Psoriasis is a severe systemic dermatological disease. The disease is characterized by a chronic, difficult disease, with a worsening period, followed by remission. Psoriasis can occur in many forms, requiring an integrated approach to treatment and dangerous with a number of complications.
What is psoriasis?
Psoriasis is a dermatological disease that can occur in both adults and children.
Psoriasis is a non-communicable inflammatory disease of the epidermis. The pathology is characterized by changes in the skin, which manifest themselves in the form of exfoliation and nodular formation.
The peculiarity of psoriasis is a chronic undulating course. The disease cannot be completely cured; therapy aims to reduce the symptoms and manifestations of visible disease. The period of exacerbation is followed by a period of remission, which can last from a few months to several years. This is the remission period which is the criterion for evaluating the effectiveness of the selected treatment regimen.
Psoriasis first appears at a young age. The disease can develop, giving complications to the joints. According to statistics, psoriasis shortens the average life expectancy of 7 years.
Although it is impossible to cure pathology, you can not let the disease continue. If there are any alarming symptoms, you should see a dermatologist. Properly selected treatment regimen will allow you to live life to the fullest, without looking back at inflammation of the epidermis.
Causes of psoriasis
The exact reason for the beginning of the pathological process has not been determined. There are several theories of the origin of this pathology.
- The autoimmune nature of the development of this disease.This theory is quite widespread. Many doctors tend to believe that inflammation of the epidermis is the result of immunopathological damage in the body, as a result of which the human immune system begins to attack epidermal cells at random in different parts of the body. In response to this attack, skin inflammation appears. 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.
- Genetic theory.This theory explains why people with psoriasis can have children with the same diagnosis. In this case, the genetic characteristics only indicate the possibility of contracting the disease, but do not determine psoriasis. For example, if parents are prone to various dermatitis, they are diagnosed with psoriasis or severe eczema, there is a risk that children will also experience chronic inflammation of the epidermis. Even so, many times, completely healthy children are born to patients with psoriasis, who may have never had a dermatological disease in their entire life, let alone with psoriasis.
- Neurogenic theory.Another fairly common explanation for the cause of the development of this disease is neuropsychic stress. In a study conducted in the middle of the last century, it was found that patients with psoriasis experienced an increase in the neurotransmitter acetylcholine at the nerve endings of internal organs and epidermis. In response to neuropsychic stress, these neurotransmitters could theoretically provoke the development of inflammation in the epidermis. In addition, in patients with psoriasis, dysfunction of the brain stem and vegetative-vascular disorders are also revealed. All of these indicate the nature of diseases such as neurosis.
- Theory of exchange.Presumably, psoriasis can occur as a result of general metabolic disorders. Deficiency or disruption of the absorption of certain vitamins and minerals can cause changes in the structure of the epidermis and make it vulnerable to negative influences, due to the growing inflammation.
After dealing with the cause of the development of this disease, you should pay attention to the factors that can potentially cause inflammation. Here we are talking about the type of trigger or trigger, under the influence of which there are major manifestations of psoriasis, or worsening after remission. These triggers include:
- infectious diseases;
- parasitic attacks;
- hormonal changes;
- allergic reactions;
- lack of immunity;
- skin damage;
- aggressive external influences on the epidermis.
Infectious diseases cause dysfunction of the immune system. Often, after severe infection in adolescents and young people, major manifestations of psoriasis are observed. From now on, a person is diagnosed, who lives with him for life. Infection is not the direct cause of the disease, but gives rise to manifestations. Also, the invasion of parasites in the liver can trigger the onset of inflammation.
Young women or adolescents tend to experience major manifestations of psoriasis against the background of hormonal disorders. Puberty is associated with significant changes in body function and rapid growth, leading to disorders of the immune system and theoretically can act as a trigger at the onset of skin inflammation.
When acetylcholine is high, stress is one of the most obvious triggers.
Severe stress is the leading cause of psoriasis in 65% of cases. The same condition can lead to forgiveness disorders and the onset of deterioration.
Symptoms of psoriasis can also appear in areas with severe skin damage. Thermal exposure, burns, deep wounds - all of these are potentially dangerous for someone who is prone to the disease. Damage to the epidermis can lead to the onset of exacerbation and is very dangerous in the early stages of the disease, as plaque-like neoplasms form at the site of injury. In some patients, exacerbations are caused by ultraviolet exposure.
Is psoriasis contagious?
The photo illustrates the peculiarities of the symptoms of psoriasis very clearly. If the inflammation is localized in an open area of the body that can be seen by others (forearms, hands and palms, face and neck), the patient may experience misunderstandings and disgust. Even so, although there are certain symptoms, psoriasis is not a contagious disease, which means it is not contagious at all.
Contact with the skin of psoriasis patients is very safe for foreigners. The disease is not spread by airborne, hematogenous or sexual droplets, as this is the result of internal disturbances in the body, but not the effects of pathogenic microbes.
Many people are intimidated by the appearance of psoriasis-affected skin. This can have a negative impact on the patient's self-esteem, which often leads to psychological problems such as complexity and dissatisfaction. Someone who is diagnosed for the first time must face problems in society. In some cases, doctors recommend a course of psychotherapy to accept their illness and social adjustment.
Mechanisms of psoriasis development
The mechanism of development of psoriasis consists of the proliferation of major epidermal cells, excessive keratinocytes. This process requires the development of inflammation, which is manifested by infiltration of the skin by lymphocytes and macrophages. Visually, this is expressed in changes in the structure of the epidermis. It becomes dense, keratinization appears. Skin with psoriasis is very moist.
The inflammatory process leads to changes in the microcirculation of blood in the affected area. Due to the thickening of the epidermis, there is a strong fragility of capillaries, as a result, the affected area acquires a purple color.
The peeling skin on the surface of the plaque produces a gray color. Also, psoriasis is characterized by severe dryness of the epidermis.
The process of forming a new focus of this disease is called progressive psoriasis. This level requires a certain period of time, and is then replaced by a stationary level. It is characterized by the absence of changes in the nature of the rash or the number of skin lesions.
The stationary level is replaced by regressive over time. At the same time, the plaque shrinks, gradually heals and becomes almost invisible. Cleansing the skin from inflammation is the beginning of forgiveness. How long it will take is impossible to predict in advance, but sooner or later forgiveness will be replaced by a progressive degree of disease.
Typical signs of psoriasis:
- chronic corrugated course;
- specificity of focal skin inflammation;
- development with each upgrade;
- changes in the epidermis and capillaries in the affected area.
The peculiarity of psoriasis treatment methods depends on the form of the disease. Overall, several clinical forms are distinguished, with special features and course features.
Classification of psoriasis - clinical form and symptomatic features
Symptoms of psoriasis depend on the form of the disease. This pathology is characterized by various forms and signs, which complicate self-diagnosis.
According to the type of inflammation, there are three main forms of the disease:
- resembles plaque or rudeness;
- in tears.
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 on the rash becomes inflamed and reddened. Over time, the nodules merge into a fairly large focus that rises above the skin.
Generally, there is no itching on plaque psoriasis. Discomfort caused by dry skin is possible. Itching is usually observed with additional exposure to allergens.
Pustular psoriasis on the skin is characterized by the formation of small vesicles filled with light exudates. The disease begins with the formation of dense nodules under the skin, which, in increasing size, form a blistering rash. In this case, the bubbles are located deep inside the epidermis, painful when pressed and easily damaged. The skin around the pustula swells, squeezes, and peels off over time with scales that are easily removed. Often, the disease affects the skin of the feet, hands, back, but can also spread to the body.
Guttate psoriasis gets its name from the characteristic rash. Its shape is like a droplet, with clear boundaries. The skin around the rash is swollen, red, itchy and sore. In the middle part of the rash, the epidermis does not change. The form of the disease in the form of tear drops occurs in the general form, i. e. the pathology spreads throughout the body.
Psoriasis can strike any part of the body. In addition, the following forms of the disease are distinguished according to the localization of the rash:
- flexor surface psoriasis;
- psoriatic onychodystrophy;
- arthritis psoriasis;
- eritroderma psoriatik.
Flexor psoriasis only affects skin folds. At the same time, the rash does not look like a plaque, but small red spots with a smooth and shiny surface. Areas of disease spread - inguinal folds, armpits, areas under the mammary glands in women. The pathology runs in a relatively mild form, but is dangerous with the addition of secondary infections due to damage to the spots. Often, this form of the disease is exacerbated by mycoses.
Onychodystrophy against the background of psoriasis is a lesion on the nail plate. Pathology rarely acts as an independent disease, often a complication of plaque psoriasis on the feet and hands. The disease is manifested by changes in the color and structure of the nail plate. They become pale, become brittle. In advanced form, this leads to the destruction of nails that are completely irreversible.
Arthropathic psoriasis is also rarely an independent disease. This is a systemic pathology affecting 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, and leads to its deformation. In severe cases, it is dangerous to develop a deformity due to loss of motor function in aching joint.
What is the picture of the symptoms of psoriatic arthritis from the photo - these are swelling and thickening of the fingers, joint deformity, and limited movement
How psoriasis starts: early stage symptoms
In severe pathology, the affected area can merge, forming symptoms with extensive size.
How precisely psoriasis in the early stages depends on the form of the disease. Psoriasis vulgaris begins with dense nodules under the skin. They rise above the epidermis, pounding well, but do not cause discomfort. The skin around the nodules quickly begins to peel off. After some time, the nodules merge into the focus of the rash, plaques form.
Pustular psoriasis begins with a deep lump under the skin that is not visible on the outside, but feels obvious. The skin around the rash element is swollen, sore with stress and mechanical damage.
Psoriasis guttate is the formation of small rashes on large areas of skin. The most common localization areas are the thighs, chest, back. The rash looks like drops with a clear border.
To understand what psoriasis is like in the early stages, you need to know the specifics of skin changes during inflammation - nodules appear earlier, then merge, and only then large plaques form.
In the early stages of the disease, exfoliation is expressed in moderation, regardless of the form of the disease. As the skin progresses, it changes, becoming concentrated, a large exfoliating focus appears
Symptoms and features of various forms of disease
What psoriasis looks like on the body depends on the form of the disease. Each type of pathology has its own characteristics.
Characteristics of psoriasis vulgaris:
- localization: legs, arms, forearms, back, chest, neck;
- rash shape: large thick plaque with abundant decoding;
- there is no discomfort other than tightness;
- Once the plaque heals, the skin remains stained.
Psoriasis vulgaris causes disruption of pigment production in the affected area. Once the plaques heal, when they heal and disappear completely, age spots are reminiscent of psoriasis. In place of plaque, there may be brown spots, bright areas due to insufficient pigmentation, or purple spots that look like scars.
Specific symptoms of pustular psoriasis:
- localization: distant limbs;
- rash shape: dense vesicles with uninfected exudates (no pus);
- secondary symptoms: pain and itching, generalized abnormalities, fever;
- there is a risk of rash element infection.
Pustular psoriasis is the most severe form of the disease. In rare cases, it becomes common, affecting the skin all over the body. In this case, the bubbles can merge into large formations. After healing, scars may remain on the skin.
Teardrop psoriasis has the following characteristics:
- localization: legs, thighs, shoulders, neck, hairy areas on the skin of the body;
- rash shape: small spots, drops or circles, with swollen skin around the rash;
- no pain or itching;
- body temperature may increase when a rash appears.
Guttate psoriasis often develops against the background of decreased immunity after an infectious disease, although the disease itself is autoimmune, not contagious. This form of the disease often appears in adolescence after having a streptococcal infection.
An experienced doctor can easily identify the symptoms of psoriatic disease through visual examination.
Psoriasis plaques are easy to diagnose. Visual examination is sufficient for an experienced dermatologist to make an early diagnosis. In addition, tests are performed for so-called psoriatic triads. This is a specific skin reaction that occurs in response to plaque erosion.
Guttate psoriasis is also diagnosed based on visual examination. With pustular psoriasis, a differential diagnosis with bacterial skin disease is performed.
If there is psoriasis on the bending surface, additional examination is required to exclude inflammatory properties of the skin on the fungus. No specific laboratory tests are required, as psoriasis does not cause changes in blood composition.
How is psoriasis treated?
How psoriasis can be cured depends on the form and severity of the symptoms. Pathology cannot be completely cured, therapy aims to achieve a stable decline. The peculiarity of psoriasis is that there is no universal treatment regimen. For psoriasis, treatment includes:
- drug therapy;
- nutrition adjustments;
- spa treatments.
There are a number of basic medications, but they are not suitable for all patients. The primary task of a physician is to determine the type of medication that is appropriate for a particular patient. Moreover, in some cases, it is necessary to try a dozen different drug treatment regimens before the optimal drug therapy direction is chosen.
Ointments and creams for the skin
How can psoriasis be cured? Scientists and doctors have overcome this problem for more than a dozen years, but there is still no effective cure for the disease. Conservative therapy suggests the use of ointments and skin creams.
Means for external use are divided into indifference and hormones.
Hormone ointments are not safe and in some cases cause worsening symptoms, so dermatologists increasingly abandon this method of treatment, choosing an indifferent ointment and physiotherapy.
Indifferent ointment is a preparation with a natural composition, enriched with various vitamins and micro elements. They aim to stop inflammation, reduce exfoliation, soften the skin.
Herbal ointments with anti-inflammatory properties can be used in the treatment of psoriasis. If there is no allergy, it is permissible to use the drug with propolis. Ointments with petroleum products are widely used, which effectively softens the skin.
In the event of severe inflammation, hormone therapy is used. This is a corticosteroid ointment. In severe cases, injections of these drugs may be prescribed.
In addition to topical products, psoriasis requires pills. If vitamin D production is disrupted, intake of this substance is indicated. Be sure to prescribe hepatoprotectors, as inflammation of the epidermis has a negative impact on liver function, especially with long-term psoriasis.
Illness is exacerbated by stress. Neurosis and other mental disorders cause worsening disease. Accordingly, traditional therapy must be complemented with sedatives. For psoriasis, anti-anxiety medications are prescribed to combat stress. For long-term use, valerian, motherwort or peony root tincture can be prescribed.
The latest psoriasis treatment method is a method aimed at suppressing excessive proliferation of skin cells. In severe forms of the disease, immunosuppressants and antineoplastic drugs may be prescribed.
Physiotherapy is essential for treatment. For psoriasis:
- PUVA therapy;
- Ultraviolet radiation (UFO);
- laser therapy;
- selected phototherapy;
- fell asleep.
Each method has its own characteristics, however, all methods affect the inflamed epidermis stimulating metabolic processes and stopping excessive cell proliferation.
In the event of an increase in psoriasis in the summer under the influence of UV rays, it is necessary to approach the issue of physiotherapy with caution. Ultraviolet techniques can boomerang and exacerbate symptoms.
Electrosleep is indicated for severe mental problems and severe stress. This method shows good results in the treatment of psoriasis.
Therapies with folk remedies for psoriasis include the use of homemade emollient ointments and medicinal plants with sedative properties.
To reduce skin edema, it is recommended to bathe with fir twigs, rub the skin with a decoction of chamomile. Ointment is prepared based on egg yolk, butter, lard. Their main purpose is to soften the skin, so this will not cure psoriasis.
For internal intake, recommended decoctions of lemon balm, St. John's wort, chamomile. At home, you can prepare sedatives from valerian root or motherwort.
Nutrition for psoriasis
Diet plays an important role in treatment. With the increase of psoriasis, it is recommended to exclude allergen foods from the diet. Because the disease has a negative effect on liver function, one should abstain from alcohol, fatty foods and fried foods. Smoked meats and pickles, semi-finished products, carbonated drinks and coffee are prohibited.
Preference should be given to fruits and vegetables, lean meats, fish. For psoriasis, it is useful to eat nuts, because they are rich in B vitamins, which are necessary for the normal functioning of the nervous system.
Spa treatment is a medical treatment, performed for the purpose of prevention and recovery in psoriasis.
Mineral water treatment is widely used in psoriasis. Patients are recommended thermal springs in the Carpathians, Bulgaria, Turkey. Good results are achieved when visiting sanatoriums and health centers, where hydrotherapy is done with the help of fish that eat keratin skin particles.
For psoriasis, sea air and sea salt, mud therapy is useful. Sanatorium treatment is recommended annually. Along with medication and physical therapy, this method helps achieve lasting remission.
Psoriasis and the army
Mild forms of psoriasis are no exception in military service. With widespread psoriasis on the skin, which is often exacerbated, a man can be given a "B" category, but will need to undergo a full medical examination and submit a certificate of treatment every six months.
If there is a common form of the disease with complications in the joints and ineffective immunosuppressive treatment, a man can be given a "D" category.
Quality of life and prognosis
Psoriasis significantly worsens quality of life, mainly due to social adjustment problems in the form of common diseases. Complicated psoriasis has a negative impact on general well-being and worsens the function of internal organs, especially the liver.
Complications of psoriasis extend to the joints. In severe cases, this can lead to their deformity, disruption of motor activity and disability.
At the same time, proper therapy allows the patient to live life to the fullest. Even with psoriasis, the prognosis is not conducive, because the disease is incurable, one can learn to live with its diagnosis.