psoriasisIs a chronic condition that affects the skin, sometimes nails, joints and internal organs. It is manifested by itching and the appearance of pinkish-red rashes - papules that can merge into larger plaques. These papules rise above the surface of the skin. They are covered with silvery scales that peel off easily when peeled.
Very often the disease is combined with impotence, accelerated ejaculation and Reiter's syndrome. Psoriatic arthritis can occur with widespread psoriasis.
Risk factors
Causes of Psoriasisnot yet fully identified. Risk factors for developing the disease are:
- microbial factor - different types of fungi, mycoplasma;
- neuropsychic trauma, stress;
- endocrine diseases - diabetes mellitus, thyroid disease;
- Foci of chronic infections, especially streptococci;
- Immunodeficiency states;
- Disorders of fat and protein metabolism;
- Injuries to the skin and joints.
Is psoriasis transmitted?
Psoriasis is not contagious. Many researchers pay attention to the familial nature of psoriasis and recognize its genetic nature. In addition, it is not the disease itself that is inherited, but a predisposition to it.
If you experience similar symptoms, contact your doctor. No self-medication - that is dangerous to your health!
Psoriasis symptoms
The first symptoms of psoriasis:Rashes in the form of light pink plaques with a scaly surface. Plaques are solitary, rise above the level of healthy skin, are located on the elbows and in the hollows of the knees.
Psoriatic plaques are more common on the skin of the knees, elbows, chest, abdomen, back, and scalp, but as the disease progresses, they can appear on any other, most unexpected part of the skin.
Initially, the papules are small - 3-5 mm, the color is light pink. Gradually, they increase in size, become covered with silvery scales, and merge into larger formations called plaques.
Fresh elements of papules are usually bright to red, "old" ones are faded. In the initial stages of psoriasis, the edges of the papules do not peel off. They represent a hyperemic border -Growth crown. . .
The trademark of psoriasis is the Auspitz triad. This triad can be observed by scratching the surface of the papules with a sharp object. It includes three phenomena:
- Stearin stain phenomenon- Layering of a multitude of silvery-white scales that can be easily separated when scraping;
- psoriatic film symptom- exuded surface with a prickly layer that opens after peeling off the lower layers of the stratum corneum;
- Blood thaw phenomenon- Exposure of superficial capillaries in the form of small blood stains after the psoriasis film has detached.
Signs of different types of psoriasis
Clinical forms of psoriasis:
- Spotted psoriasis- represented by pale pink, weakly infiltrated spots. It is similar to toxidemia.
- Irritated psoriasis- occurs when the skin is exposed to aggressive environmental factors (sunlight, cold, heat) and irritating drugs. The color of the plaque becomes more intense, it increases in size, rises more above the surface of the skin, a belt in the form of redness forms on the edges.
- Seborrheic psoriasis- common in patients with seborrhea. The clinical picture is very similar to that of seborrheic dermatitis.
- Exudative psoriasis- occurs quite often. It occurs due to the excessive secretion of an inflammatory liquid - exudate. It impregnates the dandruff accumulations and turns them into dandruff crusts.
- Psoriasis of the palms and soles of the feet- is represented either by ordinary plaques and papules or hyperkeratotic formations, similar to calluses and calluses.
- Follicular psoriasis- a rare form of the disease. The rash consists of white miliary nodules with a funnel-shaped depression in the center.
- Psoriasis of the mucous membranes- a rare form of the disease. It occurs on the lining of the mouth and bladder. It manifests itself in the form of gray-white areas with a red border.
Frequency of psoriatic manifestations
Cyclic exacerbations are characteristic of psoriasis. Most often they appear in autumn and spring.
Pathogenesis of psoriasis
Dermatosis is an inflammatory process associated with the work of immune T cells. As a result of this inflammation, the proliferation of keratinocytes, the main cells of the epidermis, is accelerated.
Psoriasis, a form of dermatosis, is a chronic inflammatory disease. It takes place with the participation of microbial pathogens that can bind to the surface of the skin.
Everything that happens in the skin under the influence of the pathogen is a classic inflammatory reaction based on the principle of RTCDF:
- Rubor - redness;
- Tumor - tubercle, edema;
- Calories - fever, fever;
- Dolor - pain;
- Functia laesa - dysfunction.
Reddening and thickening of the skin at the lesion sites, itching, increased cornification followed by flaking - all these are manifestations of the inflammatory process, a protective reaction of the body to fight the microbial pathogen. Without timely outside help, the body is often defeated.
Some scientists adhere to the theory of a genetic predisposition to violate the process of cell division. With such an injury, there is increased death and keratinization of cells, followed by their growth and the appearance of a large number of incompletely keratinized epithelial cells. But this theory does not contradict the above microbes in the least.
Classification and stages of development of psoriasis
There is no generally accepted classification of psoriasis.
TraditionallyThere are four types of the disease:
- vulgar psoriasis - seborrheic, follicular, warty, exudative, bullous, psoriasis of the palms and soles of the feet, psoriasis of the mucous membranes;
- pustular psoriasis;
- psoriatic erythroderma;
- Psoriatic arthritis.
According to ICD-10 there are:
- L40. 0 psoriasis vulgaris (coin and plaque psoriasis);
- L40. 1 Generalized pustular psoriasis (impetigo herpetiformis, Tsumbusch disease);
- L40. 2 persistent acrodermatitis;
- L40. 3 palmar and plantar pustulosis;
- L40. 4 psoriatic tear;
- L40. 5 arthropathic psoriasis;
- L40. 8 Other psoriasis;
- L40. 9 psoriasis, unspecified
Complications of psoriasis
Without timely and competent treatment, psoriasis begins to negatively affect vital organs and systems: joints, heart, kidneys and nervous system. These conditions can lead to disability and even death.
What is psoriatic arthritis?
Psoriatic arthritis is the most severe form of psoriasis as it often leads to disability.
Doctors most often face this complication. It occurs as a result of inflammatory changes in the joints.
The joints of the hands, wrists, feet, and knees are most affected. Over time, the disease can spread to the hip, shoulder, and spine joints. As you progress, the muscles near the affected joints begin to hurt. The patients complain of stiff movement, especially in the morning. Your body temperature is often elevated throughout the day.
The clinical picture of psoriatic arthritis develops in a similar way to ordinary arthritis: first pain, then swelling, stiffness and restricted mobility. A characteristic symptom of this complication is a sausage finger. It appears due to the defeat of all interphalangeal surfaces.
Other complications of psoriasis
Somewhat rarerpsoriatic erythroderma. . .This condition occurs when the skin is completely affected. Patients are concerned about itching and burning, severe peeling of dead tissue, and severe skin reaction to changes in temperature.
The second most common occurrence isPustular psoriasis. . .This complication is associated with the addition of a secondary infection - staphylococci and streptococci. Clinically, pustular psoriasis is accompanied by the appearance of pustules - pustules the size of a buckwheat kernel. Pustules appear in different places. They protrude above the surface of the skin, are characterized by rapid growth and a tendency to fuse. The existing symptoms are joined by a high fever and signs of severe poisoning.
Injuries to the internal organswith psoriasis are extremely rare today. Typically, people who lead antisocial lifestyles are prone to it. The genitourinary system is more often affected: the kidneys, the lining of the bladder and the urethra. This leads to the development of pyelonephritis, glomerulonephritis, cystitis and urethritis.
On the part of the heart, psoriasis can cause damage to the mitral valves, inflammation of the heart muscle and the outer skin of the heart - myocarditis and pericarditis. When the nervous system is damaged, patients complain of a creeping sensation, increased irritability or depression, constant fatigue, drowsiness, and apathy.
Diagnosis of psoriasis
When to see a doctor
At the first symptoms of psoriasis, it is necessary to see a doctor: the appearance on the skin of light pink plaques with a scaly surface.
Prepare to see a doctor
You should stop applying medicated ointments to the skin three days before going to the doctor. No further special training is required.
Psoriasis is such a recognizable disease that it will not be difficult to diagnose it from external signs. Often times, patients can be diagnosed, as they say, "out of the box". If necessary, the doctor scratches the surface of the skin to identify the Auspitz triad.
Medical Sciences Candidate OV Terletskiy, along with co-authors, proposed a diagnostic scheme developed based on data from the American Rheumatological Association. It includes the following exams:
- complete blood count (with platelets);
- general urinalysis;
- Blood chemistry;
- acute phase reactions of the body - C-reactive protein and rheumatoid factor;
- Immunoglobulins - IgA, IgG, IgM, IgE)
- Reaction of complement fixation with gonococcal and chlamydial antigen;
- Wright and Heddelson's reactions;
- coagulogram - assessment of blood clotting;
- Blood test for borreliosis and toxoplasmosis (depending on the indication);
- Blood test for HLA.
However, there are many diseases under the guise of psoriasis. In this context it is necessary toDifferential diagnosis, especially between papular syphilis, Reiter's syndrome, neurodermatitis, lichen rosacea, systemic lupus erythematosus and seborrheic eczema. To do this, use:
- biopsy - clamping a piece of skin with subsequent histological examination;
- laboratory diagnostics - often used to distinguish psoriasis from papular syphilis;
- Blood tests for other hidden infections for better antibiotic choices.
Instrumental diagnostic methodsis mainly used in complex forms of psoriasis associated with damage to joints and internal organs. These include: X-rays of the joints, ultrasound of the heart, kidneys and bladder.
Psoriasis treatment
Is There An Effective Treatment For Psoriasis?
Although psoriasis is a persistently recurring condition, it can be completely eradicated provided you consult a dermatologist in a timely manner who can identify the real causes of psoriasis. In the past decade, many drugs with systemic and local effects have appeared, aimed at eliminating the cause and suppressing the mechanism of development of the disease. Drugs that interact with each other via chemical signals (cytokines) have proven effective. They eliminate the increased proliferation of skin creatinocytes.
Phototherapy
In 1994, the team from the Department of Dermatovenerology at MAPO SPb introduced a method of treating psoriasis in whichUFO blood- Photo modification of blood with ultraviolet light.
The effect of sunlight on the skin in numerous diseases, including psoriasis, has always been known. At the beginning of the 20th century, a group of German scientists suggested that since ultraviolet light has a healing effect on exposed skin, that effect is likely to occur when ultraviolet radiation is applied to the blood. After all, this is also some kind of substance. This assumption was confirmed by the first meeting on UV exposure of blood, which took place in Germany in 1924.
The therapeutic effect of ultraviolet rays on the blood is associated with deep structural changes at the molecular-atomic level, which are detected by immunocompetent organs - liver, spleen, bone marrow and lymphoid tissue. These changes are interpreted by the organs as an alarm signal and therefore produce many times more immune complexes. In this case, ultraviolet light is a kind of "whip" that forces the body to dramatically increase its defenses to fight the disease.
Also noteworthy is the PT effect -Development of UV therapy. . . This method of treatment is important given the chronic nature of psoriasis, which is associated with numerous complications of the internal organs caused by a wide variety of microbial pathogens. The longer the microbes are in the body, the larger their habitat becomes. These microscopic creatures capture more and more anatomical areas through the flow of blood and lymph. Once in the tissue, they try to penetrate the intercellular spaces as deeply as possible. There they form micro-colonies, protected by the remains of dead, destroyed cells and a leukocyte shaft. Because of this, microorganisms can be out of the reach of antibiotics for years. They easily compensate for the lack of nutrients by falling into a state of floating animation - something between life and death.
The ability of ultraviolet rays to help destroy microbial "shelters". They create favorable conditions for the penetration of antibiotics and other drugs that affect the cause of psoriasis.
The cutaneous application of ultraviolet radiation is also relevant. The best known treatment method based on this principle isPUVA therapy. . . Although it is less effective than ultraviolet irradiation of the blood. The therapeutic effect does not last long, relapse can occur two weeks after the end of treatment.
Medication
From medication, the following have worked well:
- Derivatives of vitamin A, which reduce the rate of maturation of keratinocytes and normalize cell differentiation;
- Immunosuppressants that reduce the activity of T lymphocytes, which contribute to increased division of epidermal cells;
- Medicines used to treat malignant tumors, which inhibit the reproduction and growth of atypical skin cells.
What ointments and creams are effective in treating psoriasis?
Ointments and creams with anti-inflammatory components will help relieve the patient's condition.
How to treat scalp psoriasis
Ointments are not effective in treating scalp psoriasis. In addition to medication and UV treatment, a special shampoo can be used.
How to treat psoriasis on elbows and arms
Psoriasis of the elbows and arms is treated using the same methods as the rest of the body. The peculiarity of the course of psoriasis in this area is that the skin of the hands is exposed to physical, mechanical and chemical influences, which is considered an aggravating factor in the course of the disease.
Is monoclonal antibody treatment effective for psoriasis?
Therapy with monoclonal antibodies for psoriasis is very effective. Monoclonal antibody drugs are laboratory-made antibodies that are similar to those made by human immune cells. Monoclonal antibodies selectively target targets responsible for the development of the disease.
How to recognize and treat psoriasis in children
In children, psoriasis is often more severe and camouflaged as other diseases (eczema, erysipelas, herpes), which makes diagnosis more difficult. Therapy methods are similar to those for adults: phototherapy, medication, and topical treatment.
Which baths for psoriasis?
Aloe baths can reduce inflammation and itching.
How to treat psoriasis according to Pegano
The Pegano method of treating psoriasis includes colon cleansing, diet, and herbal teas. The effectiveness of this method has not been proven by clinical studies.
Role of Diet in Treatment
Diet has a strong influence on the course of psoriasis. During treatment, it is necessary to exclude alcohol, salty, spicy, pickled, nuts, citrus fruits, honey, chocolate and smoked meat.
Which sanatoriums show rest for the treatment of psoriasis?
For psoriasis, treatment by the sea in a region with a warm, dry climate and many days of sunshine should be preferred. The most suitable for this are the resorts of the Crimea.
Folk tunes
Some folk remedies can help reduce itching and flaking in people with mild to moderate psoriasis. These methods include:
- Cream with aloe extract;
- Fish oil, which is applied to the skin with a coated bandage for six hours a day for four weeks;
- Cream with Oregon grape extract.
Forecast. prevention
Psoriasis is not a phrase. If the patient timely sought qualified help from a specialist who will be able to determine the real causes of the disease and prescribe effective treatment, then the disease will be defeated.
The simple form of psoriasis manifests itself only through a skin defect. Therefore, the patient does not need special conditions for work. The exception is work in a chemical plant: In this case, staying at the workplace must be excluded.
It should be remembered that psoriasis can cause complications. Psoriatic arthritis most commonly develops. Its severe forms can limit the performance of work duties and lead to complete disability in the future.
Psoriasis prevention is an essential part of therapeutic measures aimed at eliminating one of the most serious skin diseases. After recovery, the patient needs to completely revise his lifestyle, eliminate bad habits, pay attention to the treatment of chronic diseases of other organs, adjust the diet, include walks in the open air and sports in everyday life.
Are you taking in the army with psoriasis?
Severe forms of psoriasis are sufficient reasons for determining incapacity for military service, mild forms - of restricted suitability.