Psoriasis is a chronic, non-infectious skin disease. According to statistics, 3. 7% of the world's population suffers from psoriasis. The people call the disease "scaly lichen. "
Psoriasis is gender independent, non-infectious; it most commonly develops between the ages of 14 and 27. The disease is characterized by the appearance of red scales in the form of a plaque (spot) covered with white scales. It can be a patch (or more patches) on any part of the body, but most often on thin and dry skin areas: elbows, knees, lower back, scalp.
The spots are different in size and disturb in different ways: in some patients only skin irritation is observed; in other patients, large areas of skin are affected, resulting in discomfort, itching, pain, insomnia, and deterioration in quality of life.
Psoriasis is a chronic disease characterized by flares (rashes) and periods of remission (relief of symptoms).
Psoriasis often complicates pregnancy.
Causes of psoriasis
Psoriasis is a systemic process that affects not only the skin but the entire body. The causes of psoriasis are not fully understood, but it is thought to be many of them: neurogenic (due to stress), hereditary, infectious, viral, mixed (skin damage combined with staphylococcal penetration combined with any of the above causes), and so on. In this case, cellular and humoral immunity is activated and the autoimmune process of damage to the cells, especially the skin cells (epidermis), is initiated.
In addition to activating immunity, the metabolism is disrupted. The disease is exacerbated by an inherited burden. As a result, cell renewal is accelerated 3-5 times - psoriasis plaques form on the skin.
Without timely treatment, the lesion worsens: skin patches grow, crack, and purulent; nails are ruined, joints are affected, etc.
80% of the quality of life of patients with psoriasis depends on timely diagnosis and appropriate treatment.
Once again, we list the factors that contribute to the development of the disease:
- bad inheritance. Scientists have identified 9 genes that determine the development of the disease, but their interaction is unclear. Psoriasis is known to be inherited from relatives in the 1st and 2nd generations in 15% of cases;
- stress, nervous tension, depression. Stress has been shown to cause exacerbation of psoriasis in 70% of cases;
- hormonal imbalance;
- dysbiosis;
- metabolic disorders, drug addiction;
- colitis and parasitic infections (tapeworm, lamblia, intestinal infections, etc. );
- viral infections;
- streptoderm; skin candidiasis;
- allergies.
Symptoms of psoriasis
In the initial stage, psoriasis rashes appear as red plaques with scaly scales. The appearance of skin plaque is accompanied by intense itching. There is a denser (keratin) layer 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 dry, pink rashes covered with silvery scales rising above the skin. The skin in the affected areas often peels off; red spots remain in this place, bleeding during trauma. In 60% of cases, plaques merge into large plates.
Guttate psoriasis is characterized by many small, dry lesions in the form of pink drops that rise above the surface of the skin. The rash is localized on the thighs and legs and affects large areas of the body. In 60% of cases, guttate psoriasis worsens after streptococcal infection.
Pustular psoriasis is recognized by skin fluid-filled blisters. The blisters are surrounded by reddened, edematous scaly skin. The legs and thighs are more commonly affected.
The psoriasis of the flexing surfaces is manifested in the form of smooth, non-flaky red patches found in the area of the skin folds: the lateral surface of the thighs, the armpits, and the external genitalia. As a result of mechanical irritation (physiological friction), the spots are damaged, bleed and become pus.
Psoriasis of the nails manifests itself in discoloration, spots and transverse lines on the nails. The skin around the lesion becomes harder. As the disease progresses, the nail peels, thickens, and then dries or falls off.
Psoriatic arthritis (15% of cases). Any joint is affected, but more often the small ones - the gluttones of the hands and feet. The fingers will be like a sausage. Psoriasis of the joints leads to bursitis, a person's disability.
Let’s talk separately about head and elbow lesions.
Scalp psoriasis (primarily the scalp) is the most common form of the disease. It is more common at a young age. It manifests as red flaky spots that itch and itch. Redness is almost always noticeable, causing emotional discomfort and leading to social isolation.
Elbow psoriasis is a disease of middle-aged people. It manifests itself in the form of rashes on the extensor surfaces of the elbow joints. The rash spreads outwards and merges - a large plaque (plaque) is formed, which is covered with silvery, easily falling scales. Along 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 (age) and persist for years, provoking psoriatic lesions of the elbow joint.
Diagnosis of psoriasis
Psoriasis is diagnosed and treated by a dermatovenerologist.
Due to the characteristic skin lesions, the diagnosis of psoriasis is simple. A general blood test and rheumatoid factor determination are used as an additional laboratory test. For the diagnosis of psoriasis of arthritis, a rheumatologist and an X-ray of the affected joints are recommended. In rare cases, skin biopsies are performed for differential diagnosis.
Psoriasis must be distinguished from similar skin diseases: seborrhea, lupus, etc.
Psoriasis treatment
Psoriasis is a chronic disease with periods of worsening (reappearance of the rash) and remission (disappearance of the rash). It is impossible to recover from psoriasis forever. It can prolong remission and reduce the intensity of exacerbations.
Only in 40% of cases is it possible to find an effective treatment immediately. Sometimes it lasts for months and years. Therefore, psoriasis is treated at home, except for severe exacerbations and complications. The effectiveness of treatment is affected by the type, age, comorbidities, etc. of the psoriasis. In the case of mild psoriasis, topical preparations are prescribed: ointments and creams based on:
- glucocorticosteroids;
- zinc;
- tar;
- salicylic acid;
- Vitamin D3.
In case of severe psoriasis (25% of the skin surface is affected, joint damage) and in case of ineffectiveness of topical treatment, complex therapy is prescribed:
- cytostatics that inhibit epidermal cell division;
- immunomodulators that normalize the immune response;
- glucocorticosteroids, which regulate metabolic processes and reduce inflammation;
- non-steroidal anti-inflammatory drugs (anti-inflammatory drugs);
- multivitamins.
Physiotherapy is prescribed: ultraviolet radiation, cryotherapy, plasmapheresis, hirudotherapy. Folk remedies are also used: ointments based on celandine and lard, meadow and Vaseline, beeswax and lard. To normalize immunity, oats are used to drink homemade kvass, bay leaf infusion and dill decoction.
Diet plays an important role, especially in the worsening of psoriasis. Spicy and sweet foods are excluded from the diet. Fast food and alcohol are prohibited. The diet should be balanced and rich in vitamins and minerals.
To prevent your psoriasis from getting worse, you need to improve your health, avoid stress, hypothermia, and seasonal illnesses.
Here are some simple rules to prevent psoriasis from getting worse:
- do not over-dry the skin;
- avoid prolonged exposure to the sun;
- avoid skin damage;
- avoid stress;
- do not smoke or use alcohol.
Is psoriasis contagious?
There has been no proven case of transmission of psoriasis from a sick person during household or other contact. Therefore, psoriasis is not thought to be contagious.
Which doctor to go to
Consult a dermatovenerologist to start treatment on time and to prevent the spread of psoriasis. In the presence of psoriatic arthritis, a rheumatologist should be consulted.