Psoriasis: what type of disease is it?

Although psoriasis is a common and long-known disease, it has not yet been fully studied.And most often patients do not know at all that psoriasis is not a bacterial or fungal infection, but a non-standard reaction of the immune system, caused by unknown reasons.Information about the causes and symptoms of psoriasis will be very useful to patients, as it will help them overcome the disease.

What kind of illness is this?

Lichen squamosus is another name for psoriasis, and this name perfectly characterizes this disease.Psoriasis is manifested by the formation of inflamed plaques of different sizes on the skin, densely covered with thick skin scales.

Surely almost everyone has heard of a disease like psoriasis.And this is not surprising, since scaly lichen is quite common.This disease is diagnosed in 4 to 10% of the world's population.In addition, statisticians who collect information on the prevalence of psoriasis say that the number of patients is constantly increasing.

Scaly lichen has been known to humans since ancient times;even ancient Greek healers tried to treat this disease.The modern history of the study of psoriasis dates back approximately 150 years.But during this rather long period, researchers were not able to learn enough about the causes and treatment of psoriasis.

Widespread prevalence, uncertainty about the etiology (reasons for its occurrence), insufficiently effective treatment - all this characterizes psoriasis as one of the most difficult problems of dermatology.

Today, dermatologists consider psoriasis to be a complex systemic disease associated with disturbances in the functioning of the immune system, failure of metabolic processes and the appearance of trophic disorders.The result of these failures is specific skin changes.

Therefore, answering the question of what psoriasis is, a modern dermatologist will answer that these are disorders of trophism and metabolic processes in the skin caused by malfunction of the body's systems.Today, two theories of the etiology of psoriasis are considered the most likely: genetic and viral.

• The genetic theory has many supporters, since psoriasis often acts as a hereditary or familial dermatosis.A thorough examination of the patient's family history confirms in 60-80% the presence of psoriasis in one form or another in the patient's relatives.However, in some patients it is not possible to confirm the fact of the hereditary origin of psoriasis.This circumstance is the reason why these cases are divided into a special group, in which the main cause is not genetic, but phenotypic failures.
• The viral theory, according to which psoriasis develops as a result of infection, has its supporters.Confirmation of information about the viral origin of psoriasis is the detection of antibodies in the blood of patients, as well as “elementary bodies” in the cells of the epidermis.According to this theory, psoriasis develops not only when infected with a virus, but also in the presence of certain conditions.

There are other theories explaining the appearance of psoriasis.For example, endocrine, neurogenic, metabolic, etc.Naturally, all these theories are not groundless, and their study allows you to obtain more important information about the disease psoriasis.However, today it is already known for sure that the state of the endocrine and nervous systems, as well as the functioning of the gastrointestinal tract, does not cause psoriasis, but has a significant impact on the course of this disease.

For example, pathologies affecting the liver lead to a sharp reduction in the quality of blood purification carried out by this organ.And this, in turn, can cause the appearance of various skin lesions, including psoriasis.

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc.) lead to degeneration of the tissues of this organ, that is to say, the liver is gradually replaced by connective tissue.As a result, the liver ceases to perform its cleansing functions.Outwardly, this is manifested by yellowing of the mucous membranes and skin, and the development of skin diseases, including psoriasis, is also possible.

There is also an inverse relationship: psoriasis is often accompanied by fatty degeneration that affects the liver.Therefore, when treating this skin disease, it is important to follow a diet so as not to unnecessarily burden the liver.Patients are advised to limit fatty foods and completely eliminate alcohol.

So, despite numerous studies, it was not possible to obtain an exact answer to the question of what psoriasis is.However, work continues, so there is a chance that the mystery of this mysterious disease will be solved and we will learn a lot about the skin disease psoriasis.

Classification according to the international system

Psoriasis disease manifests itself in various forms.To facilitate navigation for specialists, a generally accepted classification of psoriasis is used.

Psoriasis is also included in the International Classification of Diseases (ICD) system.Today, the 10th revision of the International Disease Registry is already in use, therefore the abbreviation ICD 10 is used.Work on the 10th revision of the International Classification of Diseases began in 1983 and was completed in 1987.

Essentially, ICD 10 is the standard assessment tool used in medicine and healthcare management.The 10th revision of the reference book is used to monitor the prevalence of various diseases and other problems related to public health.

Thanks to ICD version 10, it is possible to compare data on morbidity and mortality in different countries, which makes it possible to obtain statistical data and systematize diagnostic information.As agreed by WHO members, ICD 10 is used to assign codes to various diseases.In version 10 of the classifier, alphanumeric codes are adopted, with the help of which it is convenient to store information in electronic form.

All types of psoriasis are included in ICD 10 and each of them is assigned a specific code.In dermatology, the following forms and types of psoriasis are distinguished:

• Common psoriasis(synonyms: vulgar, simple, plate-shaped).The disease was assigned a code according to ICD 10 – L-40.0.This is the most common form, it is observed in 80 to 90% of patients.The main symptoms are the formation of raised plaques above the unchanged skin surface, covered with white-gray scales of skin.This form is characterized by a slight peeling of the scales.After their removal, red inflamed skin appears, which is very easily injured and begins to bleed.As the inflammatory process progresses, the size of the plaques can increase significantly.
• Reverse psoriasis.This is a disease that affects skin folds (bending surfaces).For this form of the disease, the ICD 10 code is L83-4.Dermatitis appears with the formation of folds of smooth or slightly scaly spots on the skin.The situation worsens when the skin is injured by friction.The disease is often complicated by streptococcal infection or an associated fungus.
• Guttate psoriasis.This form of psoriasis is characterized by the formation on the skin of a large number of small red or purple spots, shaped like water droplets.According to the 10th version of the international classifier, this disease received the code L4.Most often, guttate psoriasis affects the skin of the legs, but rashes can also occur on other parts of the body.At the same time, it is known that guttate psoriasis develops as a complication after streptococcal infections - pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasis– this is a severe cutaneous form, according to ICD 10 it receives the codes L1-3 and L 40.82.Characterized by the formation of blisters or pustules.The skin on the lesions is swollen, red, inflamed and peels off easily.If fungi or bacteria enter the pustules, the contents of the pustules become purulent.Pustular psoriasis most commonly affects the distal parts of the extremities, but in more severe cases a generalized process may develop with a rash spreading throughout the body.
• Psoriatic arthritis or arthropathic psoriasis.According to the 10th version of the ICD, the pathology is coded L5.Manifested by inflammation of the joints.Arthropathic psoriasis can affect all types of joints, but in most cases, the joints of the phalanges of the toes and hands become inflamed.The knee, hip or shoulder joints may be affected.The injuries can be so severe that they cause disability for the patient.Therefore, you should not consider psoriasis as an exclusively skin disease.Severe types of psoriasis can lead to systemic damage, disability, or even death of the patient.

• Erythrodermic psoriasis.Rare but serious type of psoriasis, according to ICD 10, this disease received the code L85.Erythrodermic psoriasis often manifests itself in a generalized manner;The affected area may include all or almost all of the skin's surface.The disease is accompanied by itching, swelling and severe pain.
• Psoriatic onychodystrophy or nail psoriasis.According to version 10 of the ICD, the disease is coded L86.The pathology is manifested by changes in the appearance of the toenails and fingers.Nails may change color, become thicker, and begin to break down.Possibility of complete nail loss.

In psoriasis, the classification of the disease takes into account not only the types of disease, but also the severity of the symptoms:

• limited psoriasis is a disease in which less than 20% of the skin is affected;
• widespread psoriasis affects more than 20% of the body surface;
• When almost the entire surface of the skin is affected, we speak of universal psoriasis.

Looking at all types of disease, generalized psoriasis is more common than other forms.

Flow stages

Limited or widespread psoriasis goes through three stages during its evolution: progressive, stable and regressive.

The progressive stage of psoriasis is characterized by the following:

• the appearance of new rashes;
• growth of existing plaques;
• the appearance of new elements of the rash at the site of skin lesions (scratches, abrasions);
• excessive peeling of existing plaques.

The following symptoms are characteristic of the stationary stage of psoriasis:

• lack of emergence of new elements;

• moderate peeling of elements;
• no signs of element growth.

The appearance of folds in the stratum corneum around the elements is a sign of the transition from the stationary stage to a regressive stage.

The regression phase is characterized by the following types of symptoms:

• reduce the intensity of peeling;
• resolution of elements.

After psoriatic plaques resolve, hypo- or hyperpigmented spots remain in their place.

Lichen squamosus is characterized by a long course with periodic exacerbations.The following types of psoriasis are distinguished:

• winter (with worsening in autumn and winter);
• summer (with exacerbations during the hot period);
• non-seasonal psoriasis is the most serious type, since there is no clear connection between relapses and seasons of the year, periods of remission can be practically absent.

Diagnostic features

If psoriasis has a typical clinical picture, the diagnosis will not be so difficult.However, this disease is often disguised as other pathologies.

For example, nail psoriasis is often confused with nail fungus, since the external manifestations in the early stages of these diseases are very similar.However, nail fungus and psoriasis are completely different in nature, so the treatment should be different.

A non-specialist may confuse it with a fungus and skin psoriasis.Since skin mycoses (skin fungi) are manifested by similar symptoms - the formation of scaly plaques.Therefore, if you notice suspicious symptoms on your body or nails, you do not need to make a diagnosis yourself and start treating the fungus using pharmaceutical or folk remedies.

If the diagnosis is incorrect and in fact the cause of the symptoms is not a fungus, but psoriasis, then the treatment will not be beneficial, but on the contrary will worsen the symptoms.

When contacting a dermatologist, a fungal test will be performed and a scraping will be done on the nail or skin.Then the resulting material is placed in a nutrient medium.If the fungus is present in the material, a large colony will develop within a few days in the tested sample.By the appearance of the material, it will be possible to understand what type of fungus caused the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, this may be a bacterial infection or a fungus.Thus, patients who change the clinical picture (appearance of purulent discharge, change in color of plaques, etc.)You will need to be tested periodically for fungi and other infectious agents.

In the diagnostic process, a certain role is assigned to a set of phenomena called the psoriatic triad.The phenomena appear sequentially when an element of the rash is scratched.

The psoriatic triad manifests itself as follows:

• when an element of the rash is scratched, the scales are removed in the form of “chips”;
• after removing the chips, a thin transparent film similar to polyethylene appears;
• When the film is damaged, localized bleeding occurs.

A dermatologist diagnoses psoriasis, but if necessary, the doctor can refer the patient to consultations with other specialists - rheumatologist, gastroenterologist, surgeon, etc.

Interesting facts about psoriasis

People have known about psoriasis since ancient times.Even the name of the disease came to our language from ancient Greek.During the prosperity of ancient Hellas, the word “psora” designated all skin diseases which manifested themselves by scaling and itching.

The first person to write a detailed treatise on psoriasis was a Roman named Cornelius Celsus.In the fifth volume of his work “De medicina”, a detailed chapter is devoted to this disease.

They knew about psoriasis, but this disease was not assessed unambiguously, since it was called either the “imperial” disease or the “devil” disease.

Of course, ancient healers knew very little about psoriasis.Until the 19th century, this disease was often confused with other skin conditions.Psoriasis was first identified as an independent nosological form in 1799. This was done by the English dermatologist Robert Willan, who identified psoriasis among a large group of skin diseases manifested by itching and peeling.

Not only ordinary people, but also prominent political figures knew about psoriasis.For example, Winston Churchill, who suffered from this disease, promised to erect a monument made of pure gold to a person who could learn everything about psoriasis and come up with effective treatment for this disease.

Modern ideas about illness

It must be said that modern science does not know much about this mysterious disease.There are various theories about the origin, development and treatment of psoriasis.

Here are some facts about psoriasis that are beyond doubt among experts:

• Despite the fact that the causes of the disease are not clear, we managed to find out the nature of psoriasis.This disease is autoimmune, that is to say it is caused by a dysfunction of the immune system;
• Another established fact about psoriasis: the disease can be hereditary.However, this is not always the case;even if both parents are sick, the risk of developing the disease in their child is 65%.At the same time, some patients develop psoriasis, even if no one close to them is sick;
• An interesting fact about psoriasis is that this disease is characterized by the Koebner phenomenon.This phenomenon is manifested by the fact that elements of the rash are formed at the sites of skin lesions - scratches, burns, frostbite.Sometimes psoriasis appears after a while, in scars;
• An important observation that allows us to obtain more information about psoriasis is the link between this disease and climatic factors.Exacerbations and relapses are often timed to coincide with the change of season;
• Patients probably noticed in practice the connection between exacerbations and stress.All patients should know for sure that the disease recurs or worsens against the background of nervous tension and anxiety;
• a new fact regarding psoriasis is that the disease can begin at any age, although previously it was thought that tinea versicolor appeared after 30 years;
• It is important that everyone knows that psoriasis is not a contagious disease.Even in the event of close contact with a patient, there is no risk of infection;
• Almost everyone has heard about the incurability of psoriasis, and this is true, since no treatment has been found that can guarantee victory over the disease.But patients should know that psoriasis can be controlled.Adequate and timely treatment allows you to achieve long-term remission.

Modern methods of treatment

Talking about the common disease of psoriasis, we cannot fail to talk about the treatment of this common disease.It must be said that it is impossible to cure psoriasis only with tablets or ointments.

In order to forget about the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will have to make efforts.You will have to organize the food well.Some experts say that you can forget about psoriasis forever only with the help of a properly formulated diet and regular cleansing of the body.

The doctor will draw up a preliminary scheme according to which the treatment will be carried out.As a rule, external (ointments, creams) and systemic (tablets, injections) methods of therapy are used.Additionally, physiotherapeutic methods will be used and treatment at resorts will be recommended.It is recommended to treat psoriasis with healing mud, mineral and thermal water.

Resorts may also offer non-traditional treatment methods.For example, with the help of fish that live in thermal springs.These little healers effectively remove dead scales and disinfect the skin, promoting faster healing.

Resorts may offer other methods of treating lichen planus.For example, leech therapy, healing baths and applications, sun care, etc.

You will need to prepare for the fact that the treatment regimen will change periodically.Since not all methods are suitable for a specific patient.If the chosen treatment methods have no effect, they will have to be replaced.

Traditional methods of treating psoriasis are also widely advertised.Indeed, some of them can help achieve remission.However, when choosing a method, you should use common sense so as not to harm your health.If in doubt about a recipe or recommendation, it is best not to use it.Consult your doctor before using any treatment method.

You need to understand that it will be possible to forget about psoriasis forever only if the patient himself and his immediate environment are in a positive mood.Only faith in success and an optimistic attitude will help defeat this mysterious and insidious disease.