Psoriasis - what kind of disease is it?

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

What disease is this?

Lichen squamosus is another name for psoriasis, and this name perfectly describes this disease.Psoriasis manifests itself in the formation of inflamed plaques of various sizes on the skin, which are covered by dense skin scales.

Almost everyone has probably heard of a disease like psoriasis.And this is not surprising, since scaly lichen is quite widespread.This disease is diagnosed in 4-10% of the world's population.In addition, statisticians collecting information on the prevalence of psoriasis claim that the number of patients is constantly increasing.

The scaly lichen has been known to people since ancient times;even the healers of ancient Greece tried to treat this disease.The modern history of the study of psoriasis goes back about 150 years.But during this fairly significant period of time, researchers have not been able to learn enough about the causes and treatment of psoriasis.

Widespread prevalence, etiological uncertainty (apparent causes), insufficiently effective treatment - all this characterizes psoriasis as one of the problems of the European Union.

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 are specific skin lesions.

Therefore, when answering the question about the nature of psoriasis, the modern dermatologist answers that these are disorders of the trophism and metabolic processes of the skin, which are caused by a malfunction of the body's systems.Today, two theories about the etiology of psoriasis are considered the most likely: genetic and viral.

• The genetic theory has many supporters, as psoriasis often acts as a hereditary or familial dermatosis.A thorough examination of the patient's family history confirms the presence of psoriasis in one form or another in the patient's relatives in 60-80% of cases.However, in some patients, the hereditary origin of psoriasis cannot be confirmed.This circumstance is the reason for separating these cases into a special group, where the main cause is not a genetic, but a phenotypic failure.
• The virus theory, according to which psoriasis develops as a result of an 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 in the case of a viral infection, but also in the presence of certain conditions.

Other theories also explain the appearance of psoriasis.For example, endocrine, neurogenic, metabolic, etc.Of course, these theories are not unfounded, and their studies allow us to obtain more important information about psoriasis.Today, however, we know for sure that the state of the endocrine and nervous systems, as well as the functioning of the gastrointestinal tract, do not cause psoriasis, but have a significant influence on the course of the disease.

For example, pathologies affecting the liver lead to the fact that the quality of blood purification performed by the organ decreases significantly.And this can trigger the appearance of various skin changes, including psoriasis.

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc.) lead to degeneration of the tissues of this organ, meaning that the liver is gradually replaced by connective tissue.As a result, the liver cannot cope with its cleansing functions.Externally, this is manifested by yellowing of the mucous membrane and skin, and the development of skin diseases, including psoriasis, is also possible.

There is also an inverse relationship: psoriasis is often associated with fatty degeneration that affects the liver.Therefore, in the treatment of this skin disease, it is important to follow a diet so as not to burden the liver unnecessarily.Patients are recommended to limit fatty foods and completely avoid alcohol.

Thus, despite numerous studies, it was not possible to get a precise answer to the question of what psoriasis is.However, the 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 manifests itself in different forms.In order to make it easier for specialists to navigate, the generally accepted classification of psoriasis is used.

Psoriasis is also included in the International Classification of Diseases (ICD).Today there is the 10th revision of the international disease register, which is why 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 a standard evaluation tool used in medicine and healthcare management.The 10th revision of the manual is used to monitor the occurrence of various diseases and other public health problems.

The 10th version of the ICD makes it possible to compare the morbidity and mortality data of different countries, which enables the acquisition of statistical data and the organization of diagnostic information.According to the agreement of WHO members, ICD 10 is used to assign codes for different diseases.Alphanumeric codes are accepted in version 10 of the classifier, which makes it convenient to store information in electronic form.

All types of psoriasis are listed in ICD 10 and each has a separate code.In dermatology, the following forms and types of psoriasis are distinguished:

• Common psoriasis(synonyms: vulgar, simple, plaque-like).The disease was assigned a code according to ICD 10 – L-40.0.This is the most common form, observed in 80-90% of patients.The main symptoms are the formation of plaques covered with white-gray skin flakes rising above the surface of the unchanged skin.This form is characterized by a slight exfoliation of the scales.After they are removed, inflamed red skin is revealed, which is very easily injured and starts to bleed.As the inflammatory process progresses, the size of the plaques can increase significantly.
• Inverse psoriasis.It is a disease that affects the folds (bending surfaces) of the skin.The ICD 10 code for this form of the disease is L83-4.Dermatosis appears as folds of smooth or minimally scaly spots on the skin.The condition worsens when the skin is caused by friction.The disease is often complicated by an associated streptococcal infection or fungus.
• Guttate psoriasis.This form of psoriasis is characterized by the formation of a large number of small red or purple spots in the shape of drops of water on the skin.According to the 10th version of the international classification, this disease was coded L4.Guttate psoriasis most often affects the skin of the legs, but rashes can also occur on other parts of the body.At the same time, guttate psoriasis is known to cause streptococcal infections - pharyngitis, tonsillitis, etc.- develops as a complication after
• Pustular or exudative psoriasis– this is a severe form of skin, according to ICD 10 it has codes L1-3 and L 40.82.It is characterized by the formation of blisters or pustules.The skin of the lesions is swollen, red, inflamed and peels off easily.If fungus or bacteria invade the pustules, the contents of the pustules become pus.Pustular psoriasis most often affects the distal parts of the limbs, but in the most severe cases, a generalized process can also develop, with rashes covering the entire body.
• Psoriatic arthritis or arthropathic psoriasis.According to the 10th version of the ICD, the pathology is coded L5.It manifests itself in inflammation of the joints.Arthropathic psoriasis can affect all types of joints, but in most cases the joints on the walls of the toes and hands become inflamed.Knee, hip or shoulder joints may be affected.Injuries can be so severe that they can lead to the patient's disability.Therefore, you should not think of psoriasis as a skin disease only.Severe types of psoriasis can lead to systemic changes, disability or even death of the patient.

• Erythrodermic psoriasis.A rare but serious type of psoriasis, according to the ICD 10, this disease was coded L85.Erythrodermic psoriasis is often manifested in a generalized form;the affected area may cover the entire or almost entire surface of the skin.The disease is accompanied by severe itching, swelling and pain.
• Psoriatic onychodystrophia or nail psoriasis.According to the 10th version of the ICD, the disease is coded L86.The pathology manifests itself as a change in the appearance of the nails on the toes and fingers.Nails may change color, become thicker, and begin to chip.Complete nail loss is possible.

In psoriasis, the classification of the disease takes into account not only the types of the 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.

When considering all types of the disease, widespread psoriasis is more common than other forms.

Stages of flow

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

The progressive stage of psoriasis is characterized by:

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

The following symptoms are typical for the stationary stage of psoriasis:

• lack of appearance of new elements;

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

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

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

• reducing the intensity of exfoliation;
• element resolution.

After the psoriasis plaques disappear, 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 (worsened in autumn and winter);
• summer (with aggravation in the warm period);
• Non-seasonal psoriasis is the most severe type, as there is no clear connection between relapses and seasons, periods of remission may be practically absent.

Diagnostic features

If psoriasis has a typical clinical picture, then 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, because the external manifestations of these diseases are very similar in the early stages.However, nail fungus and psoriasis have completely different natures, so the treatment must be different.

A non-professional can confuse it with fungus and psoriasis of the skin.Because mycoses of the skin (skin fungus) appear with similar symptoms - the formation of flaky plaques.Therefore, if you notice suspicious symptoms on your body or nails, you do not need to diagnose yourself and start treating the fungus with medicinal or folk remedies.

If the diagnosis is wrong, and the cause of the symptoms is actually not a fungus, but psoriasis, then the treatment will not be beneficial, but on the contrary, it will worsen the symptoms.

When visiting a dermatologist, a fungal test is performed and a scraping of the nail or skin is performed.The obtained material is then placed in a nutrient medium.If the fungus is present in the material, within a few days a large colony will grow in the tested sample.Based on the appearance of the substance, it is possible to understand what type of fungus caused the infection.

Sometimes psoriasis is complicated by secondary infections, which can be bacterial or fungal.Therefore, patients who change the clinical picture (appearance of purulent exudate, change in color of plaques, etc.)From time to time it is necessary to examine fungi and other infectious agents.

In the diagnostic process, a certain role is assigned to the group of phenomena called the psoriasis triad.The phenomena appear one after the other when one element of the rash is scraped off.

The psoriatic triad is manifested as follows:

• when an element of the rash is scraped, scales are removed in the form of "chips";
• after removing the chips, a thin transparent film similar to polyethylene is visible;
• If the film is damaged, accurate bleeding occurs.

A dermatologist diagnoses psoriasis, but if necessary, the doctor refers to another specialist - rheumatologist, gastroenterologist, surgeon, etc.

Interesting facts about psoriasis

Psoriasis has been known to people since ancient times.Even the name of the disease came into our language from ancient Greek.During the heyday of ancient Hellas, the word "psora" meant any skin disease manifested as peeling 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", an extensive chapter deals with this disease.

They knew about psoriasis, but they did not clearly evaluate this disease, since it was called either an "imperial" or a "devilish" disease.

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

Not only ordinary people, but also prominent political figures knew about psoriasis first hand.For example, Winston Churchill, who suffered from this disease, promised to erect a monument of pure gold to a person who could learn all about psoriasis and offer an effective treatment for this disease.

Modern ideas about the disease

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

Here are some facts about psoriasis that experts have no doubts about:

• Despite the fact that the causes of the disease are unclear, we managed to learn about the nature of psoriasis.This disease is autoimmune, that is, it is caused by a malfunction of the immune system;
• Another established fact about psoriasis is that the disease can be inherited.However, this is not always the case;Even if both parents are sick, the risk of developing the disease in the child is 65%.At the same time, some patients develop psoriasis, although none of their relatives have the disease;
• An interesting fact about psoriasis is that this disease is characterized by the Koebner phenomenon.This phenomenon manifests itself in the fact that the elements of the skin rash are formed at the site of skin damage - scratches, burns, frostbite.Sometimes psoriasis appears after a while in the place of scars;
• An important observation that allows us to gain more information about psoriasis is the relationship of this disease to climatic factors.Exacerbations and relapses are often timed with the change of season;
• Patients have probably noticed the connection between exacerbations and stress in practice.Every patient should know for sure that the disease recurs or worsens its course against the background of nervous tension and anxiety;
• a new fact about psoriasis is that the disease can debut at any age, although it was previously believed that pityriasis versicolor appeared after 30 years;
• It is important for everyone to know that psoriasis is not an infectious disease.Even in close contact with the patient, there is no risk of infection;
• Almost everyone has heard of the incurability of psoriasis, and this is true, since no treatment has been found that can guarantee that the disease can be overcome.But patients should know that psoriasis can be controlled.Adequate and timely treatment makes it possible to achieve long-term remission.

Modern treatment methods

When we talk about the common disease of psoriasis, we cannot ignore the treatment of this common disease.It must be said that psoriasis cannot be cured with tablets or ointments alone.

In order to forget the manifestations of psoriasis for a long time, the patient must make efforts in close cooperation with the doctor.It will be necessary to properly organize the meal.According to some experts, psoriasis can only be forgotten forever with the help of a properly prepared diet and regular cleansing of the body.

The doctor prepares the preliminary treatment plan according to which the treatment will be carried out.External (ointments, creams) and systemic (pills, injections) therapeutic methods are usually used.In addition, physiotherapy methods are used and treatment at resorts is recommended.The treatment of psoriasis is recommended using medicinal mud, mineral and thermal water.

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

Resorts may offer other ways to treat lichen planus.For example, leech therapy, healing baths and applications, sun treatment, etc.

You should be prepared for your treatment regimen to change regularly.Because not all methods are suitable for a particular patient.If the chosen treatment methods are not effective, they must be replaced.

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

You must understand that you can only forget about psoriasis forever if the patient himself and his immediate environment are in a positive mood.Only faith in success and an optimistic attitude will help to overcome this mysterious and insidious disease.