One of the most common skin diseases is "psoriasis" or psoriasis. According to statistics, it occupies 15% of dermatological diseases. 3% of the world's population suffer from this disease, most often in regions with a cool climate. The tendency to develop severe forms of the disease is increasing. Recently, the diagnosis of psoriasis has become relevant not only for adults; cases of this diagnosis have become more frequent in very young people, and even in children. Until now, all the causes of this disease have not been disclosed.
What is psoriasis
Psoriasis, the clinic and diagnosis of which is known to every dermatologist, is a chronic skin disease. It is characterized by the presence of red outlined spots that are covered with flaky silvery scales. Over time, the activity of the disease fades. The disease mainly affects the skin, although there are cases of diseases of other organs, in particular joints and nails.
Although psoriasis is called "scalydeprive", unlike other types of lichen, the disease is not contagious. The triggering mechanism of the disease is a process that occurs in the epidermis. Keratinocytes are formed in the deep (basal) layers, then keratin must be produced from them - the protein from which nails, hair, skin are built. Keratinocytes in normal development from the lower to the upper layer move imperceptibly, in about a month.
In psoriasis patients, keratinocytes multiply too quickly and move to the upper layer in 4 days. The skin is not able to get rid of these cells so quickly, their number is constantly growing, and there are dry, compacted areas on the skin in the form of plaques. At the same time, the lower layer of the dermis, where the blood and lymphatic vessels, nerves pass, becomes inflamed and swollen. Diagnosis of psoriasis will help to correctly identify the type of disease.
Types and symptoms of disease
Different types of disease can proceed in different ways, follow alternately or simultaneously. There are several types of psoriasis:
- Spotted. The most common type. Manifested by rashes on the skin, first covers small areas, then grows, appears in the same places of the body on the opposite side. This type of disease is possible after any viral or streptococcal infection, after treatment with corticosteroids. Small spots, increasing, turn into plaques, unite into large areas. If damaged, small hemorrhages are possible (Auspitz sign). Locations affected: knees, elbows,legs (lower part), palms, thighs, calves, lower back. In 50% of patients, psoriasis of the scalp is observed, plaques appear along the border of hair growth. Diagnosis of psoriasis in children is carried out in basically the same ways as in adults.
- Teardrop shaped. A rare form of the disease. Plaques suddenly appear on the legs, arms, and head. Often disappear on their own, but may reappear in stressful situations.
- Reverse. This form is difficult to treat. Inflamed, smooth areas occur in the folds of the body (under the breasts, armpits, in the groin).
- Seborrheic. The patches are red scaly areas located above the shoulder blades, behind the ears, in the armpits, in the groin and on the face. Treatment is difficult. When diagnosing seborrheic psoriasis, attention is paid to the fact that, despite a long-term skin lesion, there is no alopecia, hair thinning.
- P soriasis nails. With this type, on the legs and arms, the nail plates change color, exfoliate. Often this type of psoriasis is associated with psoriatic arthritis. Usually, the diagnosis of psoriasis of the nails is carried out without difficulty. Sometimes a histological examination is performed.
- Psoriarthritis arthritis. An inflammatory disease that leads to inflammation and stiffness in the joints. It is divided into several types: symmetrical, asymmetrical, mutilated.
- Psoriatic erythroderma. A severe, rare form in which almost the entire body is covered with a red scaly crust.
- Pustular. Pustules form on the legs and arms. This species can appear on its own,or be concomitant with another form of psoriasis. In the latter case, it is quite dangerous.
Causes of disease
Etiology, clinic (the diagnosis of psoriasis does not cause problems) have long been studied, but the reasons why the disease occurs are still being investigated:
- Medicine claims that psoriasis occurs when there is a malfunction in the immune system, with various factors that are responsible for the correct division of skin cells. Faulty immune responses cause inflammation and dramatically increased production of immature cells.
- Heredity plays a big role in this disease. 35% of patients have these problems genetically. The genetic factor is leading in the causes of psoriasis.
- Weather conditions play a big role in the course of illness. In dry, cold weather, an outbreak can occur. Some suffer from photosensitivity and experience relief only in winter, when there is much less sunlight.
- Strong emotions, stress. Relapses of psoriasis occur with stress, emotional disorders, depression and anxiety.
- Infections. Some bacteria and viruses can cause psoriasis, such as streptococci that affect the upper respiratory tract. Often transferred pharyngitis, tonsillitis, sinusitis in adolescence becomes the cause of guttate psoriasis. Linked to psoriasis and HIV, and in some cases HPV (human papillomavirus).
- Skin injury. This reaction is calledthe Koebner phenomenon, when the skin is damaged in the form of red lines. These areas may develop psoriasis. May develop in areas that were not affected by trauma.
- Drugs can trigger psoriasis, these are: ACE drugs, beta-blockers, chloroquine, lithium, NSAIDs (indomethacin), the hormone progesterone, various steroid ointments covering large areas of the skin.
Methods for diagnosing psoriasis
The doctor who determines the disease takes into account:
- clinical picture of the disease;
- presence of the Koebner phenomenon;
- symptoms of the psoriatic triad.
Diagnosis of psoriasis relies on the psoriatic triad - these are phenomena that occur when plaque is scraped off. It could be a phenomenon:
- stearin stain, scraping off the papule, you can observe peeling, which looks like pounded stearin;
- spot bleeding, after scraping off the terminal film, separate droplets of blood appear;
- Koebner, new rashes appear in places of irritation, especially in the acute phase of the disease.
Sometimes a histological examination is required for certain changes.
Blood tests
If the doctor finds it difficult to diagnose by external signs, laboratory diagnostics of psoriasis is prescribed, it includes the following tests:
- Complete blood count, it does not include leukocyte formula and ESR. Often psoriasis is a companionanemia and leukocytosis.
- Rheumatoid factor helps detect a protein that is elevated in inflammation. For psoriasis, the result should be negative. This is its difference from rheumatoid arthritis, when this factor rises.
- ESR (erythrocyte sedimentation rate). This indicator should be normal. The exception is cases of pustular psoriasis or psoriatic erythroderma.
- Uric acid. With psoriasis, this figure increases. Psoriatic arthritis resembles gout, which is characterized by an increase in the concentration of uric acid in the blood. In this case, a complete diagnosis of psoriasis is necessary, tests are one of the stages.
- Antibodies to HIV. This infection often causes sudden onset of psoriasis symptoms.
Psoriasis: differential diagnosis
In clinical practice, situations often arise when similar symptoms resemble different diseases. It is necessary to distinguish one condition from similar ones; differential diagnosis of psoriasis helps in this. Outwardly, psoriasis and red lichen are similar in their first signs. To prescribe adequate therapeutic measures, the doctor must clearly know the distinguishing features. When examining, the doctor sees typical clusters of papules, which are covered with white silvery scales, they then form psoriatic plaques. Pathological elements are bordered by a red corolla, which is called the Pilnov rim, it indicates what is happeningprogression of psoriasis. Differential diagnosis allows this to be revealed. It is easy to establish a diagnosis after grattage (scraping), which makes it possible to detect the phenomena included in the psoriatic triad.
Severity of disease
Psoriasis, which is diagnosed and treated in every dermatological clinic, has a different severity of the disease. Starting from one or two papules, psoriasis develops to the post-usual type, sometimes it poses a threat to life. There are several degrees of severity of psoriasis:
- Mild psoriasis. Cases where the surface of the skin on the body is covered by 3%, most often even only 2% of the skin is affected.
- Moderate psoriasis. The skin is affected by 3-10%.
- Severe form of psoriasis. In this case, the disease affects 10 or more percent of the skin. The severity is also measured by the impact of the disease on the quality of life of the patient.
Another classification is also proposed, which involves a two-level system, according to which patients are divided into those in need of systemic and local treatment.
Common and severe psoriasis is more difficult to treat. Some forms are very resistant to treatment, even if they are not severe. This includes:
- psoriasis on soles and palms;
- in the folds of the skin (inverse psoriasis);
- psoriatic arthritis;
- psoriasis affecting the scalp.
Psoriasis treatment
Treatment of severe and moderate formstreatments for psoriasis include light therapy, systemic drugs, combined and excimer laser therapy, which are often very effective.
TNF inhibitors reduce the activity of immune factors, help with severe forms of psoriasis, but complications can occur with other infections.
Ustekinumab. This product contains monoclonal antibodies. The remedy helps with severe and moderate forms of the disease. Studies of the drug are still ongoing, at the moment positive qualities have been identified.
There are new drugs that are not yet fully understood. Preliminary studies indicate a positive trend. There are methods that are not approved. The use of various ointments, sprays, creams can alleviate the symptoms of psoriasis. The clinic, diagnosis, treatment of the disease are described by many medical scientists. They identify three main treatment options for the disease:
- Topical products (creams, shampoos, ointments, sprays).
- Drug treatment. The drugs used (injections, tablets) affect not only the skin, but the entire body.
- Phototherapy. Light is used for healing.
For each person, treatment is selected separately, taking into account all the individual characteristics of the body, as well as the type and form of the disease.
Alternative Methods
Those who suffer from a protracted course of psoriasis are trying to look for some alternative, non-traditional methods of curing the disease. But it is worth remembering that thisnot an ordinary skin pathology, although it resembles lichen. The reason for it lies within the body. It is better to entrust the choice of treatment method to the doctor.
For example, it has been found that green tea slows down the growth of skin cells, but studies have so far only been conducted on animals. What reaction the human body will give is not yet known.
Unconventional methods offer some herbal preparations in the treatment of psoriasis, but clinically confirmed data on their effectiveness still does not exist.
You should not use some folk remedy that you have heard again, you need to make sure, after consulting with your doctor, that it will not cause even more harm to your body.
Herbal preparations, as well as dietary supplements, are not controlled by the system, so manufacturers do not need permission to sell them. Do not forget that any substance of plant origin also has its own side effects, in some cases it can even cause damage to he alth.
Sometimes patients have real problems after using natural remedies.
The effectiveness of products containing zinc pyrithione is doubtful. In many countries, this connection is even banned for use, but, unfortunately, such tools are available on the Internet.
Used to treat Gotu Kola cream. If this herb is used internally, many side effects are possible. For pregnant women, it is also dangerous to terminate a pregnancy.
Disease prevention
Despite the fact that there is an unambiguous opinion about the harmsunburn and sunlight, with psoriasis it is very useful. Regular exposure to moderate sunbathing develops positive dynamics, reduces anxiety and stress.
There is a relationship between relapses of the disease and negative emotions, so you can alleviate the symptoms by any anti-stress methods. Seeing a psychotherapist and psychologist greatly relieve symptoms.
If the skin is too dry and itchy, you can try the following remedies:
Take a warm bath for 15 minutes. Then apply salicylic acid, which removes scales from the skin. After that, use any emollient cream - Cetafil, Vaseline or Eucerin. Moisturizing gloves can be worn at night.
Capsaicin ointment, where the active ingredient is chili pepper seeds, will help against itching and irritation. It helps relieve psoriatic itching. There is a burning sensation at first, but then it fades.
Nutritional factors. Patients should consume enough folic acid. It is found in foods such as asparagus, leafy greens, fruits, peas, dried beans, liver, yeast, orange juice.
Include omega-3 foods in your diet, use fish oil, which has anti-inflammatory properties, has a positive effect on autoimmune diseases.
