Psoriasis is a chronic skin disease of non-infectious origin. According to statistics, 3. 7% of the world's population suffers from psoriasis. People call the disease "scaly lichen".
Psoriasis is not gender dependent, is not contagious; most often develops at the age of 14-27 years. The disease is characterized by the appearance of red scales in the form of a plaque (spot) covered with white scales. A spot (or several spots) can be located on any part of the body, but most often in places with thin and dry skin: elbows, knees, lower back, scalp.
The spots are of different sizes and disturb in different ways: in some patients, only skin irritation is noted; in other patients, large areas of the skin are affected, which is accompanied by discomfort, itching, pain, sleeplessness and reduced quality of life.
Psoriasis is a chronic disease characterized by periods of exacerbations (rashes) and remission (disappearance of symptoms).
Psoriasis often complicates pregnancy.
Causes of psoriasis
Psoriasis is a systemic process that involves not only the skin, but the whole body. The causes of psoriasis are not fully understood, but it is assumed that there are several: neurogenic (due to stress), hereditary, infectious, viral, mixed (skin lesions with penetration of staphylococci in combination with any of the above reasonsabove), etc. In this case, cellular and humoral immunity is activated and an autoimmune process of damaging cells, mainly skin cells (epidermis), is triggered.
In addition to the activation of immunity, the metabolism is disturbed. The disease is aggravated by overwhelmed heredity. As a result, the renewal (regeneration) of cells is accelerated 3-5 times - psoriatic plaques form on the skin.
Without prompt treatment, the lesion worsens: skin spots develop, crack, become infected; nails are destroyed, joints are affected, etc.
80% of the quality of life of a patient with psoriasis depends on timely diagnosis and appropriate treatment.
Again, we list the factors that contribute to the onset of the disease:
- bad heredity. Scientists have identified 9 genes that determine the development of the disease, but their interaction is unclear. It is well established that in 15% of cases, psoriasis is inherited by relatives of the 1st and 2nd generation;
- stress, nervous tension, depression. It has been proven that stress in 70% of cases causes exacerbation of psoriasis;
- Hormonal imbalance;
- dysbiosis;
- metabolic disorders, drug addiction;
- colitis and parasitic infections (roundworms, lamblia, intestinal infections, etc. );
- viral infections;
- streptoderma; candidiasis of the skin;
- allergic.
Symptoms of psoriasis
At the initial stage, the rashes of psoriasis appear as red patches (spots) with scaly scales. The appearance of a skin plaque is accompanied by intense itching. A denser layer (keratin) is found under the scales.
Here are the 6 main forms of psoriasis; each has its own symptoms:
Plaque psoriasis occurs in 85% of patients. It is characterized by a dry, pink rash, raised above the skin, covered with silvery scales. The skin in the affected areas often exfoliates; there, red spots remain, bleeding during trauma. In 60% of cases, the plaques merge into large plaques.
Guttate psoriasis is characterized by many small, dry lesions in the form of pink droplets raised above the surface of the skin. Rashes are localized on the thighs, legs, affecting large areas of the body. In 60% of cases, guttate psoriasis gets worse after a strep infection.
Pustular psoriasis can be recognized by skin blisters filled with clear fluid. The blisters are surrounded by reddened, edematous skin that peels. The legs and thighs are more often affected.
Psoriasis of the flexor surfaces manifests as smooth, non-scaly red spots, located in the area of skin folds: the lateral surface of the thighs, armpits and the area of the external genitalia. Due to mechanical irritation (physiological friction), the spots are damaged, bleed and become infected.
Psoriasis of the nails is manifested by discoloration, the appearance of spots and transverse lines on the nails. The skin around the lesion is hardened. As the disease progresses, the nail will exfoliate, thicken and then dry out or fall off.
Psoriatic arthritis (15% of cases). All joints are affected, but most often the smallest - the phalanges of the hands and feet. The fingers become like sausages. Psoriasis of the joints leads to bursitis, a disability of a person.
Let's talk about head and elbow injuries separately.
Psoriasis of the scalp (mainly the scalp) is the most common form of the disease. It is more common at a young age. It manifests as red scaly patches that itch and itch. The redness is almost always noticeable, therefore it causes emotional discomfort and leads to social isolation of a person.
Elbow psoriasis is a disease of middle-aged people. It manifests as rashes on the extending surfaces of the elbow joints. The rash spreads outward and merges together - a large plaque (plaque) forms, covered with silvery scales that fall off easily. With the scales, a thin protective film comes off, exposing the bleeding surface. In 80% of cases, the spots go away on their own, without treatment, but sometimes they thicken (get old) and persist for years, causing psoriatic damage to the elbow joint.
Diagnosis of psoriasis
Diagnosis and treatment of psoriasis is carried out by a dermatovenerologist.
Due to the characteristic skin lesions, the diagnosis of psoriasis is straightforward. As additional laboratory tests, a general blood test and the determination of rheumatoid factor are used. For the diagnosis of psoriatic arthritis, a consultation with a rheumatologist and an x-ray of the affected joints are indicated. In rare cases, a skin biopsy is done for the differential diagnosis.
Psoriasis should be distinguished from similar skin conditions: seborrhea, lupus, etc.
Psoriasis treatment
Psoriasis is a chronic disease with periods of exacerbation (reappearance of rashes) and remission (disappearance of rashes). It is impossible to recover from psoriasis forever. You can prolong remission and reduce the intensity of exacerbations.
It is only in 40% of cases that it is possible to find an effective treatment immediately. Sometimes it takes months and years. Therefore, psoriasis is treated at home, except for exacerbations and severe complications. The effectiveness of treatment is influenced by the type of psoriasis, age, concomitant diseases, etc. With a mild degree of psoriasis, topical preparations are prescribed: ointments and creams based on:
- glucocorticoids;
- zinc;
- tar;
- salicylic acid;
- vitamin D3.
In severe cases of psoriasis (25% of the skin surface is affected, joint damage) and the ineffectiveness of local treatment, complex therapy is prescribed:
- cytostatics which inhibit epidermal cell division;
- immunomodulators which normalize immune responses;
- glucocorticoids, which regulate metabolic processes and reduce inflammation;
- nonsteroidal anti-inflammatory drugs (to reduce itchy skin);
- multivitamin.
Physiotherapy is prescribed: ultraviolet irradiation, cryotherapy, plasmapheresis, hirudotherapy. Folk remedies are also used: ointments made from celandine and lard, meadowsweet and petroleum jelly, beeswax and lard. To normalize immunity, they drink homemade kvass from oats, an infusion of bay leaves and a decoction of dill.
Diet, especially with exacerbations of psoriasis, plays an important role. Spicy and sweet dishes are excluded from the diet. Fast food and alcohol are prohibited. Nutrition should be balanced, rich in vitamins and minerals.
To avoid exacerbations of psoriasis, you need to improve your health, avoid stress, hypothermia and seasonal illnesses.
Here are the simple rules for preventing exacerbations of psoriasis:
- do not over-dry the skin;
- avoid prolonged exposure to the sun;
- avoid skin injuries;
- avoid stress;
- do not smoke or abuse alcohol.
Is psoriasis contagious?
There is not a single proven case of transmission of psoriasis from a sick person through family or other contact. Therefore, it is believed that psoriasis is not contagious.
Which doctor to contact
To start treatment in a timely manner and prevent the spread of psoriasis, see a dermatovenerologist. In the presence of psoriatic arthritis, consultation with a rheumatologist is indicated.