Psoriasis is a common non-contagious skin condition that is associated with inflammatory lesions. It is chronic - the acute phase is followed by periods of relief or disappearance of symptoms - and is caused by a combination of factors.
The disease is widespread and is slightly more common in women than men. It is not completely cured, but it is possible to alleviate symptoms and improve the patient's quality of life.
Psoriasis can lead to arthritis, which is inflammation of the joints.
Synonyms Russian
Scaly lichen.
English synonyms
Psoriasis.
Symptoms
Symptoms and signs of psoriasis depend on the type of psoriasis.
- Plaque psoriasis. It is accompanied by specific inflammatory skin formations - raised, oval, sharply outlined reddened lesions, scaly and covered with silvery scales. Most often, formations appear on the outer surface of the elbows, knees, scalp and trunk. Elements of a rash can be painful and itchy. In severe cases, the skin near the joints of the affected area will tear and bleed.
- Guttate psoriasis. This type is associated with the appearance on the body of numerous papules (nodules) of orange-pink color, 1-10 mm in size. The rash usually appears on the torso, shoulders, and thighs, but can be found all over the body. It usually affects people under the age of 30 and 2-3 weeks after infectious diseases of the upper respiratory tract, after superficial bacterial infections in the anus.
- Psoriasis of the nails. It is characterized by compaction, peeling, discoloration of the nail plates, discoloration, yellowing of the nails, the presence of stains, the formation of pits, cracks and damage to the nails. The nail plates are destroyed, nail growth is disturbed, they can be separated from the nail bed. It occurs in 30-50% of patients with psoriasis.
- Large wrinkle psoriasis. In this case, skin lesions appear in the form of red spots of inflammation in the area of the axillary folds, under the mammary glands, in the folds of the neck, in the genital area, on the foreskin. Cracks may appear around the edges and in the center of the lesions. Most commonly, large wrinkle psoriasis occurs in overweight and obese people. Sweating and friction make the disease worse.
- Psoriasis of the head. It is accompanied by reddening of the scalp, itching, peeling of the scalp with the appearance of white scales on the hair and shoulders - particles of dead skin.
- Psoriatic arthritis. Skin lesions are accompanied by joint pain, swelling, curvature and deformation of the joints. The joints of the fingers, wrists, feet, knee joints can be affected.
- Pustular psoriasis. This type is characterized by reddening of the skin and the formation of a large number of pustules - small vesicles filled with pus. Formations can appear on the palms and feet, or all over the body. When multiple pustules appear on the body, fever and weakness come together.
- Psoriatic erythroderma. Parts of the skin are reddened and plaques can appear. Lesions are usually accompanied by severe itching. Most commonly, psoriatic erythroderma is associated with sunburn or drug abuse.
Usually, in various types of psoriasis, the disease manifests itself gradually, the skin lesions spread and are observed for several weeks. Then the symptoms go away. Symptoms reappear after some time after exposure to a factor that contributes to the development of psoriasis (or spontaneously).
General information about the disease
Psoriasis is a common non-contagious skin condition that is associated with inflammatory lesions.
It is chronic and often repetitive - the acute phase is followed by phases of symptom weakening or disappearing, and symptoms return after a while.
Psoriasis is widespread, especially among people aged 16-22, 57-60 years old. Women are more prone to this than men. People with fair skin are at increased risk of developing the disease.
Despite the fact that psoriasis is synonymous with scaling of lichen, it is absolutely not contagious to others.
The causes of psoriasis are not yet fully understood. Its occurrence is associated with a genetic predisposition, with malfunctions of the immune system and with environmental factors that affect the body.
The development of psoriasis is associated with one of the cell types of the immune system (including T lymphocytes), while T cell hyperactivity is observed. Usually, they travel around the body in the blood, recognizing foreign substances - viruses and bacteria. In psoriasis, T cells begin to accumulate in the skin for reasons unknown. Their hyperactivity causes the blood vessels to dilate in the affected area, disrupts the circulation of new skin cells - they are formed much faster than usual. In the meantime, dead skin cells have no time to peel off and accumulate on the surface of the skin and form plaques.
Psoriasis can be triggered by any of the following factors:
- Infections (tonsillitis, thrush, HIV);
- Damage to the skin - cut, scratch, bite, or burn;
- Hypothermia;
- Sunburn;
- Emotional stress;
- Smoking, alcohol abuse;
- taking medication (antimalarials, etc. ).
At the same time, some patients with psoriasis have rashes without the obvious influence of environmental factors.
There are the following main types of psoriasis.
- Plaque psoriasis. It is the most common.
- Guttate psoriasis. It usually affects people under the age of 30. It occurs 2-3 weeks after the transmitted infectious diseases of the upper respiratory tract as well as after superficial bacterial infections in the area around the anus.
- Psoriasis of the nails.
- Psoriatic arthritis. In this type of psoriasis, skin lesions are accompanied by arthritis - inflammation of the joints.
- Psoriatic erythroderma. Mostly in connection with sunburn and drug abuse.
- Pustular psoriasis. It is quite rare, in severe cases it threatens the patient's life.
- Psoriasis of the head. In this case, as a rule, disease-related hair loss does not occur, since the hair roots are much deeper than the scaly formations.
Classification of psoriasis according to the severity of the course:
- soft (less than 2% of the total skin is affected);
- moderate (skin lesions occupy no more than 3-10% of the skin surface);
- severe psoriasis (more than 10% of the skin is affected).
Depending on the type, location and extent, psoriasis can cause complications:
- Thickening of the skin, adding a secondary infection from scratching and scraping caused by itching in psoriasis;
- mental problems (stress, low self-esteem, depression, social self-isolation);
- Joint damage (deformity with stiffness and decreased joint mobility);
- increased risk of developing various diseases and conditions: high blood pressure, inflammatory bowel disease, cardiovascular disease, skin cancer.
Psoriasis is usually relatively mild. However, for most patients, social adjustment becomes the main problem, especially when there are skin lesions in visible areas of the skin - the hostility of others to the nature of the skin lesions, their fear of contagion (many do not know that the disease is not contagious).
Who is at risk?
- People with a hereditary predisposition (more than 40% of patients with psoriasis have a relative with psoriasis).
- People with viral, bacterial or fungal infections (strep, thrush, HIV, etc. ).
- Emotionally stressed out.
- Obese and overweight people.
- Smoker.
- Alcohol abusers.
- Use of certain medications (antimalarials, etc. ).
- Sunburn.
diagnosis
The diagnosis of psoriasis is usually based on the typical type of lesion, taking into account its location. In difficult cases, additional tests may be needed to rule out other skin conditions.
Laboratory research
- General blood analysis. With psoriasis, leukocytosis and anemia can be detected.
- Rheumatoid factor (RF) is a protein whose level in the blood can increase in systemic inflammatory diseases with joint damage, particularly in rheumatoid arthritis. The test result for psoriasis is negative. This is how you can differentiate psoriasis from rheumatoid arthritis, where RF is elevated.
- Erythrocyte sedimentation rate (ESR) is generally normal, with the exception of pustular psoriasis and psoriatic erythroderma.
- Uric acid. In psoriasis, the uric acid level can be increased (especially in pustular psoriasis), which leads to the mistake of psoriatic arthritis for gout, in which the uric acid concentration rises significantly.
- Antibodies against HIV (human immunodeficiency virus). The sudden onset of psoriasis may be due to HIV infection.
Other research methods
- X-ray of the joints. Allows assessment of the severity of joint damage in psoriatic arthritis.
- Skin biopsy. During the examination, a small sample of skin is taken for later examination under the microscope. It is done in difficult cases to distinguish psoriasis from other skin conditions.
treatment
Therapy for psoriasis includes local treatment of skin lesions, drugs, phototherapy, and prevention of exposure to factors that provoke the appearance of rashes. It depends on the type and severity of the psoriasis.
To get rid of skin lesions, emollients (creams, petroleum jelly, paraffin, vegetable oils) can be used. They are most effective when used twice a day after a shower. Also used are salicylic acid, anthralin, tar preparations, ointments, solutions, shampoos with coal tar. These active ingredients have anti-inflammatory effects and slow down the formation of new skin cells.
The use of corticosteroid ointments makes the treatment more effective. They are indicated for mild to moderate psoriasis. However, their long-term use is not recommended (skin wasting, drug addiction possible).
Light therapy - exposure of the skin to ultraviolet radiation - can be beneficial. In this case, burns should be avoided.
Local treatment of lesions in more severe cases is combined with the use of drugs - retinoids, vitamin D supplements, methotrexate, etc.
Treating psoriasis can be difficult because the disease is chronic and comes back after symptoms go away. The effectiveness of a particular treatment method depends on the patient's susceptibility to it.
Daily baths (bath oil, oatmeal, or sea salt are recommended; hot water and scrubs should be avoided) and post-bath moisturizers can help soften skin and reduce psoriatic inflammation.
prevention
- Avoid hypothermia, sunburn.
- Avoid emotional stress whenever possible.
- Quit smoking and alcohol abuse.
- Take certain medications (antimalarials, etc. ) with caution.
Recommended analyzes
- General blood analysis
- Erythrocyte sedimentation rate (ESR)
- Rheumatoid factor
- Serum uric acid
- HIV 1, 2 Ag / Ab combo (determination of antibodies against HIV types 1 and 2 and p24 antigen)