Psoriasis is a non-communicable, chronic disease that until recently was simply considered a skin condition. The peculiarity of the inflammatory process in patients with psoriasis in certain areas of the skin is that the life cycle of normal skin cells is approximately 30-40 days, when - as in psoriasis - after 4-5 days, i. e. 4 days, the skin cells gradually die, forming plaques. , dryness, peeling of the skin, etc.
The treatment of this complex and difficult-to-treat disease today is not only urgent for dermatologists, many other physicians are often involved in determining the causes of a patient's psoriasis and are also directly 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 its name has changed, now it's a psoriatic disease. Why is psoriasis a systemic pathology? Because patients have multiple disorders in the work of the whole body at the same time - in the nervous, endocrine, immune systems. There are several types of psoriasis in medicine, and the appearance of this disease is also due to a large number of causes, mainly theories, as there is no convincing evidence for these alleged causes, which will be examined in more detail.
Some facts:Psoriasis is not contagious as it is presumably caused by a defect in the human immune system, namely overactive T lymphocytes on the skin. Psoriasis is a hereditary disease, with 1 in 25 parents having a 25% risk of developing psoriasis in a child if both parents have 65%. In addition to the hereditary factor, the onset of psoriasis or relapse is triggered by intake of antibiotics, NSAIDs, B vitamins, and stress, alcohol, and skin injuries.
Virus theory of the cause of psoriasis
Several studies in patients with psoriasis have found various changes in the peripheral lymph nodes that may indicate the viral nature of the development of this disease. It is suspected that genetically transmitted retroviruses may be one of the causes of psoriasis, but proving the viral nature of the origin of psoriasis requires virus identification, isolation, and habitat selection, and so far no one can do that.
The situation is that retroviruses are able to alter the genetic code of the host, synthesize DNA using the enzyme reverse transcriptase, and a "fake program" develops in the cells that alters the human genome. However, it was found that no infection or spread of the disease was experienced even in patients with psoriasis who had blood transfusions from healthy individuals. Therefore, a 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 cellular immune disorders are considered to be the cause of the disease. It has long been observed that in individuals with a genetic predisposition to psoriasis, provocative factors for the development of psoriasis in chronic foci of infection — tonsillitis, sinusitis, which indicate a deterioration in immunity.
When the primary focus of psoriasis occurs, medicine also suggests that damage to the epidermis is caused by autoimmune aggression. Studies in a number of patients with psoriasis have identified immune system disorders, antibodies, immunoglobulins that cause Munro microabescences.
During the activation of inflammation of psoriasis, the hypersensitivity of the skin is greatly increased, so psoriasis-specific rashes appear at the site of physical or chemical irritation. Examination of skin scales found antigenic components and autoantibodies in the blood that were not found on the skin or in the blood of healthy people.
This fact states that the autoimmune process plays an important role in the induction of psoriasis. But all processes, even the immune response, in the body are played out as an integrated system, so a combination of other factors must be considered, such as endocrine influences, hereditary factors, metabolic disorders.
Infectious Theory of Psoriasis
One hundred years ago, many researchers stubbornly searched for the infectious agent of psoriasis disease, and streptococci, spirochete, and epidermophytosis were blamed for its occurrence. However, none of these pathogenic microorganisms or fungi have been found to cause psoriasis after research.
However, infectious diseases, tonsillitis, and ARVI influenza affect the exacerbation or cause of psoriasis, especially during the cold season, when the immune system is weakened, and patients with psoriasis are often hospitalized.
Some authors believe that the development of psoriasis in the background of acute and chronic infection can be explained by the influx of impulses from the focus of the infection into the endocrine system and the vegetative stage, leading to a transformation of body reactivity. Very often, namely in 90% of cases, chronic tonsillitis is accompanied by psoriasis, which confirms the effect of infectious processes and harmful immunity on the development of psoriasis.
In addition, many experts say there is an infectious-allergic cause of psoriasis. Proponents believe that psoriasis is an allergic tissue reaction to viruses, streptococci, and their metabolic products. However, neither viral nor infectious theory has yet been confirmed.
Genetic cause
This cause is based on the family history of psoriasis among close and distant relatives. However, psoriasis is not considered to be a strictly hereditary disease, as well as diabetes, cancer, ischemic heart disease, as it is not the psoriasis itself that is inherited, but only a genetic predisposition to it. Yes, 60% of patients with psoriasis have ancestors or close relatives who suffer from this disease, and if one parent is a patient, the theoretical probability is that a child has a 25% risk of developing psoriasis, and if both parents areit increases by up to 75%.
However, in psoriasis, the cause is not always a genetic factor. This disease has recently become very common in clinical practice and does not always depend directly on the associated predisposition. The causes of psoriasis are so multifactorial that it is impossible to clearly point to a specific cause. Because the pathogens are violations of protein or carbohydrate metabolism, as well as changes in the metabolism of lipids, enzymes, the combination of streptococcal infection with foci, or viral in nature.
Metabolic disorders as factors in the development of psoriasis
Considering metabolic disorders in psoriasis, a slight decrease in body temperature is observed in many patients, and this is a symptom of a slowed metabolism, an elevated cholesterol level, which indicates a change in lipid metabolism. Given the high cholesterol level, many researchers consider psoriasis to be cholesterol diathesis and consider its increase to be an initial manifestation of dermatosis because a violation of lipid metabolism stimulates the development of keratinization of the skin.
In addition, the metabolism of vitamins in psoriasis is disrupted, especially vitamins C, A, B12, B6, while the vitamin C content of the skin increases. Changes in the content of iron, copper, zinc have also been observed, which significantly reduces the adaptive properties of the human body. Nearly 25% of patients with psoriasis also suffer from diabetes mellitus, but some researchers see this fact not as a cause of psoriasis but, on the contrary, as a manifestation of psoriasis.
As the disease progresses, patients with psoriasis have the most frequent increase in basal metabolism, and patients with decreased metabolism often have hypothyroidism, endocrine glands, glandular symptoms, 60% of patients with psoriasiscauses disruption of carbohydrate metabolism. Low-calorie foods, or even moderate fasting, reduce the body’s self-poisoning, so a diet to treat psoriasis improves the patient’s condition.
Provocative Factors for Psoriasis
At the current stage of medical research in determining the cause of psoriasis, we can say that it is a recurrent systemic disease that occurs in genetically predisposed people, simultaneously disrupting various metabolisms in the central nervous system.
Stress
Stress, psychological trauma, prolonged fatigue, and nervous tension are the most common triggers for both the development of psoriasis and the exacerbation of existing chronic psoriasis.
Stress triggers immunological and biochemical reactions that contribute to the development of psoriasis. However, sometimes negative emotions, on the contrary, serve to complete the clinical symptoms of psoriasis. According to a survey of patients with psoriasis, this provocative factor causes the disease to develop in 49% of patients and a relapse in psoriasis in 41%.
Infectious diseases, vaccinations, chronic foci of infection
Tonsillitis, sinusitis, sexually transmitted diseases, otitis media and so on, especially highly virulent streptococci are detected. This factor is relevant for disease progression in 21% of patients, and infection is triggered in 15% of patients for the onset of psoriasis.
Hormonal changes in women
During pregnancy, lactation, menopause, or adolescence - in 6% of patients interviewed, this was also a provocative factor in the development of psoriasis.
Injuries, bites, burns
Any kind of skin trauma - in 12-14% of patients, psoriasis is caused by physical trauma.
Prolonged hypothermia
The cause or exacerbation of psoriasis occurs in 5% of patients.
Medications
Like any type of antibiotic, NSAID. Vitamin therapy — especially the use of vitamins C, B, beta-blockers, cytostatics, vaccinations, and herbal treatments — provokes the appearance of psoriasis in 6% of patients.
Food poisoning, misuse of certain foods
Chocolate, citrus fruits and other products - according to a survey of patients, this is the cause of psoriasis in 4% of patients.
Drinking
The provocative factor that contributes to the generalization of the inflammatory process also shortens the period of remission and increases the risk of complications, as indicated by 3% of respondents.
Climate change
High humidity, prolonged intense ultraviolet radiation, sudden changes in temperature and humidity - exacerbate in 2% of patients.
The first symptoms of incipient psoriasis can occur regardless of age, are common in infants and people aged 20 to 40, and can cause psoriasis even in old age. Of course, the earlier it appears, the more severe the consequences for the patient. If psoriasis starts in a person after 30 years, it is usually accompanied by gastritis, liver disease, overweight, various neuroses, diabetes, arthritis and other diseases.