After onset, psoriasis in most patients does not go away on its own, but only progresses and becomes more extensive, spreading over the skin.
However, with early diagnosis it becomes easier to treat and recovery is much faster.
The main thing here is to pay attention to the first signs of psoriasis in time and immediately make an appointment with a dermatologist.
Characteristic signs of psoriasis
Early psoriasis can present as small, reddish, scaly patches.
The place of appearance of these rashes directly depends on the form in which the disease develops.
In most cases, they can be seen:
- on the elbows and knees;
- on the head (in the hairy area);
- on the palms and feet;
- in the fold area (buttocks, armpits, areas under the breast in women).
Primary eruptions (papules) are very small: their diameter does not exceed 4 millimeters.
However, as the disease progresses, they grow larger and fuse with each other, forming unclear plaques.
Most often, the appearance of papules is not accompanied by pain or itching. The feeling of discomfort increases with the development of psoriasis and an increase in the size of the affected skin areas.
The affected area begins to hurt and itch, and there is a strong burning sensation.
These signs of psoriasis are supplemented by emotional discomfort which can dramatically increase the rate at which the disease spreads.
It is inappropriate, when such rashes are detected, to start self-treatment, since psoriasis in the early stages of development has similarities with other skin diseases.
Accordingly, the wrong choice of drugs will not lead to positive results, but will only make the situation worse.
Cumulative symptoms
Squamous lichen belongs to the category of systemic pathologies.
This means that it manifests not only on the skin and nails, but can also affect the spine, joints and tendons, certain bodily systems (eg, endocrine, immune, and nervous).
There are cases when the disease affects the digestive (liver) and urinary (kidney) systems.
The first symptoms of psoriasis
- constant feeling of fatigue;
- weakness;
- a state of depression (up to depression).
Due to the complex effect of the disease on the body, experts consider it appropriate to call it psoriatic disease.
But, despite this, the key aspects of the disease are based on the damage to the skin.
As mentioned above, the first call at the onset of the development of pathology are small papules in the color range between pale pink and red.
They differ in a symmetrical position on the surface of the skin (folds, lower back, area of the head covered with hair), sometimes on the mucous membrane of the external genitalia.
The size of the papules during the course of the disease can exceed 10 centimeters.
Psoriatic rashes, depending on their characteristics, are subdivided into:
- dotted (their size is not larger than the head of a pin);
- teardrop-shaped (similar in shape to a teardrop, equivalent in size to a grain of lentils);
- in the shape of a coin (plates 5 mm in diameter, with rounded edges);
- Rarely arched, ring-shaped, or card shaped.
Above the papules are covered with plaques with scales, which are formed from keratinized cells of the epidermis and are removed without much effort. At first, they appear in the center of the plaque and gradually spread more and more.
Keratin cells have air spaces, which results in visual friability and slight shadow.
Sometimes the elements are surrounded by a pink ring, which acts as an area for plaque growth and inflammation. In this case, the condition of the surrounding skin does not change.
Plaque removal reveals a deep, shiny red surface based on capillaries, which in turn have very thin walls.
The presence of such small vessels in diameter is due to damage in the structure of the upper layers of the skin, the structure of which is disturbed due to the incomplete process of maturation of epidermal cells (keratinocytes), which makes their differentiationcorrect impossible.
Symptoms of different forms of psoriasis
Common psoriasis has some pretty specific symptoms, so it won't be difficult to diagnose it.
It appears as scaly, rounded areas that protrude from normal skin and are pink or red.
Sometimes in the early stages of the disease there are no typical plaques: before they appear on the scalp and in the area of the joints (ankle, elbows and knees), small papulescan be observed.
They are able to persist for a sufficiently long period of time and not cause any inconvenience to the patient: nothing stings and does not cause pain or no pain at all, or they are hardly felt, papulesthemselves are almost impossible to notice.
They do not flake, but when lightly scraped, the scales appear immediately. These rosy seals can disappear or decrease significantly in summer, as solar radiation affects the skin.
The acute form of common psoriasis manifests as multiple, constantly itchy rashes with brightly colored papules and is the result of the influence of disease-activating factors.
To avoid confusing it with an allergic reaction, the surface of the plaque must be scratched a little before the characteristic phenomena appear.
Seborrheic psoriasis begins on the scalp (in the area covered with hair) and then spreads to the face and shoulders.
It is characterized by severe peeling of the skin in the corresponding area, which is most often seen by patients as dandruff, so that they do not rush to a dermatologist.
This fact allows the disease to quietly reach the stage of development when the forehead and the areas behind the ears are peeled. And only after the plaques are formed.
Lesion of the skin folds accompanied by psoriasis (armpits, genital area and groin, under the breast in women) is often mistaken for ordinary irritation caused by friction or sweat.
This type of disease is characterized by smooth plaques that look like spots. The coat is not observed, but they are often wet. The rashes themselves are bright red, they are uniform and shiny.
When the genitals are affected, the characteristic signs of psoriasis can be misinterpreted as balanoposthitis (lesion with eruptions of the glans penis, as well as of the foreskin on its inner part) in men and vulvitis (rasheslocated on the labia minora) in women.
The palmoplantar form of the disease manifests as compacted, callus-like areas, the surface of which is covered with yellow scales that are difficult to remove.
The affected area is cracked and painful. With this form of the disease, it is difficult to induce the appearance of terminal film and bloody dew by scratching.
Nail psoriasis begins with psoriatic onychodystrophy, which is one of the main symptoms of this form of the disease and appears much earlier than the rash.
At first, the edge of the nail is covered with grooves and small depressed areas.
With the development of the disease, they spread, reaching the root, after which color changes are observed. The nail becomes blunt and thickens. Due to failures of blood circulation, the manifestation of the disease increases.
The epidermal cells accumulate under the nail plate and are lined with reddened tissue on all sides, after which they may peel off after a while.
This type of psoriasis is dangerous because it increases the sensitivity of the tissues, which in turn increases the risk of infection. Very often this disease is confused with a fungus.
Movable joints of bones (joints) are often affected. They are deformed, the joint capsule undergoes dystrophic type changes.
Psoriatic arthritis begins with an increase in joint volume, which is accompanied by pain.
The fingers of the hands and feet are most susceptible to this type of psoriasis.
In severe forms, the shoulder and elbow, hip and knee joints, as well as parts of the spine, are exposed to the disease.
Effect on manifestation of symptoms of stages of psoriasis
The symptoms of psoriasis are directly proportional to the season of the year and the stage of the disease.
Most often in spring-summer there is a noticeable decrease in the activity of the disease, facilitated by ultraviolet rays.
As a result, during the autumn-winter period due to the lack of sunlight, the disease quickly grows. There are practically no patients with summer exacerbations.
There are three stages of psoriasis:
- progressive- characterized by the continuous appearance of new rashes, an increase in the size of previously appeared plaques and their surroundings with a pink border, the affected area is very itchyand scaly;
- stationary- new rashes no longer appear and old rashes do not grow; the top layer of skin in the area of the plaques becomes wrinkled;
- regressive- the skin does not peel off, the plaques disappear, leaving behind heavily pigmented areas.
Diagnosis of psoriasis
The diagnosis of psoriasis is made on the basis of information received from a medical examination by questioning a patient, as well as the symptoms inherent in one form or another of the disease.
The earlier a disease is detected, the faster the treatment process begins. As a result, more tangible results will be obtained.
Due to the fact that the picture of the disease is extremely specific, the diagnosis of psoriasis can be limited to a simple examination by a dermatologist.
But in some cases, difficulties may arise due to the implication or absence of symptoms, which occurs if the disease does not manifest itself in any way or seems unusual. This situation requires additional research procedures.
A specific method is used to make the diagnosis, which consists of the gradual scratching of papules along the layer.
As a result of such manipulation, it is possible to identify characteristic signs (psoriatic triad) to differentiate psoriasis from other diseases and to make a final diagnosis:
- stearin stain;
- terminal film (pink epidermal cells);
- dew of blood (droplets of blood appear on the surface of the plaque due to the rupture of capillaries).
If necessary, the patient is tested as samples of affected tissue.
X-rays are taken if arthritis related to psoriasis is suspected.
If the psoriasis is at an early stage, its diagnosis is not difficult: the picture of osteoporosis is clearly visible.
In later periods, there is a narrowing of the joint space, erosion of the tissues that form the bones, osteosclerosis and periostitis.
If the disease is severe, the wrist and metatarsal joints are destroyed, as a result, the joint completely loses its mobility.
It is worth noting that all the tests carried out are necessary not only for the final diagnosis, but also for differentiation with other diseases, which, at first glance, are the same.
These diseases include: parapsoriasis, seborrheic eczema, lichen rosacea, atopic dermatitis, lupus erythematosus, rheumatoid arthritis and others.