Scaly lichen is one of the most common chronic dermatosis. 5-7% (according to different authors) of the population of the entire planet suffers from symptoms of varying severity. This disease is better known as psoriasis. And if previously the pathology was studied only from the point of view of skin lesions, it is now more often considered a systemic process, covering almost all organs. Therefore, doctors sometimes use the term "psoriatic disease", which to a greater extent characterizes clinical symptoms and pathophysiological processes.
The main cause of pathology is called a specific autoimmune reaction, an inherited tendency. In other words, to the question of how psoriasis is contagious, doctors answer emphatically - the disease is completely harmless to others. For the onset of symptoms, a combination of hereditary gene mutations and the influence of certain provoking factors that trigger a chain of immunological reactions is required.
The main link in the pathogenesis of such dermatitis is the tendency of keratinocytes, which form most of the epidermal cells, for increased proliferation, i. e. cleavage. In this case, the pathological process can include any part of the body - the scalp (seborrheic form), nails on the fingers and toes, plantar and palmar zones, etc. But often psoriasis is localized symmetrically to the bending surface of the limb, around large joints (elbows, knees in the lower leg area), along the spine, including the back of the neck.
Depending on the pathogenetic mechanism of pathological development, psoriasis is divided into two types. The first occurs in almost 70% of patients. Its occurrence is associated with a complex HLA antigen system; this form of the disease is characterized by manifestations at a relatively early age. This usually occurs at the age of 20-25, but recently there has been a tendency for the appearance of rashes such as plaque or tear forms, characteristic of psoriasis, even in infants (usually the skin on the back, genitals, and face is affected). Photos of such symptoms can be easily found on the internet.
In addition to external manifestations, the development of the disease is usually accompanied by significant violations of internal organs, such as:
- Endocrine system disorders. In adolescent girls and women, increased pathology is often associated with the menstrual cycle, lactation period, etc. In most patients, decreased glucocorticoid function of the adrenal glands is also detected (modern scientists seek to link this fact with the mechanism of development of the disease).
- Metabolic Disorders. This is a significant disturbance of nitrogen metabolism, a decrease in albumin content with a simultaneous increase in the levels of α-, β- and γ-globulin. Also, changes in lipid metabolism were detected, manifested in the form of hypercholesterolemia and hyperlipidemia. In a clinical study, conducted in the late 90s, experts established a link between the severity of the manifestations that characterize psoriasis and the level of free cholesterol.
- Destructive changes in connective tissue. Arthropathy occurs on average in 5-10% of patients, and if with a vulgar form of pathology, it occurs in 6-7% of cases, then with pustular-in 32%. Psoriatic arthritis can occur in different ways, the severity of clinical manifestations due to genetic characteristics. But usually the disease begins aggressively and within 2 years causes serious changes in the joints, which often lead to deformities. In addition, there is a clear link between the intensity of the inflammatory process in the cartilage tissue and the epidermis.
- Disorders in the activity of the cardiovascular system. Already in the early stages, psoriasis is accompanied by rhythm disturbances in the form of notches- or bradycardia, increased ventricular size, fibrotic changes in myocardial structure, and mitral valve defects.
- Disorders of the gastrointestinal tract. In 93% of patients diagnosed with psoriasis, there are atrophic changes in the mucous membranes of the digestive system. Decreased secretion of hydrochloric acid, an important enzyme, is also observed. The process of nutrient absorption is disrupted, leading to vitamin deficiency. In addition, liver function activity also decreased.
Variety of psoriasis
- At my feet
- On the genitals
- In the head
Psoriasis is usually diagnosed by the clinical manifestations of a specific disease, which differs significantly from the symptoms of normal dermatitis, whose main symptom is intense itching. But recently, narrowly focused laboratory blood tests have been available to identify specific markers of the autoimmune process. This is the determination of the concentrations of various interleukins, some forms of HLA and tumor necrosis factors.
In difficult cases, a diagnostic biopsy is used. This is usually required to distinguish from lichen planus and lichen pink, seborrheic dermatitis, toxicoderma and other types of dermatosis and bacterial pustules. If psoriatic arthritis is suspected, X-ray and ultrasound examination of the joint is required.
Haemoscanning is widely offered in some cities. This is a diagnostic method based on the detection of various diseases, including psoriasis, by a drop of blood. But in scientific medical circles, this technique is addressed with much skepticism.
Psoriasis is a chronic disease that tends to recur, and doctors sometimes find it difficult to say what can provoke them. Therefore, patients are strongly advised to adhere to a strict diet and limit the use of cosmetics. For skin care at home, only special shampoos and creams are indicated.
The treatment of psoriasis is complex and involves the use of both external agents and medications in the form of injections and tablets. So, for local therapy, ointments with corticosteroids are usually prescribed, as well as medications that help soften the skin. Severe forms of the disease, especially psoriatic arthritis, require the use of strong immunosuppressants and cytostatics. Complex with prescribed vitamins.
At the remission stage, pathology is allowed to be treated in a sanatorium. Patients are offered sunbathing or solarium, applying tar to the affected skin area, various physiotherapeutic procedures. The psycho-emotional state of the patient also plays an important role in the therapeutic process.
Psoriasis: classification and symptoms
There are many classification systems for this pathology, but the simplest and most common division is considered based on course characteristics, prognosis and clinical picture.So, psoriasis is of the following types:
- psoriasis vulgaris, which by the nature of the rash can be inverted, freckled, seborrheic, etc . ;
- psoriatic arthritis with primary joint involvement;
- psoriatic erythroderma, which, in addition to cutaneous manifestations, systemic manifestations are also characteristic;
- pustular psoriasis, which in turn, is divided into general (Tsumbush type disease) and palmar-plantar (barber type psoriasis). The difference between these forms lies in further predictions. The first belongs to the rapidly evolving and therefore fatal types of disease, while the second clinical signs are quite appropriate for drug control.
Psoriasis in most patients is characterized by a symmetrical arrangement of papular rashes. But doctors emphasize that any area of вЂ ‹вЂ‹ not only the skin, but also nails can be affected. The main element of the rash is a so -called pink epidermal papule. It has a flat shape, a rough surface and is covered with silvery white scales that easily peel off when scraped. This shadow occurs due to the accumulation of air bubbles.
The size of the papule depends on the stage of the disease. At first a few millimeters, but over time, the rash spreads and merges into large plaques of various shapes. Psoriasis can also be accompanied by a separate combination of papules and a broad rash.
A hallmark of pathology is the Kebner phenomenon, it is also called the psoriatic triad.
Therefore, when plaque is scraped, the following changes will occur:
- initiates the separation of abundant silvery scales, resembling shavings from wax (“stearin spot” phenomenon);
- after removing the scales, the wet "varnished" surface opens (psoriatic film phenomenon);
- by further scraping the skin, droplet bleeding begins (the phenomenon of "blood dew").
Other pathological classifications are based on the appearance of the rash and the size of the papules produced. For example, there are types of psoriasis such as: puncture, when the rash element is similar to a pinhead, annular when a circle is formed from the rash, geography when the papule merges into a map -like picture, etc.
In 85% of patients, skin lesions are localized to the arms and legs, in 70% of cases, they extend to the trunk. In half of the patients (mostly girls and women), the pathology included the genitals. Often, such a rash is combined with the formation of papules in the hair growth zone on the crown, temples, back of the head, usually here the rash is a natural focus. Defeat of the palms and soles of the feet was observed in almost every tenth patient, in which case a wide round and scaly plaque formed, covered with grooves.
This is important
Psoriasis is a genetically determined autoimmune disease, so it is not contagious in others. Symptoms can be controlled with certain medications, but some of them can only be taken at a pharmacy with a doctor's prescription.
Psoriasis: causes, severity, effects on one's lifestyle
The exact cause of the pathology has been known in recent times. Only with the advent of methods to study hereditary genetic mutations, experts can explain why psoriasis develops. It has now been precisely established that the cause of pathological development is an autoimmune process with a background of hereditary predisposition.
Symptoms of skin lesions appear after being exposed to certain factors that stimulate the process of increased keratinocyte distribution, and as a result of the weakness of the mechanism that suppresses it.
Causes that can cause psoriasis include:
- nerve or mental trauma, severe stress;
- endocrine pathology (diabetes mellitus, thyroid disorders);
- chronic infectious disease, usually provoked by streptococcus;
- fungal infections of a systemic or local nature;
- immune deficiency conditions;
- disorders of metabolic processes, especially lipids and proteins;
- sudden changes in hormonal background;
- Long-term untreated parasitic infection.
Currently, hypotheses are put forward about the possible effects of various viruses on the genetic apparatus of epidermal cells.
Depending on the severity of clinical symptoms and the localization area of the skin lesion, psoriasis can occur in three stages:
- Light, characterized by the appearance of a single papule, almost no itching and exfoliating areas of the skin.
- Mediumis accompanied by damage from 3% to 10% of the skin surface, so the symptoms are much stronger, disorders of the digestive and cardiovascular systems occur. Pathology
- Severe courseis characterized by the presence of an inflammatory focus on more than 10% of the epidermal surface. Concomitant organ disorders are pronounced.
Psoriasis, like other dermatological pathologies, has a significant impact on quality of life, as the skin is the main visible part of the body. And his condition undoubtedly affects one’s attractiveness. And his self-esteem is highly dependent on the level of acceptance in society, the breadth of the circle of friends, the order of his personal life.
The unesthetic clinical manifestations of psoriasis, visible to the naked eye, result in a person’s special position among others. The patient felt that he was always being watched, and sometimes ridiculed and cursed. Therefore, patients should cover the defect with clothing and beard. In addition, the everyday problems that are not uncommon for healthy people always arise with the choice of hairdressers, beauticians, swimming pools both in the pool and in the open waters.
All of these factors have a significant effect on a person's psychosomatic condition. There are constant problems with adjustment in the team, which is very important for a teenager. People often have difficulty starting a family, finding a job, etc. Unwanted reactions from the use of various drugs designed to reduce psoriasis affect the human condition not in the best way.
Psoriasis skin diseases: main treatments, recipes and nutrition
To date, it is impossible to completely get rid of this pathology, and therapy aims to suppress the uncontrolled process of epidermal cell division. Therefore, it is necessary to ensure that skin disease psoriasis enters a stage of remission, and to prolong this stage as long as possible.
There are no generally accepted treatment regimens for pathology today, so doctors select funds for local or systemic use based on the severity of disease symptoms, the person’s condition and the surface area of the affected skin. Preparations for external use are only suitable for mild psoriasis. In other cases, combination treatment is required.
- moisturizing and anti-inflammatory creams with keratolytic action based on lanolin, salicylic acid, coal tar, etc . ;
- ointments with corticosteroids, which have significant anti-inflammatory properties, such drugs are the most common way to relieve the symptoms of psoriasis skin disease;
- topical use of vitamin D derivatives to avoid side effects from the use of hormone creams;
- oral retinoids, inhibit epidermal cell division and stabilize cell membranes;
- cytostatics that suppress autoimmune reactions;
- multivitamin complex;
- drugs that contain enzymes;
- psychotropic drugs.
This is important
Psoriasis is a non-communicable skin disease, so antibiotics are not used in its treatment, it is only needed in the event of complications.
Birch tar is the most commonly recommended alternative therapy. At night, it should be rubbed on the affected part of the skin, left to soak slightly, and then covered with a linen or cotton diaper. Wrap all of this on top with paper or thick paper, but do not use cellophane for this purpose. Cover with a fur scarf and secure with a bandage. The procedure is repeated three times, after which you need to take a bath with soap. Continue this course for up to a month. Instead of birch tar, grated raw potatoes can be applied to the lesion.
Psoriasis skin disease requires a hypoallergenic diet. But at the same time, it must be rich in all the necessary vitamins and minerals. The basis of the diet is vegetables and fruits, except tomatoes, eggplant, peppers, citrus fruits, red apples, raspberries, strawberries, etc. You can eat ingredients, root vegetables, garlic and onions.
Lean boiled meats and legumes are good sources of protein. This diet can also include cereals, wheat flour products, natural dried fruits, vegetable oils. However, you should refrain from honey. It is also recommended to consume at least one and a half liters of water a day, reducing the amount of salt and animal fat. Alcoholic beverages, chocolate and other products with cocoa are contraindicated. It is very important to quit smoking.
Pathological prevention is essential for people whose close relatives know firsthand what skin diseases are. First of all, nerve strain should be avoided, if necessary, control the emotional state with sedatives. In addition, you should avoid food intake, use of cosmetics and medications that can cause symptoms of allergic reactions. Timely cleaning the focus of viral or bacterial infections is also required.