For more than two thousand years, mankind has been trying to solve all the mysteries of this serious dermatosis, but much is still unknown. According to statistics, the disease affects 4-7% of the population, women and men are equally susceptible. The first symptoms of psoriasis usually appear during adolescence and accompany a person throughout life, then decrease and disappear completely, then intensify.
Can psoriasis be treated?Modern medicine has gained a lot in the treatment of this chronic dermatosis and has been able to provide the patient with a decent standard of living.
Causes of psoriasis
Psoriasis is a chronic inflammatory process of the skin, which modern medicine calls autoimmune (associated with allergies to their own tissues). There are many causes of psoriasis and factors that predispose to the development of this dermatosis, and a number of theories have been put forward in this regard.
Autoimmune
This is the main system, because it is well established that the immune system actively reacts to certain types of skin exposure. The skin of people suffering from psoriasis is very sensitive to mechanical, physical and chemical effects. Not only epithelial cells, but the whole immune system reacts to such effects.
Cellular immunity is compromised: the ratio between individual subtypes of lymphocytes responsible for the formation of a normal immune response. Thus, the number of helper T-lymphocytes in psoriasis increases - helpers that regulate immunity, the number of suppressor T-lymphocytes, which suppress the overactive immune response, decreases. Lymphocytes and some other cells produce cytokines - active substances that stimulate the immune response. Humoral immunity also suffers, an imbalance of antibodies (immunoglobulins) in the blood serum develops, antibodies appear in the tissues of the patient's body.
Inflammation begins against the background of activation of T-lymphocytes, but it is not clear why they are activated. In the research process, there is also the question of how to suppress the autoimmune reaction without harming the patient.
exchange
Imbalances in metabolism have a significant effect on the skin and immunity. Patients with psoriasis have the appearance of increased metabolism, large amounts of toxic free radicals and other toxins that support the inflammatory reaction. Metabolism is concerned:
- protein- The tendency CDSN gene stimulates the synthesis of corneodesosin, a protein that sensitizes the body (allergenic); the amount of albumin proteins in the blood decreases and the amount of globulins increases; this condition is called dysproteinemia and increases sensitivity;
- greasy- The amount of lipids and cholesterol in the blood increases; the use of mainly plant-based foods and a general reduction in the caloric content of the daily diet can reduce the activity of psoriasis inflammation;
- carbohydrate- almost always violated;
- vitamin and mineral metabolism- The amount of vitamin C in the skin increases, the amount of vitamins C, A, B6, B12, iron, copper and zinc in the blood decreases.
Infectious
This theory was relevant at the beginning and middle of the last century. Some bacteria (streptococci), fungi, and viruses were thought to cause psoriasis. These theories have not been confirmed. However, dermatologists note that any acute infectious process or the presence of a permanent focus of infection can lead to relapses. Virus theory has a special place. Recent studies have revealed the effect of retroviruses (RNA-containing viruses - HIV, etc. ) on the genetic apparatus with the formation of genes for psoriatic predisposition.
Genetic
The tendency to autoimmune reactions is inherited. If a person's relatives suffer from psoriasis, the probability of developing this disease increases many times. There are genes for susceptibility to psoriasis (local PSORS1 - PSORS9, PSORS1 complexes are particularly active, they contain HLA-C, HLA-Cw6, CCHCR1 and CDSN genes responsible for the development of the disease). Genes affect metabolism, immunity and the development of autoimmune processes. However, the presence of such genes does not guarantee the development of the disease. The influence of provocative factors is of great importance.
Neurogenic
Prolonged stress, high neuropsychic stress, disorders of the autonomic nervous system (innervation of the walls of blood vessels and internal organs) can lead to the development of psoriasis, cause imbalances in the endocrine system, impaired metabolic and immunological processes.
Endocrine
Endocrine diseases are common in psoriasis and mainly play a motivating role. There is no clear link between the two. Dermatologists often note that patients have dysfunction of the thyroid gland, adrenal glands and pituitary gland. Menstrual disorders in women, sexual function in men.
Psoriasis symptoms
The main symptoms of psoriasis are skin rashes. But there are other signs. The first manifestations usually occur in adolescence or childhood against the background of hormonal disorders, vegetative-vascular dystonia and long-term stress.
The disease begins with a feeling of constant fatigue, mood swings. It is characterized by small, pink formations (papules) rising on the surface, dusted with a whitish crust on top. It is surrounded by a brighter, higher edge.
The elements of the spill grow and merge into large slabs of strange shapes. The base of the papule is an inflammatory infiltrate. According to the nature of the rash, psoriasis is divided into:
- point- elements not exceeding 1 mm in diameter;
- tears- papule-drops up to 2 mm;
- in the form of a coin- Round papules up to 5 mm in size.
Characteristic features of the spill:
- stearin stain- If you shave, the surface of the papules;
- terminal film- We will see a transparent film when thoroughly cleaning the surface of the papules from the scales;
- blood clot (Auspitz phenomenon)- When you break the film and break its integrity, we will see small drops of blood on the surface.
Stages of psoriasis
There are three stages of the disease:
- progressive- the first elements of the eruption appear, the number increases, all new areas are captured; rashes also appear when the skin is itchy or exposed to some external irritants (Kebner phenomenon); in the early stages of psoriasis, the papules begin to clump into large plaques;
- stationary- there are no new elements and the previous ones are not withdrawn;
- regressive- the rash becomes pale, the bottom is less dense; the rash gradually recedes, the process often beginning in the central part, so that the plaques may be in the form of rings; if the plaques in the psoriasis are resolved from the periphery to the center, they gradually decrease in size and form a white ring around them - Voronov's pseudoatrophic edge; Where there is a rash, white, pigmented areas remain - psoriatic leukoderma.
Sometimes papules appear on the skin at the same time in three stages of development. There are also summer and winter forms that are dominated by flares in summer or winter.
Is psoriasis contagious?
Numerous studies have confirmed that it is not a contagious disease. If infectious pathogens are involved in its development, it only has a general effect on metabolism, immunity and the genetic apparatus.
Patients often ask:
- How does psoriasis spread?
Psoriasis is not transmitted from person to person.
- Pearls are inherited?
The answer is again negative, but there is a hereditary tendency in the form of metabolic characteristics and the functioning of the immune system, and it is passed on to close relatives.
Types of psoriasis
In this chronic dermatosis, the nature and location of the rash, as well as damage to other organs and systems, may be different. According to these symptoms, several types of diseases are selected.
Simple (vulgar, plaque)
The most common. Symptoms are a characteristic bright pink papules covered with white scales. In the lower part, plaque psoriasis is divided into the following forms:
- easy- if the lesion does not cover more than 3% of the skin; in the advanced stage, the papules grow, but then quickly reverse development;
- average- rash occurs between 3 and 10%; papules are large, fused to plaques;
- heavy- defeat accounts for more than 10%; The debris is numerous, combines and takes different forms.
Vulgar psoriasis persists in the form of variable relapses with remission, but there is also a persistent course.
Psoriasis of the elbow
This is one of the manifestations of a mild form of plaque inflammation. A distinctive feature of psoriasis in the elbows is the presence of one or more "duty" plates on the extensor side of the elbow joints. If these elements are damaged, ignition begins.
Guttate psoriasis
Bacterial (mostly streptococcal) and viral infections are important in the development of guttate psoriasis. Occurs in childhood. Inflammation begins after infection. Streptococci secrete toxins (antigens - substances that are foreign to the human body) that bind to tissue proteins. They produce antibodies and develop autoimmune inflammation.
The start is sharp. Tears appear on the skin of the extremities (less on the body and face) with a small red papule-stained surface. Injuries to the rash area cause small erosions and wounds, increasing the risk of infection.
Psoriasis quickly takes a subacute and chronic course. Recurrences are replaced by remissions, independent recovery or transition to a mature form of the disease is possible.
Palmar-plantar psoriasis
It develops in those who are engaged in physical labor, is accompanied by severe itching and almost always causes a complication on the nails. There are subtypes:
- in the form of a board-fan- palm and plantar surfaces covered with large elements, white scales, attached to fan-shaped boards; such psoriasis on the hands is more common;
- rounded- ring-shaped scaly elements on palm and plantar surfaces;
- horny- characterized by the growth of coarse epithelium with the formation of corn;
A separate subtype is pustular psoriasis on the hands and feet of the hairdresser. The areas under the thumbs of the extremities are covered with vesicles and pustules (purulent), there is a strong itching. Cancers coalesce, then dry up, crusts form. Characteristic psoriatic elements develop in other parts of the body. The disease often spreads to the nails.
Psoriasis in the legs is protected and aggravated by varicose veins, in which case the rash will be mainly in the lower leg.
Nail psoriasis
Damage to the nails can be either independent or a complication. Typical symptoms:
- small holes appear at different depths in the nail plate; similar nail lesions are found in other dermatitis, but are deeper in psoriatic lesions and slightly painful when pressed;
- spontaneous slow painless separation of the nail (onycholysis);
- subungual bleeding in the toenails, especially if the patient wears tight shoes;
- trachonics - nausea and disorders of the nail plate; A depression develops in the middle of the nail and the nail becomes like a spoon (koilonychia).
Sometimes the periungual roller is affected by the spread of inflammation to other tissues (psoriatic paronychia).
Psoriasis of the scalp
Here the disease persists independently or as part of a general pathological process. Acne is characterized by the formation of crusts on parts or the entire surface of the head. Hair growth is not affected at the same time: psoriasis on the head does not impair the function of hair follicles. However, the leak poses a risk of infection with subsequent damage to the hair follicles.
It flows in waves, then decreases with the disappearance of the crusts, then worsens again and is accompanied by severe itching, often leading patients to neurosis.
Seborrheic psoriasis
Seborrhea is a condition caused by a malfunction of the sebum-producing skin glands. It produces a viscous oil that irritates the skin and promotes the development of inflammation - dermatitis.
Seborrheic psoriasis quickly spreads all over, covers it in the form of a cap and is accompanied by severe itching. Crying sometimes develops in the areas behind the ear and is associated with an infection. The head, covered with dandruff and hard shells, sometimes resembles a psoriasis crown.
Psoriasis on the face
Psoriasis on the face is usually localized in the nasolabial triangle, eyelids, eyebrows, behind the ears. The molten elements of the spill form extensive redness and swelling areas. If there is dysfunction of the sebaceous glands, the process is often accompanied by crying, peeling and an increased risk of infection.
Psoriasis in the genitals
This is not an isolated process. Simultaneously with the defeat of the genitals, there are characteristic psoriatic rashes all over the body, so the disease is not difficult to diagnose.
In the penis in men and in women, psoriasis manifests itself in the form of oval, pink scaly papules that rise slightly above the skin in the labia majora, as well as in adjacent skin areas. There is practically no itching. Sometimes the process spreads to the mucous membrane and appears as vulvovaginitis in women and balanoposthitis in men.
Atypical psoriatic rashes can be observed in obese people in the groin (inguinal, intergluteal) near the genitals. Here, red areas with a mirror-like surface are formed without signs of peeling due to constant moisture.
What is the danger of psoriasis and whether it should be treated
The danger is that psoriasis can take a widespread, severe form, with rashes occupying more than 10% of the integrity. This stage of the disease is difficult, relapses, rash elements are injured and wet, an infection often combines. Only timely treatment of psoriasis can stop its spread.
Sometimes the disease is complicated by inflammation of the joints with the development of psoriatic arthritis, in which case the function of the joints can be significantly impaired.
Other autoimmune diseases often develop against the background of a systemic autoimmune process that significantly affects the patient's condition (rheumatoid arthritis, some types of osteoarthritis, Crohn's disease, etc. ), as well as severe cardiovascular pathology, diseases of the digestive system, neurological reactions.
If you do not start treatment for psoriasis on time, the patient's condition will deteriorate sharply and lead to disability.
There is also a complication such as psoriatic erythroderma, which develops with improper or inadequate treatment of psoriasis, as well as when the skin is exposed to various irritants. The skin acquires a bright pink color with a clean separation of the affected areas from healthy areas, small and large lamellar crusts. Such a patient needs urgent medical attention.
Is psoriasis treated?
Yes and quite successful, but full recovery cannot be guaranteed.
Treatment methods
Autoimmune inflammation requires individually selected complex therapy, lifestyle changes, nutrition and elimination of all bad habits. Modern medicine has proposed three basic principles for the successful treatment of psoriasis:
- strictly follow the algorithms for the prescribed therapy;
- regular monitoring of the effectiveness of therapy;
- timely correction of the prescribed therapy with sufficient effectiveness.
Nutrition for psoriasis
There is no specific diet for psoriasis, but nutrition is very important. Therefore, when prescribing a complex treatment, recommendations on nutrition are given:
- determine the body's increased sensitivity to certain foods and eliminate them from the diet;
- prefer fresh vegetables, non-acidic fruits and berries, boiled and cooked lean meat, drink more;
- What to eat with psoriasis:
- products containing essential oils - onion, garlic, radish;
- beverages containing caffeine (concentrated tea, coffee), alcohol;
- everything is salty, sour and sweet, rich;
- products that promote the body's sensitivity (allergy) - oranges, honey, nuts, cocoa, eggs;
- Do not eat fatty animal products.
Pegano diet for psoriasis
This diet was developed by American physician John Pegano, but did not find official medical recognition. The principle of building a Pegano diet for psoriasis is associated with the alkalization of the body by choosing the right diet. According to this principle, all products are divided into:
- alkaline (two-thirds of the daily diet) - non-acidic fruit and berry mixtures and juices, vegetables (except for those that produce increased gas);
- acid-forming (one-third of the diet) - meat, fish, dairy products, beans, peas, potatoes, cereals, sweets and pastries.
Patients are advised to drink still mineral water, up to 1. 5 liters of water per day, as well as other liquids (compotes, juices, etc. ).
Drug treatment
Mild psoriasis is treated with topical medications. Severe and rapidly developing forms of the disease are mainly treated in a hospital setting with the appointment of drugs that have a general (systematic) effect.
External psoriasis treatment
The drug is selected by a dermatologist. Ointments are suitable for psoriasis vulgaris with dry shrinkage boards, if leakage occurs (with seborrhea), creams and medicinal solutions are used. It changes over time to prevent the body's resistance (resistance) to a particular drug.
In the acute (progressive) stage, the following external therapy is performed:
- agents with emollient effect - boric oil gel, 2% salicylic ointment;
- effective non-hormonal ointments for psoriasis containing activated zinc pyrithione; suppress infection and have a cytostatic (suppress tissue proliferation) effect;
- external agents containing glucocorticosteroid (GCS) hormones;
- calcipotriol (an analogue of vitamin D3) and corticosteroids in combination with betamethasone; perfectly suppresses the inflammatory process.
External treatment of psoriasis in the inpatient stage:
- ointments with scales (keratolytic) and anti-inflammatory effect - 5% naphthalene, boron-naphthalene, tar-naphthalene;
- corticosteroid medications.
External treatment of psoriasis in the solution stage:
- the same keratolytic ointments, but in higher concentrations: 10% tar-naphthalene ointments;
- ointments based on vitamin D3 analogues - for 6 - 8 weeks; suppresses rash inflammation and peeling.
For the treatment of psoriasis of the nails are used special varnishes that suppress the development of the pathological process. It is recommended to treat periungual phalanges with moisturizing gels.
Systematic treatment of psoriasis
- anti-inflammatory and intoxication drugs - calcium chloride, sodium thiosulfate, injectable unitiol;
- tablets for psoriasis, which suppress the processes of proliferation (proliferation of epithelial cells) - cytostatics that suppress the activity of the immune system, vitamin A analogues, corticosteroid hormones;
- biological agents containing IgG class human monoclonal antibodies that act on certain inflammatory connections by suppressing the synthesis of cytokines; is a very effective modern drug administered by injection;
- Vitamins for psoriasis help to restore metabolism and keratinization of epithelial cells; Doctors prescribe vitamins A, E, D3, B group.
Folk remedies for psoriasis
Any treatment for psoriasis, including the use of folk remedies, can be prescribed only by a doctor. Self-medication can cause side effects: the spread of the disease.
The following methods can be used as part of complex therapy:
- fat- products of processing of industrial oils; to prepare an ointment you need to buy a medical ointment in a pharmacy; recipe: add 50 g of honey and half a packet of baby cream in 0. 5 kg of solid oil; procedures are performed daily; You can buy solid-based preparations at the pharmacy.
- baking soda- Folk remedies for psoriasis, which helps to clean the skin and eliminate itching; Recipe for soda applications: Take 60 g of soda, dissolve in 0. 5 liters of water, immerse a piece of gauze in the solution, fold in several layers and apply. lesion 20 minutes; after the procedure, stain the skin and apply emollient ointment; treatment of psoriasis with soda is carried out once a day;
- mummy- has a clear anti-inflammatory effect, eliminates itching well; 0. 2 g orally can be taken once a day for two weeks; external therapy is carried out with a mummy solution; applied to dry itchy boards twice a day; Treatment of psoriasis on the head is carried out by rinsing the scalp with mummy solution after washing;
- sea salt- eliminates inflammation, itches well; baths with sea salt: take 1 kg of salt, dilute in two liters of water and add to the bath; Take a bath for 15 minutes, then wash the solution under a warm shower, stain the body with a towel and apply a emollient ointment; treat psoriasis with baths no more than twice a week;
- gil- has a pronounced cleansing effect, adsorbing on the surface of toxic substances formed as a result of inflammation and improper metabolism; helps to dry, remove peels and itching; you can buy any clay, but it is better to buy blue clay in a pharmacy; clay pieces should be well dried, broken with a hammer, diluted with water and stand for several hours; Place the resulting plate on a clay napkin (up to 3 cm thick) and apply to inflamed areas for three hours; to treat psoriasis with clay every day.
Important: treatment of psoriasis at home with folk remedies should be carried out with caution and in accordance with a doctor's prescription. Such treatment will help one patient, while in another it can lead to inflammation and rapid spread of inflammation. Therefore, if the patient's condition worsens in the background of therapy, it is necessary to stop immediately and consult a doctor.
Home treatment for psoriasis
When treating psoriasis at home, it is important to follow dietary recommendations, lead a healthy lifestyle, rule out bad habits and strictly follow all the prescriptions of a dermatologist.
How to treat psoriasis at home? Some patients try to rid themselves of toxins and toxins using all sorts of non-traditional methods (enemas, etc. ). This can have the opposite effect: the digestive system will break down and start to burn. Modern medicine recognizes that the body is cleansed in the form of proper nutrition and getting rid of bad habits.
It is important to follow all doctor's prescriptions and pay attention to how the prescribed therapy works. If it is not effective enough, the doctor will replace the treatment to get the maximum therapeutic effect.