Psoriasis is a chronic non-communicable disease that until recently was considered to be a simple skin disease. The peculiarity of the inflammatory process in certain areas of the skin in patients with psoriasis is that the life cycle of normal skin cells is about 30-40 days, when, as in psoriasis, it is 4-5 days. , that is, after 4 days, the skin cells gradually die off, forming plaques. , dryness, peeling of the skin and so on.
The problem of treating this complex and difficult to treat disease today is urgent not only for dermatologists, many doctors of other specialties are often involved in determining the causes of psoriasis in a patient, and are alsodirectly involved in the complex treatment of this disease. Today, medicine considers psoriasis to be a systemic failure of the body, and not just an inflammatory process in the skin.
Even her name has changed, now it's psoriatic disease. Why is psoriasis a systemic pathology? Because in patients several different disorders in the work of the body as a whole are found at once - in the nervous, endocrine, immune system. In medicine, there are several types of psoriasis, there are also a large number of reasons for the appearance of this disease, mainly theories, since there is no convincing evidence of these alleged causes, we will examine them more indetail.
A few facts:Psoriasis is not contagious because it is believed to be caused by a dysfunction of the human immune system, namely overactive T cells in the skin. Psoriasis is classified as an inherited disease, with psoriasis in 1 of the parents the risk of developing psoriasis in a child is 25%, if both parents have 65%. In addition to the hereditary factor, the trigger mechanism for the onset of psoriasis or relapse is the intake of antibiotics, NSAIDs, B vitamins, as well as stress, alcohol and skin injuries.
Viral theory of the cause of psoriasis
A number of studies in patients with psoriasis have revealed various changes in the peripheral lymph nodes, which may indicate the viral nature of the development of this disease. It is suspected that it is the retroviruses that are genetically transmitted by inheritance that may be one of the causes of psoriasis, but to prove the viral nature of the origin of psoriasis, it is necessary to identify the virus, isolate itand select the habitat, and so far no one can do that.
The point is that retroviruses have the ability to change the genetic code of the host, they have, with the help of the reverse transcriptase enzyme, the ability to synthesize DNA, and a "bogusprogram "forms in cells that modifies the human genome. However, it has been established that even with blood transfusions from psoriasis patients to healthy people, infection or disease transmission has never been noted. Therefore, the version on the viral cause of psoriasis has not yet been proven.
The immune cause of psoriasis
This is one of the generally accepted theories about the causes of psoriasis, as disorders of cellular immunity are believed to be the primary trigger mechanism for the disease. It was noticed long ago that in people with a genetic predisposition to psoriasis, in case of chronic foci of infection - tonsillitis, sinusitis, which indicate impaired immunity - provoke factors of the appearance of psoriasis.
When a primary focus of psoriasis occurs, medicine also suggests that the damage to the epidermis is caused by autoimmune aggression. In numerous studies on patients with psoriasis, abnormalities of immune complexes, antibodies, immunoglobulins, which cause micro-abscesses of Munro, have been identified.
In the process of activating the inflammation of psoriasis, the hypersensitivity of the skin increases sharply, therefore, in places of physical or chemical irritation, rashes characteristic of psoriasis appear. When examining the skin scales, antigenic components were found, as well as autoantibodies against them in the blood, which are not found in healthy people, neither on the skin nor in the blood.
This fact confirms that the autoimmune process plays an important role in the cause of psoriasis. But all the processes, even immune reactions, take place in the body as an integral system. Therefore, a combination of other factors, such as endocrine influence, hereditary factors, metabolic disorders, must be taken into account.
Infectious theory of the development of psoriasis
One hundred years ago, many researchers stubbornly searched for an infectious agent of psoriatic disease, and streptococci, spirochetes and epidermophytos were believed to be responsible for its occurrence. However, none of these pathogenic microorganisms, fungi, after studies were found to be the cause of psoriasis.
However, infectious diseases, tonsillitis, ARVI influenza affect the exacerbation or trigger the primary onset of psoriasis, especially during the cold season when the immune system weakens and patients with psoriasisare often admitted to hospital.
Some authors believe that the development of psoriasis against the background of acute and chronic infection is explained by the influx of impulses from the focus of infection into the endocrine system and vegetative section, which leads to restructuringof the reactivity of the body. Very often, namely in 90% of cases, chronic tonsillitis accompanies psoriasis, which confirms the influence of infectious processes and impaired immunity on the development of psoriasis.
In addition, according to many experts, there is an infectious allergic cause of psoriasis. Its supporters believe that psoriasis is an allergic reaction of tissues to viruses, streptococci and their wastes. However, neither the viral theory nor the infectious theory has yet been confirmed.
Genetic cause
This cause is based on a familial manifestation of psoriasis in near and distant relatives. However, psoriasis should not be considered a strictly hereditary disease, as well as diabetes, cancer, ischemic heart disease, since psoriasis itself is not hereditary, but only a genetic predisposition to it. Yes, 60% of patients with psoriasis have ancestors or close relatives suffering from this disease, and if one of the parents is sick, then, according to the theoretical probability, the risk of developing psoriasis in children increases by25%, and if both parents are sick, up to 75%.
However, not always with psoriasis, the cause is only a genetic factor. This disease has recently become very common in clinical practice, and there is not always a direct dependence on a related predisposition. In psoriasis, the causes of its appearance are so multifactorial that it is impossible to unequivocally indicate a specific cause. Since the pathogenic factors are also violations of protein or carbohydrate metabolism, and changes in lipid, enzymatic metabolism, a combination with foci of streptococcal infection or viral nature.
Metabolic disorders as factors in the development of psoriasis
If we consider the metabolic disorders in psoriasis, then in many patients there is a slight decrease in body temperature, and this is one of the symptoms of a slowed metabolism, an increase in the contentin cholesterol is also noted, indicating changes in lipid metabolism. Given the high level of cholesterol, many researchers consider psoriasis to be a diathesis of cholesterol and consider its increase as the initial manifestation of dermatosis, since a violation of lipid metabolism stimulates the formation of keratinization of the skin.
In addition, in psoriasis the metabolism of vitamins is disturbed, especially vitamins C, A, B12, B6, while the vitamin C content of the skin is increased. In addition, changes in the content of iron, copper and zinc have been noticed, which significantly reduces the adaptive properties of the human body. Almost 25% of patients with psoriasis also suffer from diabetes mellitus, however, some researchers do not consider this fact to be the cause of psoriasis, but on the contrary as a manifestation of psoriatic disease.
As the disease progresses, the basal metabolism in patients with psoriasis is most often increased, and in patients with reduced metabolism, symptoms of hypothyroidism, endocrine glands and gonads often occur, in60% of patients with psoriasis, the general carbohydrate metabolism is disturbed. Low-calorie nutrition, or even moderate fasting, reduces auto-intoxication of the body, therefore, a diet in the treatment of psoriasis improves the patient's condition.
Factors causing psoriasis
At the present stage of medical research in the field of determining the cause of psoriasis, it can be said that it is a constantly recurring systemic disease that appears in genetically predisposed people, with concomitant disturbancevarious metabolisms and the central nervous system.
Stress
Both for the onset of psoriasis and for the exacerbation of existing chronic psoriasis, the main triggers are most often stress, psychological trauma, prolonged fatigue and nervous tension.
Stress triggers immunological and biochemical reactions that contribute to the development of psoriasis. However, sometimes negative emotions serve, on the contrary, to supplement the clinical symptoms of psoriasis. According to a survey of patients with psoriasis, this provoking factor causes the onset of the disease in 49% of patients and in 41% a relapse of psoriasis.
Infectious diseases, vaccination, chronic infectious foci
Tonsillitis, sinusitis, STIs, otitis media, etc. , a very virulent streptococcus is often detected. For exacerbation of the disease, this factor is relevant in 21% of patients, and for the onset of the development of psoriasis, infection is a triggering mechanism in 15% of patients.
Hormonal changes in women
During pregnancy, lactation, menopause or adolescence - in 6% of the patients surveyed, this was also a provocative factor in the development of psoriasis.
Wounds, bites, burns
Any skin trauma - in 12-14% of patients, the onset of psoriasis is caused by physical trauma.
Prolonged hypothermia
Is the cause of psoriasis or its exacerbation in 5% of patients.
Drugs
Like any type of antibiotic, NSAIDs. Vitamin therapy - especially vitamins C, B, beta blockers, cytostatics, vaccination, the use of herbal remedies in the treatment - this causes the onset of psoriasis in 6% of patients.
Food poisoning, abuse of certain foods
Chocolate, citrus and other products - according to a patient survey, it is the cause of psoriasis in 4% of patients.
Drink alcohol
In addition, a provocative factor provoking the generalization of the inflammatory process shortens the period of remission and increases the risk of complications, this is indicated by 3% of respondents.
Climate change
High humidity, prolonged exposure to intense ultraviolet radiation, sudden changes in temperature and humidity - cause exacerbation in 2% of patients.
The first symptoms of nascent psoriasis can occur regardless of age, it also often appears in infants and in people aged 20-40 years, even in old age psoriasis can start to develop. Naturally, the earlier it appears, the more serious its consequences for the patient. If psoriasis begins in a person after 30 years of age, it is usually accompanied by gastritis, liver disease, overweight, various neuroses, diabetes, arthritis and other diseases.