As you know, the development of medicine does not stand still. New drug discoveries are made every day. However, it has not been possible to completely eliminate some ailments so far. An example is psoriasis. This pathology is characterized by a systemic lesion of the skin, its dryness and the appearance of hard plaques. Specific symptoms help to recognize the presence of the disease - the psoriatic triad. This phenomenon has been known for many years. It is the main diagnostic criterion for the disease and an indication for treatment.
Psoriatic triad: description of the phenomenon
Psoriasis has several clinical forms. Therefore, the signs of pathology do not have to be the same in different patients. However, there are a number of symptoms that are characteristic of all varieties of the disease. These include the psoriatic triad. What is it and how to recognize it? Only a doctor can identify specific signs of the disease.dermatovenereologist after examination. To see such symptoms, the doctor must carefully examine the skin during the period of exacerbation and scrape the plaques. The psoriatic triad includes the following components:
- Presence of stearin spot syndrome.
- Appearance of pinpoint hemorrhages on the skin during scraping.
- Availability of terminal film.
Stearin is a type of fat. This substance is not related to psoriasis. However, one of the signs of the triad was called "stearin spot syndrome". This happened due to the fact that when the upper layers of the affected skin are exfoliated, large white areas of the epidermis are separated. Outwardly, they resemble stearin.
The next characteristic sign of psoriasis is pinpoint hemorrhages. They appear when the scales are separated. Another name for this phenomenon is bloody dew syndrome. The last component of the triad is the presence of a terminal film on the skin. It is located under psoriatic plaques. The film has a smooth shiny surface. Only by removing it, you can see pinpoint hemorrhages.
Experienced doctors immediately recognize the phenomena of the psoriatic triad. However, it is not worth removing the scales on your own to make sure the diagnosis. This can damage the skin and spread the lesion.
Causes of psoriasis
Psoriasis is a chronic pathological process that doctors have been struggling with for several centuries. Find a cureable to completely eliminate this disease, and failed. This is due to the fact that doctors have not yet figured out the exact etiology of the disease. There are several hypotheses regarding the cause of psoriasis. The main one is the genetic theory. After all, the disease is often observed in members of the same family. To a greater extent, this hypothesis is applicable to early cases of psoriasis. If the disease occurs in adulthood and there is no burdened hereditary history, then the disease is associated with other causes. Among them are the viral and bacterial theory. In addition, almost all patients have immunological disorders.
Based on this, we can say that psoriasis is a polyetiological disease, that is, it develops under the influence of several causes and has a complex pathogenesis. Among the factors that are predisposing to this pathology, there are:
- Burdened heredity.
- Taking toxic drugs.
- Thin and dry skin.
- Exposure to chemical and physical irritants.
- Stress effects.
- Chronic pathological processes affecting the skin.
The disease is actively studied not only by dermatologists, but also by such specialists as immunologists and allergists. After all, finding out the cause and pathogenesis of the pathology will allow you to find the best method of treatment.
Mechanism of symptom development
You can make a diagnosis on such a basis as the presence of the psoriatic triad. Each of the main symptomshas a certain mechanism of development. Stearin spot syndrome is the result of flaking of the top layer of the epidermis. The skin loses moisture and becomes dry. As a result, scales are formed. With the accumulation of several layers of dry epidermis, the skin begins to peel off. As a result, psoriatic plaques appear on the affected areas. When scraped off, the damaged epidermis resembles stearin.
The primary element of psoriasis is the papule. It occurs on the skin due to the inflammatory process. The appearance of papules is also due to the rapid division of epidermal cells. This leads to the fact that the top layer of the skin does not have time to fully form and, as it were, is “pushed” to the surface, forming rashes. This characterizes the pathohistology of the psoriatic triad. The papule is covered with a thin layer of terminal film. Outwardly, it resembles polyethylene. The appearance of "bloody dew" is due to damage to small vessels penetrating the thickness of the skin.
Classification of psoriatic elements
There are several varieties of psoriasis, which differ in the location of the lesion and skin elements. The classic rashes include plaques. They are small pinkish-red papules covered with scales. In the affected areas, the skin temperature is higher than in he althy neighboring tissues. This is due to the inflammatory nature of the disease. On the surface of the papule, the epidermis is flaky and has a dry structure. As a result, scales of a whitish-silver color appear. With the progression of the pathology, the plaques increase and merge,forming "paraffin lakes".
The next type of disease is psoriasis of the flexion surfaces. It is characterized by the appearance of pink-red inflammatory spots on the folds of the skin. Localization of the lesion - axillary and inguinal region, inner thighs. In women, spots can appear on the abdomen and under the mammary glands. Such psoriatic elements are not covered with scales, therefore, they are easily damaged.
Rare rashes include pimples that look like drops or coins. An unfavorable type of skin rash is a pustule. It is a blister filled with exudate. On the surface of the pustule there is a dry exfoliating layer of the epidermis. Even with minor injuries, the blisters open, forming erosion. The pustules tend to coalesce and become infected. Nail psoriasis is considered a separate type of disease.
Characteristic clinical manifestations
The peculiarity of the disease is that it is not transmitted by contact. Therefore, psoriasis is not dangerous to others. However, the genetic nature of the pathology should be taken into account. Children whose parents have psoriasis are much more likely to develop the disease. In addition to skin lesions, inflammation of the joints, pathologies of the endocrine, bone and nervous systems are often observed. For this reason, psoriasis should be classified as a systemic disease. The disease has an undulating chronic course. In addition to the psoriatic triad, the characteristic features of the disease include: the presence of a rim around plaques, a dense structureskin elements and the appearance of papules when the epidermis is damaged. If these symptoms are found, it is worth getting an examination.
Diagnosis of the psoriatic triad
Diagnosis of the disease begins with a dermatological examination. The doctor performs a skin scraping at the site of the plaques and detects signs of the psoriatic triad. Stearin stain is the first diagnostic criterion. Skin scraping does not cause pain to the patient. Dry epidermis is easily peeled off with a spatula. After removing all scales, a thin terminal film is found. It is also easy to separate from the papule. If you continue to scrape the skin, the third sign of the disease is diagnosed - pinpoint hemorrhages.
In addition to dermatological examination, perform:
- X-ray of bones and chest.
- Arthroscopy.
- MRI.
- Bacteriological examination of the skin.
- General and biochemical blood tests.
Diagnostics should be complex, since psoriasis can damage various structures. Depending on the clinical manifestations, the doctor selects an individual set of examinations for each patient.
Performing differential diagnosis
Differential diagnosis is made with other diseases of the skin. Most often it is required for atypical forms of psoriasis. For example, if there are pustular rashes on the skin or damage to the nails. The psoriatic triad allows with confidencemake a diagnosis.
Features of the treatment of the disease
To pathogenetic therapy of psoriasis include the use of ointments based on glucocorticosteroids. Hormonal drugs help to relieve the inflammatory syndrome and slow down the progression of the disease. However, long-term treatment with steroids leads to the development of side effects. Safer drugs include ointments that have a keratolytic effect. They soften the scales and moisturize the skin. Also, antihistamines are used.
Baths with anti-inflammatory herbs (calendula, chamomile) and clay applications help improve skin condition. Also, you should always use creams.
Drug therapy for psoriasis
In the period of exacerbation of psoriasis, hormones are prescribed. These include ointments such as Flucinar, Triamcinolone and Hydrocortisone. To prevent itching and the spread of rashes, antihistamines are prescribed. "Salicylic" ointment has a keratolytic effect. It destroys dry skin that forms plaques. Also used drugs "Sinalar" and "Dermovate". Additional remedies include ointments containing zinc, tar and ichthyol.
Preventive measures for psoriasis
To increase the duration of remissions, it is recommended to avoid physical and chemical effects on the skin. Sunbathing is not recommended. Improving the condition of the skin contributes to the constant use of ointments and creams. Positive dynamics is found after sanatorium treatment andclimate change.
