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psoriasis

What does psoriasis look like on the skin

A pathological condition characterized by scaly and nodular changes in the skin and nails is called psoriasis. Dermatologists are involved in the diagnosis and treatment of the disease.

Psoriasis is a chronic skin and nail disease that causes a rash of pink nodules and silvery scales to appear on the skin. Usually, the nodules fuse into large plaques, around which the skin is quickly covered with scales. With prolonged development of the disease, joint damage is possible, accompanied by reduced mobility and constant pain. Different forms of psoriasis differ in the degree of skin damage: the patient may have only subtle patches on the scalp or large plaques on different parts of the body. The likelihood of developing complications of psoriasis also depends on many factors. This disease is especially dangerous for pregnant women, since the pustular form of the disease can lead to miscarriage.

About the disease

Psoriasis is one of the most common skin diseases. The first symptoms of skin changes usually appear between the ages of 18 and 35. Often psoriasis occurs on the background of cardiovascular diseases, Crohn's disease and depression. About 30% of patients develop joint damage (arthritis). The actual cause of psoriasis cannot be eliminated, but symptomatic therapy can significantly alleviate the course of the disease.

types of psoriasis

Depending on the prevailing symptoms, several types of psoriasis are distinguished:

  • Plaque: characterized by the appearance of classic plaques covered with silvery scales; preferred localization: elbows, knees, torso, scalp;
  • drop-shaped: the main manifestation is orange-pink nodules 1-10 mm in size;
  • Nail psoriasis: nail plates are predominantly affected;
  • Psoriasis of large wrinkles: rashes appear in the armpits, neck folds, genitals and other places of excessive friction; this form is more common in obese people;
  • Psoriasis of the head: the scalp is affected;
  • arthropathic psoriasis (psoriatic arthritis): joints are affected;
  • pustular psoriasis: several small vesicles with pus appear on the patient's skin;
  • Psoriatic erythroderma: In addition to the rash, there is a pronounced reddening of the skin in the area of \u200b\u200bthe rash.

Symptoms of Psoriasis

Plaques are most common in the forearm, lower leg, navel and scalp. The pustular form of psoriasis is characterized by the formation of pus-filled sacs on the skin. At certain times, many patients experience a change in the color and structure of the nails. Damage to the skin scales leads to spot bleeding. Patients also complain of itchy skin. Skin lesions periodically disappear and reappear.

Other symptoms and signs:

  • the appearance of red spots in the area of \u200b\u200bthe skin folds;
  • severe rashes appear after infectious diseases and stress;
  • slight increase in body temperature;
  • the appearance of new rashes in the winter months;
  • joint pain;
  • limited mobility in the area of the affected joint;
  • Dryness and hypersensitivity of the skin.

Plaque resorption usually begins in the central part, as a result of which the psoriatic elements acquire a ring-like or garland-like shape. Temporary depigmentation (pseudo-leukoderma) remains at the sites of the resolved rashes. In periods of incomplete remissions, single "duty" plaques may remain in certain areas of the skin (more often in the area of \u200b\u200bthe elbow and knee joints).

The most severe forms of psoriasis are psoriatic erythroderma and arthropathic psoriasis.

With psoriatic erythroderma, all (or almost all) skin is involved in the pathological process. The skin becomes tight, rough, infiltrated, colored red, with abundant large and small lamellar peeling on the surface. Peripheral lymph nodes increase, subfebrile temperature appears, the general condition of patients is disturbed, changes in the blood (leukocytosis, increased ESR), urine (proteinuria) are observed. The development of erythroderma is promoted by irrational, irritating therapy in the progressive stage of psoriasis.

Arthropathic psoriasis is characterized by lesions of mainly small joints of the hands and feet, less often the wrist, ankle, intervertebral vertebrae, etc. , accompanied by severe pain and swelling of the joints, limitation of their mobility and deformities. X-ray shows lysis of the distal phalanges of the fingers and changes in the joints, similar to those seen in rheumatoid arthritis. The Waaler-Rose test and the latex test are usually negative. In the blood, leukocytosis, increased ESR, hypergammaglobulinemia. Joint involvement can be associated with skin lesions or be isolated over several years.

In all these forms of psoriasis, damage to the nails in the form of punctured nail plates ("thimble phenomenon"), their clouding or thickening, up to onychogryphosis is possible. The course of the disease is chronic and wavy. The seasonality of the process is usually expressed - worsening in winterwith a significant improvement in summer (winter type), less often - vice versa (summer type).

Causes of Psoriasis

The exact mechanisms of psoriasis development are not yet understood. It is believed to be an autoimmune disease where the body's defense system mistakenly attacks healthy tissue. The T cells and neutrophils needed to fight pathogens can begin attacking skin cells and joint structures. In this case, characteristic changes in the skin appear, including the formation of blisters with an inflammatory liquid. The dilation of blood vessels in the area of inflammation is accompanied by reddening of the skin. Autoimmune diseases can be caused by hereditary factors.

Additional risk factors:

  • skin infections. First of all, these are bacterial infections caused by streptococci;
  • skin damage from cuts and burns;
  • prolonged stress and psychotraumatic factors;
  • alcoholism and smoking;
  • lack of vitamin D in the body;
  • taking certain medications, including lithium and beta-blockers;
  • unfavorable family history. The discovery of psoriasis in a close relative of the patient indicates the possibility of a genetic predisposition to this disease;
  • acquired or congenital impairment of immunity. It could be HIV infection, AIDS, or another condition.

Despite the discovery of the putative immunopathological causes of psoriasis, the disease remains poorly understood. There are a large number of diseases and lifestyle features that provoke the manifestation of hidden factors of predisposition to this disease.

diagnosis of psoriasis

If skin changes occur, you should consult a dermatologist. The doctor of our clinic first conducts a general examination of the skin to assess the nature of the rash. By gently scraping, you can see peeling papules and a thin film beneath the nodules. Under the film is a moist skin surface prone to small bleeding. At the same time, there are atypical signs of psoriasis that resemble other diseases, so the doctor needs to conduct instrumental and laboratory diagnostics.

  • blood analysis. The dermatologist will prescribe a venous blood test to rule out other diseases and detect signs of psoriasis. In the treatment room, the nurse applies an antiseptic to the skin of the patient's elbow, applies a tourniquet, and draws blood with a syringe. In our laboratory, specialists first rule out the presence of rheumatoid factors. In pustular psoriasis there is often an increase in the sedimentation rate of the erythrocytes. Elevated uric acid levels are noted;
  • Examination of the pustular fluid. The doctor collects the liquid in a sterile container and sends the material to the laboratory. Microbiological examination does not show bacterial culture, but an increase in the number of neutrophils characteristic of psoriasis is noted;
  • skin biopsy. The dermatologist prescribes this study in order to make an accurate diagnosis of atypical rashes. During the procedure, the doctor treats the skin with an antiseptic, numbs and removes a small area of skin with a scalpel. Tissue material is examined in the laboratory of our clinic using microscopy. The results allow to clarify the cellular composition of the nodules;
  • X-ray of the affected joint. The doctor prescribes this study to determine the type of arthritis. Even with severe complications of arthropathic psoriasis, X-ray diagnosis of the bones is required;
  • Skin scrapings to rule out fungus. The doctor cleans the surface of the skin and, using a special spatula, collects several scales for microbiological examination. This analysis is especially necessary when rashes appear only in the area of the foot and nails.

If necessary, a consultation with a rheumatologist is carried out.

expert opinion

Psoriasis is a disease with many manifestations. It can either be almost invisible or cause serious health problems. The most dangerous complications of psoriasis are joint damage, which can lead to patient disability. The disease can also lead to autoimmune diseases, in particular, Crohn's disease and ulcerative colitis, metabolic pathology, erectile dysfunction in men. Women suffering from psoriasis can experience infertility and miscarriage. In order to avoid these complications, it is necessary to consult a doctor immediately after the appearance of suspicious signs, and with an already diagnosed diagnosis, carefully follow all the recommendations of a specialist.

treatment of psoriasis

The main goal of psoriasis treatment is symptomatic therapy. Patients need medications that reduce inflammation and prevent rashes from forming. In addition to drug therapy, the dermatologist of our clinic necessarily prescribes a special diet for the patient. Lifestyle normalization and elimination of stressors can reduce the severity of psoriasis symptoms.

Depending on the situation, a dermatologist may use different methods to treat the disease.

  • administration of corticosteroids. The dermatologist prescribes ointments with these active ingredients. Beneficial effects of corticosteroids include reducing inflammation in tissues and eliminating itching;
  • Dietary supplement with vitamin D. Synthetic forms of this vitamin slow the growth of skin cells, thus preventing the formation of scales and nodules;
  • Therapy with drugs containing derivatives of vitamin A. A dermatologist will prescribe retinoid-based ointments to reduce inflammation and itching. These medicines increase the skin's sensitivity to light, so sunscreen must be used.
  • Use of calcineurin inhibitors. These are immunosuppressants that reduce inflammation. The dermatologist will prescribe topical agents such as tacrolimus. Such drugs are used in a short course to prevent the development of side effects and complications;
  • Treatment of the skin with salicylic acid to remove dead cells. A dermatologist prescribes this drug along with corticosteroids for complex skin treatment;
  • Using a moisturizer to get rid of dry skin and itching;
  • Irradiation of the skin with ultraviolet light. This safe method of physiotherapeutic treatment improves the functioning of local immunity. The doctor selects an individual dose of radiation for the patient;
  • phototherapy. With this method, the skin is irradiated with special equipment. Phototherapy combines the technologies of laser therapy and photochemotherapy;
  • Joint puncture in severe psoriasis. The doctor applies an antiseptic to the skin at the puncture site, numbs the tissue, and inserts a needle. With the help of a syringe, drugs are injected into the joint cavity to reduce the inflammatory process.

The dermatologist controls all phases of the treatment in order to achieve the best result and avoid complications. Corticosteroids, retinoids, and calcineurin inhibitors are used only under specialist supervision.

Prevention of psoriasis

The recommendations of the dermatologist of our clinic will help reduce the severity of rashes and alleviate the course of the disease.

Prevention of exacerbations of psoriasis:

  • Relieve anxiety and stress by improving sleep, avoiding coffee, and taking prescription tranquilizers.
  • Exclusion of foods containing allergens;
  • timely treatment of infectious skin diseases.

rehabilitation

Psoriasis is a chronic disease that cannot be cured. Rehabilitation measures are aimed at preventing relapses. Depending on the form of the disease, physiotherapy, spa treatment, mud therapy, medicinal baths and other procedures may be prescribed.

questions and answers

Is it possible to treat psoriasis with folk remedies?

There are no methods with proven effectiveness. It is important not to rely on dubious forms of treatment, but to follow the doctor's recommendations.

Does stress affect the course of psoriasis?

Yes, stressful situations can aggravate the course of the disease.