Psoriasis

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

The disease causes severe psychological discomfort 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 cause disability.It is impossible to completely cure the pathology.However, proper treatment allows you to achieve 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 pink spots of various sizes accompanied by itching.Most often, they are located on the scalp (along the hairline, can also be behind the ears), elbows, knees, and can also be 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 dilation of blood vessels in the affected areas.

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

Keratinocytes are constantly renewed.Their synthesis takes place in the basal layer.Then they move higher, where each time they perform a new function.After reaching the stratum corneum, they lose their nuclei and turn into corneocytes (special sacs containing keratin).Now their function is a barrier.Exceeding their lifespan, corneocytes are shed from the surface of the skin.Keratinocytes live for about 2-4 weeks, then they are replaced by new ones.

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

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

Causes of psoriasis

The exact causes of psoriasis are still unknown.But the most common are 2 theories of the origin of this disease:

1. Hereditary disease - the tendency to develop psoriasis is genetically transmitted.
2. The result of the violation of immunity caused by infections, bad lifestyle, climatic conditions and bad habits.

Reference!In 40% of patients suffering from this pathology, relatives also suffered from psoriasis.Also, close relatives of patients often experienced a hidden form of psoriasis, which is manifested by changes in the structure of capillaries.

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

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

• Injuries, fractures.
• Don't freeze.
• Sunburn.
• Don't smoke.
• Alcohol abuse.
• Obesity.
• Chemical damage to the skin.
• Food allergy.
• Parasitic infections.
• Pregnancy and childbirth.
• Other skin diseases - eczema, dermatitis.

Reference!It is well 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 passed from person to person.

Types and stages of psoriasis

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

1. Common psoriasisdevelops the most.It is characterized by the presence of itchy plates with a scaly surface on the skin.Also, with this form, it is often observed that the color of the nails changes and small white spots appear on them.In some cases (at an advanced stage), the nails move away from the nail bed.
2. Guttate psoriasisit manifests itself as a small rash localized mainly on the chest and back.The rash is accompanied by itching in the affected areas of the skin.Usually, the symptoms of the disease disappear after 4-6 months and are no longer visible.However, the patient may later develop another form of psoriasis.That's about half.Guttate psoriasis is usually seen in children and adolescents.It often develops as a result of an infection, most often after a bacterial infection of the throat.
3. Recurrent psoriasisresponds well to treatment, sometimes it is possible to achieve a stable remission without relapses.Red, weeping plaques appear only in some parts of the body, in folds, and do not spread further.Typically, the rash appears in the groin area or under the mammary glands, as well as in the armpits.Relapsing psoriasis develops most often in elderly patients.
4. Pustular psoriasisis a severe and dangerous form.In some cases, it develops rapidly and suddenly.It is characterized by the appearance of blisters with purulent content on the soles and palms, then the affected skin thickens and begins to peel off actively.The rash then spreads over large areas.In advanced cases, the skin of the whole body can be affected.Pustular psoriasis can be life-threatening.It mainly affects adults.

Psoriasis develops in 3 stages:

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

Progressive stagecharacterized by the appearance of multiple nodular rashes and spread to new areas of the body.The size of the boards gradually increases.

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

In the regression phaseplates become denser, their elements dissolve, peeling decreases.Then there are spots devoid of pigment at the site of the rash.

Reference! Psoriasis can also be classified according to seasonality: there are summer and winter forms according to the development of exacerbations.Often, relapses still occur more often in the fall-winter period than in the spring-summer period.

Symptoms of psoriasis

Symptoms of psoriasis include:

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

Reference!About 1 in 10 patients develop arthritis as a result of psoriasis.Therefore, it is necessary to start treatment as early 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 break the papules (plaques), 3 main events are observed:

1. Stearin stain - with a light scraping, peeling intensifies, and the rash resembles a drop of stearin.
2. Terminal film - if you remove the scales from the surface of the board, it has a shiny, moist surface.
3. Bloody dew - if you scratch the terminal film, clear 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 (because this is impossible), but to achieve a stable remission.Comprehensive treatment is carried out, its plan is prepared according to the course of the disease in a particular person.This includes:

• Local drug treatment - ointments, creams, shampoos, aerosols, lotions.
• General drug treatment - injections of antihistamines, sedatives, vitamins, immunosuppressants, cytostatics, retinoids, corticosteroid hormones.
• Maintenance therapy - the patient is prescribed ultraviolet radiation 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 detected, they are also treated.

Lifestyle with psoriasis

The patient should take into account that the treatment of the disease will continue throughout his life.In many ways, the duration of remission depends on it.It is important to give up bad habits (smoking, drinking alcohol).It is also necessary to follow a diet.Exclude from the diet citrus fruits, whole milk, chocolate, honey, eggs, foods with red pigment (strawberry, watermelon) and other foods that may cause the development of allergic reactions.It is also recommended to stay away from spicy, oily, fried, smoked foods, rich meat and fish broths.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, B, as well as zinc and calcium.

The following simple measures will help alleviate the situation:

• Refusal to stay in water for a long time - it is necessary to swim and take a bath less often, it is recommended to take a short shower.
• Harsh washing clothes should be replaced with a soft sponge or cotton cloth, and regular soap should be replaced with a pH-neutral product.
• After the shower, you should not wipe, but rub 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 loose, light clothes made of soft natural fabrics, because the pressure of clothing items on the skin can lead to the development of new rashes.
• Itching often forces the patient to scratch, which can cause damage to the skin - it is better to cut your nails short to avoid new damage.
• It is necessary to avoid drying the skin, therefore, avoiding air conditioning and moisturizing the indoor air will be useful.
• Although sunbathing is beneficial for psoriasis, excessive exposure to UV rays can make the condition worse - you should consult your doctor about your sun exposure regimen.
• The risk of skin irritation should be avoided.
• Cuts and wounds can cause new rashes to appear, so you should protect yourself from them.
• Stress is a common trigger for disease exacerbation, so traumatic situations should be avoided whenever possible.
• Physical inactivity (inactivity) should be avoided - moderate physical activity will benefit the condition of the whole organism.

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