3 stages of the cyclical development of psoriasis

The stages of psoriasis are defined time intervals during which the disease takes on its characteristics. Many psoriatic sufferers mistakenly refer to the stage as a severe or mild form of the disease, but in medical records the term is used in a completely different sense.

What are the stages of psoriasis?

Psoriasis is recognized as a recurrent skin pathology, for which genetics are responsible. According to dermatologists, at least 2% of the world's population suffers from this disease, which means that the problem is very urgent. During psoriasis, 2 conditions are clearly distinguished:

1. Relapse.This term refers to the deterioration of the skin. In the event of a relapse, the patient suffers from itching, pain, burning, profuse rash, irritation and discomfort. The victim's situation is aggravated by insomnia, neurosis and anxiety.
2. Remission.This word is used to mean improving the appearance of the skin. In remission, the skin returns to its normal color, the redness disappears, and the area of ​​psoriatic plaques is reduced.

The stages of psoriasis partly mirror the description of remission and relapse, so many dermatologists use these words as synonyms. In clinical practice, 3 stages of psoriasis are described:

• progress step;
stationary
• ;
• regression step.

Considering that we are talking about a cyclical process, the stages follow one another sequentially and form a continuous course of the disease.

Done!The stage of progression is considered the most difficult to experience.

What is the progression of psoriasis?

The progression stage is triggered by a number of triggers, such as cold season or stress. In some cases, even an experienced dermatologist cannot unambiguously identify the trigger. During the progressive phase, this is what happens:

1. Psoriatic nodules grow rapidly, affect the skin, interconnect in the so-called plaques, which flake and itch. A plaque is a spot of arbitrary shape, most often round or oval, sometimes with an irregular edge.
2. Papules, which are the individual lumps of a psoriatic rash, are lumps on the skin. The edges of the papules do not peel off and the central part is peeled off. As a large number of dead scales accumulate, the plaques begin to rise above the surface of the skin. The pockets give them an even more convex and uneven appearance.
3. This stage of the pathology is characterized by an isomorphic reaction, which consists of an exacerbation of skin rashes in the event of skin lesions, scratches, injections, cuts, microtrauma. This phenomenon is called Köbner.

A delayed reaction is characteristic of the progressive stage of psoriasis. In some cases, rashes appear about 9 days after exposure to a trigger (such as a food allergen). Usually, a psoriatic rash appears within 24 hours of exposure to unwanted factors.

Interesting!95% of psoriatics have some type of food intolerance that can trigger a relapse. To avoid exacerbations, you need to keep a food diary and observe the reaction to different types of food.

Stationary and recessive stages

The stationary phase is the period during psoriasis when the victim's condition is relatively stabilized. At the stationary stage:

1. Psoriatic plaques have a smooth outline. The entire surface of the plate is covered with a thick layer of scales that peel off easily. Itching and discomfort are moderate. There is no bright red inflamed rim around the papules.
2. With skin microtrauma, Koebner's phenomenon is not observed, that is, scratching or cutting healthy skin no longer turns into psoriatic plaque.

The regressive or recessive stage is characterized by massive lesions of psoriasis. First, a pseudo-atrophic edge can be seen around the papules, then patients notice a rapid stop of the peeling of the skin, with the formation of hyperpigmentation plaques at the site.

Severity of the pathology

An additional diagnostic criterion is the assessment of the area of ​​psoriatic lesions. The term "gravity" is used to describe it. Dermatologists distinguish 3 degrees of severity of skin diseases:

1. Easy.Psoriatic plaques occupy 1 to 3% of the total body surface. The small size of the affected areas does not mean that the patient is well. With psoriasis of the head or face, even a few plaques will be enough to cause a person discomfort and anxiety.
2. Medium.The volume of psoriatic eruptions takes from 3 to 10% of the total body surface. In this case, the back, chest and external surfaces of the joints, scalp, palms and feet are affected. This prevalence leads to severe poisoning and severe pain. The patient may lose his ability to work completely or partially, the mental state and the state of the nervous system deteriorate.

3. Heavy.The disease covers more than 10 to 15% of the skin surface. According to rough estimates, if psoriasis occupies more than a quarter of the total body surface area, the likelihood of liver or kidney failure increases several times. Decompensated damage to internal organs can lead to death in psoriatic patients.

In order to comprehensively assess the severity of psoriasis, a special scale called PASI is used. The scale takes into account:

• percentage of healthy and diseased skin;
• stage of the pathology;
• patient response to drug therapy;
• individual tolerance of psoriasis (mental state, complications of the nervous system and psyche);
• objective data from dynamic laboratory tests (for example, the volume of uric acid in a blood test).

The diagnosis takes into account all the symptoms that affect the condition of a person with psoriasis. The intensity is reflected in the medical record:

• process of itching of the skin;
• redness;
• pockets;
hyperemia
• ;
• thickening of the skin;
• exfoliation;
• blood flow;
swelling
• ;
• infections;
pain syndrome
• .

On the PASI scale, the volume of skin lesions is described by numbers, from 0 to 72, where 0 is the absence of skin symptoms, and 72 is the maximum possible large-scale spread of the disease.

Warning!It is important for the patient to know and watch for signs of exacerbation first. If unfavorable symptoms appear, you should immediately consult a dermatologist, since psoriasis does not always enter the stationary stage itself. A relapse can last for decades.

Treatment of psoriasis depends on the stage

For each stage of the disease, its own set of therapeutic measures have been developed, so the first thing a dermatologist does is determine whether the psoriasis is progressing, stabilizing, or regressing.

How is the progressive stage treated

Everyone with psoriasis assumes that remission ends with their own feelings. If the itching gets worse, the skin looks worse, and the psoriasis is clearly spreading to the surface of the body, treatment should be started. Therapy for the advanced stage has the following characteristics:

1. The patient is engaged in the prevention of further deterioration, strictly adheres to the diet, refrains from triggering the pathological process (stress, smoking, alcohol).
2. For severe itching, antihistamines can be used, an additional benefit of this class of drugs is the elimination of puffiness in the area of ​​psoriatic plaques.
3. The dermatologist prescribes a wide range of topical treatments to heal, soften and brighten the skin. By decision of the doctor, creams, ointments or sprays are selected. Tar soap and solid oil compresses give a positive dynamic. You can also apply compresses or apply cosmetics with Dead Sea mud.

The main task at this stage is to stop the exacerbation before the disease goes into a prolonged relapse. Depending on the indications, the doctor selects corticosteroids in injections or in the form of ointments.

Warning!Corticosteroids should be used as part of a short and intensive course under the supervision of a dermatologist. You can give yourself injections or rub antihistamine ointments.

Stationary and regressive phase therapy

Further actions of the dermatologist depend on the body's response to the chosen treatment. The following scenarios are possible:

1. Medicines have a positive effect. Within 1 to 2 weeks, psoriasis passes the stationary stage, regresses, and remission occurs.
2. The drugs have no effect. If, after 2 to 4 weeks from the time of prescription of the treatment, the results are still not visible, this is a reason to change the list of medications or the attending physician.
3. Drugs make it worse. Such a dynamic is also possible, especially if the dose or frequency of administration is not enough. The relapse is delayed, the psoriatic plaques cover a large part of the body, the person must be hospitalized.

In a medical institution, more powerful therapy is used, for example, material purification of blood. With a favorable reaction, psoriasis enters the stationary phase, which can last from several days to several months.

Interesting!More than 80% of patients notice the seasonality of exacerbations. This makes the disease predictable and allows you to prepare for the onset of relapse.

The list of drugs for stationary and regressive stages is exactly the same, but the dosage and frequency of administration are lower than for the progressive stage.

10-15 years of remission

A competent dermatologist sets himself the task of choosing those drugs and physiotherapeutic agents that will give psoriatic patients the longest possible improvement. At the same time, the patient himself should promote the treatment in every possible way, avoid triggers and take his medications responsibly. If the alliance between the patient and the doctor has developed successfully, the duration of remission is unlimited. Stable well-being can last 15 years or more.