After its onset, psoriasis does not go away on its own in most patients, it only progresses and becomes more extensive, spreading to the skin.
However, with a timely diagnosis, it is easier to treat and recovery is much faster.
The most important thing here is to monitor the first signs of psoriasis in time and make an appointment with a dermatologist immediately.
Signs of psoriasis
Early psoriasis can appear as small, reddish, scaly patches.
The location of such rashes depends directly on the form in which the disease develops.
In most cases, these are:
- at the elbows and knees;
- on the head (in the hairy area);
- on palms and feet;
- in the area of the folds (buttocks, armpits, women under the breasts).
Primary eruptions (papules) are very small: they do not exceed 4 millimeters in diameter.
However, as the disease progresses, they enlarge and merge 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 the increase in the size of the affected skin surfaces.
The affected area begins to ache and itch and a strong burning sensation occurs.
These signs of psoriasis are accompanied by emotional discomfort that can significantly increase the rate at which the disease spreads.
If such rashes are found, it is inappropriate to start self-treatment as psoriasis in the early stages of development is similar to other skin conditions.
Accordingly, the wrong choice of drugs does not lead to positive results, but only worsens the situation.
Cumulative symptoms
Scaly lichen belongs to the category of systemic pathologies.
This means that it affects not only the skin and nails, but can affect the spine, joints and tendons, certain body systems (such as the endocrine, immune and nervous systems).
There are cases where the disease affects the digestive system (liver) and urinary system (kidneys).
The first symptoms of psoriasis
- constant feeling of tiredness;
- weakness;
- depressed state (until depression).
Due to the complex impact of the disease on the body, experts consider it appropriate to call it psoriasis.
Nevertheless, the main aspects of the disease are based on skin damage.
As mentioned above, the first call for the onset of pathology is 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, hair-covered head area), sometimes - on the mucous membranes of the external genitalia.
Papules can exceed 10 centimeters in size during the course of the disease.
Outbreaks of psoriasis can be divided into the following, depending on their characteristics:
- dotted (no larger than the head of a pin);
- teardrop-shaped (similar to a teardrop, the same size as the lens eye);
- coin-shaped (5 mm diameter plaques with rounded edges);
- Rarely curved, circular, or map-like.
Above the papules are scales that form from the keratinized cells of the epidermis and are removed without much effort. Initially, they appear in the middle of the plaque and gradually spread further and further.
Keratin cells have air gaps that result in visual fragility and light shadows.
Sometimes the elements are surrounded by a pink ring that acts as an area for plaque growth and inflammation. In this case, the condition of the surrounding skin does not change.
Plaque removal shows a bright, deep red surface based on capillaries, which in turn have very thin walls.
The presence of such small-diameter vessels is caused by damage to the structure of the upper layers of the skin, the structure of which is disrupted by the incomplete maturation of epidermal cells (keratinocytes), making it impossible to distinguish them properly.
Symptoms of different forms of psoriasis
Common psoriasis has rather specific symptoms, so it will not be difficult to diagnose.
Appears as scaly, rounded areas that protrude above normal skin and are pink or red.
Occasionally, there are no characteristic plaques in the early stages of the disease: before they appear on the scalp and in the area of the joints (ankles, elbows and knees), tiny papules are observed.
They are able to survive long enough and do not cause discomfort to the patient: nothing itches, pains or causes pain at all, or is practically not felt, the papules themselves are almost impossible to notice.
They do not peel off, but after a light scratching, the scale appears immediately. Such pink seals may disappear or decrease significantly in summer as sunlight affects the skin.
The acute form of psoriasis is manifested in the form of multiple, itchy rashes of brightly colored papules and is the result of the action of disease-activating factors.
To avoid being mistaken for an allergic reaction, the surface of the plaque should be scraped slightly before the characteristic phenomena appear.
Seborrheic psoriasis begins on the scalp (the area covered with hair) and then spreads to the face and shoulders.
The right area is characterized by severe exfoliation of the skin, which patients most often consider dandruff and therefore do not rush to a dermatologist.
This fact allows the disease to quietly reach the developmental stage when the areas behind the forehead and ears peel. And only after these plaques form.
Lesions of the skin folds in psoriasis (underarms, genitals and loins, in women under the breast) are often confused with normal irritation caused by friction or sweating.
This type of disease is characterized by plain plaques that appear as spots. Peeling is not observed but is often soaked. The rash itself is bright red, even and bright.
In the case of genital damage, the characteristic signs of psoriasis can be misinterpreted as balanopostitis (a lesion of the vaginal penis and the skin of the internal foreskin) in men and vulvitis (a rash on the small lips) in women.
The palm-plantar form of the disease manifests itself in the form of compacted areas, similar to calluses, the surface of which is covered with yellow scales that are difficult to remove.
The affected area is cracked and sore. Scraping this form of the disease makes it difficult to trigger the appearance of the final film and bloody dew.
Nail psoriasis begins with psoriasis onychodystrophy, which is one of the primary symptoms of this form of the disease and appears much earlier than the rash.
In the early stages, the edges of the nail are covered with grooves and small depressed areas.
As the disease develops, they spread, reach the root, and then change color. The nail becomes dull and thickens. Due to circulatory failures, the manifestation of the disease increases.
Epidermal cells accumulate under the nail plate and are bordered by reddish tissue on all sides, after which it can peel off after a while.
This type of psoriasis is dangerous because it increases the sensitivity of the tissues, which in turn increases the likelihood of infection. Very often this disease is confused with a fungus.
Moving joints in bones (joints) are often affected. Deformed, the joint capsule undergoes dystrophic-type modifications.
Arthritis of psoriasis begins with an increase in joint volume accompanied by pain.
Both the fingers and toes are more prone to this type of psoriasis.
In severe form, the joints of the shoulders and elbows, hips and knees, as well as parts of the spine are exposed to the disease.
Effect on symptoms of psoriasis stages
The symptoms of psoriasis are directly proportional to the season of the year and the stage of the disease.
Most often, in the spring-summer period, there is a noticeable decrease in disease activity, which is facilitated by ultraviolet rays.
Accordingly, in the autumn-winter period, due to lack of sun, the disease quickly accelerates. There are virtually no patients with summer exacerbations.
Psoriasis has three stages:
- progressive- characterized by the constant appearance of new rashes, the growth of previously appeared plaques and their pink-bordered environment, the affected area is very itchy and scaly;
- standing- new rashes no longer appear and old ones do not grow; the top layer of skin will be wrinkled in the area of plaques;
- regressive- skin does not peel off, plaques disappear, leaving heavily pigmented areas.
Diagnosis of psoriasis
The diagnosis of psoriasis is made on the basis of the information obtained during the medical examination by asking the patient and the symptoms of one form or another of the disease.
The sooner a disease is detected, the faster the treatment process begins. Accordingly, more tangible results are obtained.
Due to the very specific nature of the disease, the diagnosis of psoriasis may be limited to a simple examination by a dermatologist.
However, in some cases, difficulties may arise due to the tacit absence or absence of symptoms, which occurs when the disease is not manifested in any way or is not characteristic. This situation necessitates further research procedures.
A specific method is used to establish the diagnosis, which consists of gradually scraping the papules along the layer.
As a result of such manipulation, the characteristic signs (psoriasis triad) can be identified to distinguish psoriasis from other diseases and to make a definitive diagnosis:
- stearinfol;
- terminal film (pink epithelial cells);
- blood dew (blood droplets appear on the surface of the plaque due to rupture of the capillaries).
If necessary, the patient is examined in the form of samples of the affected tissues.
X-rays are taken if arthritis associated with psoriasis is suspected.
If psoriasis is in its early stages, it is not difficult to diagnose: the picture of osteoporosis is clearly visible.
In later periods, the joint space narrows, erosion of the tissues that make up the bones, osteosclerosis, and periostitis occur.
If the disease is severe, the joints of the wrist and metatarsus are destroyed, with the result that the joint completely loses its mobility.
It should be noted that all tests performed are not only necessary for a definitive diagnosis, but can also be distinguished by other diseases that are identical at first glance.
These diseases include parapsoriasis, seborrheic eczema, lichen rosacea, atopic dermatitis, lupus erythematosus, rheumatoid arthritis, and others.