Psoriasis is a chronic, non-infectious, inflammatory skin lesion with negative effects on the quality of life of patients ("psora" from the Greek - scales). From there, as with many other diseases, the first observations on psoriasis are described. This term was introduced by Galen, one of the most important researchers in medicine.
The cutaneous signs of psoriasis confused people and doctors as leprosy was widespread at the time and had dire consequences. Patients with psoriasis were exposed to social pressure, they were avoided, they were forcibly isolated. In Europe such people were forced to ring the bell to warn others of their arrival. Treatment attempts consisted of the use of manure, onions, sea salt, oil, and urine, but all were ineffective and made psoriasis patients disliked.
The disease can occur at any age, but is more common in the 49 to 69 age group. The reported prevalence of psoriasis in countries ranges from 0. 09% to 11. 4%, making psoriasis a serious global problem.
Despite the widespread misconception that psoriasis is not as severe as other non-dermatological conditions, psoriasis creates a burden of disease that extends well beyond dermatological symptoms. Its psychological effects are similar to those of cancer, heart disease, and diabetes. Psoriasis plaques are often visible, which can have a negative impact on interpersonal relationships, school or work success. Unsurprisingly, people with psoriasis have higher rates of depression with an increased number of suicidal thoughts.
Patients with psoriasis are also at risk of developing serious comorbidities that make disease control difficult and increase the risk of early death. Cardiovascular disease and metabolic syndrome are more common in patients with psoriasis.
In addition, psoriasis is itself a risk factor for cardiovascular disease and triples the relative risk of developing myocardial infarction. Severe psoriasis is also associated with an increased risk of mortality, resulting in a reduction in life expectancy for men and women by 3, 5 and 4, 4 years, respectively, compared to people without psoriasis.
There are many theories about the origin of psoriasis. This is the influence of microbes, viruses, allergies, poor hygiene, disturbed blood supply to the skin, disturbance of the functional balance of the internal organs and one of the most pressing factors at present is the autoimmunity of the disease when human immune cells attack their own tissues. And this assumption also remains a theory, since no skin-damaging antibodies have been found in patients with psoriasis.
At the moment the cause of the pathology is unknown. However, over the course of research, scientists have identified factors that have a certain likelihood of causing psoriasis.
The following points are highlighted:
In 50% of cases, psoriasis makes itself felt from the head. Psoriasis can appear anywhere on the head. Sometimes small plaques develop that are easy to hide in the hair. However, if the entire scalp is covered, it will be difficult to hide the plaques.
The appearance of psoriasis on the head manifests itself as follows:
These clinical manifestations can increase and collapse quickly. This is an individual process. In one patient, the entire pathological process ends on a pale plaque under the hair, while the other has a lot of light-colored lesions all over the head. This is influenced, among other things, by the triggers described above.
A number of problems the patient may face:
The decision whether to see a doctor or not depends on the patient, depending on the severity of the symptoms. However, the best solution, regardless of the location of the plaque, would be to see a doctor. For further treatment to be as effective as possible, an accurate diagnosis must be made, even if symptoms are mild.
In most cases, scalp psoriasis is diagnosed after a physical exam and medical history analysis.
A dermatologist can determine scalp psoriasis by examining pathological elements of the skin.In exceptional cases, the patient may be advised to undergo a skin biopsy to rule out other diseases.
Unfortunately there is no cure for this disease at the moment. Therapy is required for life and aims to maintain remission. In addition, caring for patients with psoriasis not only requires skin treatment, but it is also very important to control existing chronic diseases and prevent new ones from occurring.
These conditions include cardiovascular disease, metabolic disease, and mental health.
Treatment traditionally begins with diet. Foods that contain antioxidants like vitamins C, E, beta-carotene (vegetables, fruits, sage, ginger, and others) can play a beneficial role, as can omega-3 fatty acids, which are high in salmon, sardines, and other fish.
The link between alcohol and psoriasis is unclear, but experts say that people who drink less respond to treatment and that remission of psoriasis continues after alcohol abuse stops. In addition, some antipsoriatic drugs are incompatible with alcohol.
A clearer correlation is observed with overweight. In overweight people, the pathology, as a rule, proceeds faster with a lighter clinical picture.
Hair makes the treatment of psoriasis on the scalp particularly difficult. Few people agree to having their hair removed in order to more effectively resolve the clinical manifestations of the disease, especially given the fact that the defects are even more noticeable to others.
Conventional hair care products are not suitable in this situation, as they can also irritate the scalp and contribute to the progression of the pathology. Therefore, tar shampoos are used, the effectiveness of which in the fight against psoriasis on the scalp has long been established.
Tar has a "calming" effect on the epidermis of the scalp and inhibits the formation of dandruff. Shampoos with phenolic acid are also used, as these have a keratolytic effect (destroy dense horn scales). The plus is used to improve the penetration of other drugs, including corticosteroids.
When prescribing shampoo, the individual characteristics of a person in hair hygiene are taken into account. For example, some women don't wash their hair every day, so it is best if they apply the solution to their hair 2-3 times a week before going to bed, and then wash their hair in the morning.
Phenolic acid can also be used on its own as an ointment. The fact that the ointment is used for a relatively long time increases the effectiveness of the hyperkeratic properties. And for patients who complain about the difficulty of separating dandruff from their hair, applying an ointment before a shower can help resolve this situation.
Coal tar has been used to treat psoriasis for several decades due to its antiproliferative, anti-inflammatory and strong anti-pruritic properties.
Although raw coal tar is the most effective resin. Applying raw stone tar to the scalp is problematic. It is generally recommended to use a resin solution (5-20%) formulated as a lotion or added to a corticosteroid. This remedy helps to fight psoriasis, but it has a number of side effects: coloring, hair loss and a more serious negative effect - carcinogenic, which is why the use of this method is limited.
For this reason, coal tar is banned in Canada and the European Union, for example.
Of all the topical treatments available, corticosteroids have been shown to be the most effective in clinical trials for treating scalp psoriasis and are the most widely prescribed treatments. Corticosteroids are also useful in that there are a large number of forms of production for every situation: creams, lotions, ointments, oils, gels, foams, solutions, sprays and shampoos.
Do not underestimate the importance of psychological harmony in this pathology. Stress can become a trigger, cause a detailed clinical picture, and also inhibit the treatment process. Therefore, patients with internal anxiety are advised to consult a psychotherapist or psychologist.
For a patient with psoriasis, it is important to first follow the advice of a doctor. Nevertheless, you can continue to improve the quality of life by following the simple rules described below:
By monitoring the progression of psoriasis, you can help the patient better control their disease, take the necessary measures in a timely manner and increase the productivity of the doctor-patient relationship. A few simple rules will help you with this:
Although the disease is not transmitted through contact, the appearance of patients discourages those who do not know. Beauty salons are afraid to provide services, some taxi drivers do not want to transport such people, it is difficult to find a job. Not to mention starting a family and the fear that their children will be sentenced to the same suffering prevents them from having children.
There have even been reports of people with psoriasis being denied access to the Olympic swimming pool due to collective complaints from other athletes. Management had to refuse such people, although they fully understood that this pathology is not dangerous in the contagious sense.
It is difficult for them to engage in everyday activities because the burden of psychological pressure is high and a person needs social contact. For these reasons, societies are being established in many countries to protect and support psoriasis patients. Companies are used to educate outsiders about this disease.
People should be judged on their actions, deeds, and not on their looks. Indeed, among patients with such a nosology there are highly professional doctors, police officers, firefighters, athletes and many others, whose actions not only their relatives, but also their country can be proud of.