Psoriasis is a chronic skin disease of non-infectious origin. According to statistics, 3. 7% of the world population suffers from psoriasis. People call the disease "scaly lichen".
Psoriasis does not depend on sex, it is not contagious; most often it develops at the age of 14-27. The disease is characterized by the appearance of red scales in the form of a plaque (spot) covered with white scales. One point (or several points) can be on any part of the body, but more often in places with thin, dry skin: elbows, knees, lower back, scalp.
The spots are of different sizes and disturb in different ways: in some patients, only skin irritation is noted; in other patients large areas of the skin are involved, which is accompanied by discomfort, itching, pain, insomnia and decreased quality of life.
Psoriasis is a chronic disease characterized by periods of exacerbation (rash) and remission (relief of symptoms).
Psoriasis often complicates pregnancy.
Causes of psoriasis
Psoriasis is a systemic process that involves not just the skin but the entire body. The causes of psoriasis are not fully understood, but it is assumed that there are many: neurogenic (due to stress), hereditary, infectious, viral, mixed (damage to the skin with penetration of staph in combination with any of the above reasons), etc. In this case, cellular and humoral immunity is activated and an autoimmune process of damage to cells is triggered, mainly to skin cells (epidermis).
In addition to the activation of immunity, the metabolism is disturbed. The disease is aggravated by a burdened inheritance. As a result, the renewal (regeneration) of cells is accelerated 3-5 times - psoriatic plaques are formed on the skin.
Without timely treatment, the lesion is aggravated: skin spots grow, crack, deteriorate; nails are destroyed, joints are involved, etc.
The quality of life of a patient with psoriasis is 80% dependent on timely diagnosis and adequate treatment.
Again, we list the factors that contribute to the onset of the disease:
- bad inheritance. Scientists have identified 9 genes that determine the development of the disease, but their interaction is unclear. It is now established that in 15% of cases psoriasis is inherited from relatives of the 1st and 2nd generation;
- stress, nervous tension, depression. Stress has been shown to exacerbate psoriasis in 70% of cases;
- hormonal imbalance;
- dysbiosis;
- metabolic disorders, drug addiction;
- colitis and parasitic infections (roundworms, lamblie, intestinal infections, etc. );
- viral infection;
- streptoderma; candidiasis of the skin;
- allergies.
Symptoms of psoriasis
In the initial stage, psoriasis rashes occur in the form of red plaques (spots) with scaly scales. The appearance of a skin plaque is accompanied by intense itching. A denser (keratinous) layer is found 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, raised rashes above the skin, covered with silvery scales. The skin in the affected areas often exfoliates; in this place remain red spots, bleeding during the trauma. In 60% of cases, the plaques merge into large plaques.
Guttate psoriasis is characterized by many small dry lesions in the form of pink droplets raised above the surface of the skin. Rashes are localized on the thighs, legs, affecting large areas of the body. In 60% of cases, guttate psoriasis worsens after strep infection.
Pustular psoriasis can be recognized by skin blisters filled with clear fluid. The blisters are surrounded by red, swollen skin. The legs and thighs are most often affected.
Psoriasis of the flexor surfaces manifests itself in the form of smooth, non-flaky red spots, which are located in the area of the skin folds: the lateral surface of the thighs, armpits and the area of the external genitalia. Due to mechanical irritation (physiological friction), the spots are injured, bleed and rot.
Nail psoriasis is manifested by discoloration, the appearance of spots and transverse lines on the nails. The skin around the lesion is hardened. As the disease progresses, the nail exfoliates, thickens, and then dries up or falls off.
Psoriatic arthritis (15% of cases). All joints are affected, but more often small ones - the phalanges of the hands and feet. The fingers become like sausages. Joint psoriasis leads to bursitis, a person's disability.
Let's talk about head and elbow injuries separately.
Psoriasis of the scalp (mainly the scalp) is the most common form of the disease. It is more common at a young age. It manifests itself as scaly red spots that itch and itch. Redness is almost always noticeable, so it causes emotional distress and leads to a person's 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 outward and merges: a large plaque (plaque) forms, covered with silvery scales that fall off easily. Together with the scales, a thin protective film peels off, exposing the bleeding surface. In 80% of cases, the spots disappear on their own, without treatment, but sometimes thicken (age) and persist for years, causing psoriatic lesions of the elbow joint.
Psoriasis diagnostics
Diagnosis and treatment of psoriasis is done by a dermatovenerologist.
Due to the characteristic skin lesions, the diagnosis of psoriasis is simple. As additional laboratory tests, a general blood test and rheumatoid factor determination are used. For the diagnosis of psoriatic arthritis, a consultation with a rheumatologist and an x-ray of the affected joints are indicated. In rare cases, a skin biopsy is done for differential diagnosis.
Psoriasis should be distinguished from similar skin diseases - seborrhea, lupus, etc.
Psoriasis treatment
Psoriasis is a chronic disease with periods of exacerbation (reappearance of rashes) and remission (disappearance of rashes). It is impossible to cure psoriasis forever. It is possible to lengthen remission and reduce the intensity of exacerbations.
Only in 40% of cases is it possible to find an effective treatment immediately. Sometimes it takes months and years. Therefore, psoriasis is treated at home, with the exception of severe exacerbations and complications. The effectiveness of the treatment is influenced by the type of psoriasis, age, concomitant diseases, etc. With a mild degree of psoriasis, topical preparations are prescribed: ointments and creams based on:
- glucocorticosteroids;
- zinc;
- tar;
- salicylic acid;
- vitamin D3.
In severe cases of psoriasis (25% of the skin surface is affected, joint damage) and the ineffectiveness of local treatment, complex therapy is prescribed:
- cytostatics that inhibit epidermal cell division;
- immunomodulators that normalize immune responses;
- glucocorticosteroids, which regulate metabolic processes and reduce inflammation;
- non-steroidal anti-inflammatory drugs (to reduce itchy skin);
- multivitamins.
Physiotherapy is prescribed: ultraviolet irradiation, cryotherapy, plasmapheresis, hirudotherapy. Folk remedies are also used: ointments based on celandine and lard, meadowsweet and petroleum jelly, beeswax and lard. To normalize immunity, they drink homemade kvass from oats, an infusion of bay leaves and a decoction of dill.
Diet, especially with psoriasis exacerbations, plays an important role. Spicy and sweet dishes are excluded from the diet. Fast food and alcohol are prohibited. Nutrition must be balanced, rich in vitamins and minerals.
To avoid psoriasis flare-ups, you need to improve your health, avoid stress, hypothermia, and seasonal ailments.
Here are the simple rules for preventing psoriasis flare-ups:
- do not overdry the skin;
- avoid prolonged exposure to the sun;
- avoid injury to the skin;
- avoid stress;
- do not smoke or abuse alcohol.
Is psoriasis contagious?
There is not a single proven case of transmission of psoriasis from a sick person during domestic or other contacts. Therefore, it is believed that psoriasis is not contagious.
Which doctor to contact
To initiate timely treatment and avoid the spread of psoriasis, consult a dermatovenerologist. In the presence of psoriatic arthritis, a consultation with a rheumatologist is indicated.