especially for people with chronic dermatitis. Complex preparations keep the body in good condition, help fight viruses and prevent metabolic diseases.

Psoriasis- This is not a death sentence, but a very serious reason to reconsider the rules you have lived before. Your allies in the way of taming the disease should be competent specialists - dermatologists, nutritionists, therapists. With their help, as well as through a deliberate approach to treatment, you can learn to live comfortably despite your diagnosis.