Psoriasis or scaly lichenIt is a chronic disease that affects the skin and its appendages: nails and hair. It is characterized by periods of deterioration (relapses) and temporary well-being, when the manifestations of the disease subside. This disease is not contagious and the patient is not dangerous to others. Because the appearance of psoriasis is not associated with microorganisms.
Psoriasis occurs most often between the ages of 15 and 45. People with fair skin are more susceptible to it. In developed countries, the number of patients with psoriasis reaches 2-4% of the population. Every 25 inhabitants of the earth on all continents suffer from it.
A huge number of medical institutions are dealing with this problem. Therefore, psoriasis was recognized as the most studied disease. But still, this disease is not fully understood. Officially, it is considered incurable and raises many questions.
Psoriasis is caused by the body's immune cells. They rise from the lower layers of the skin to the upper ones, causing inflammation, proliferation of epidermal cells and the formation of small capillaries.
The manifestations of psoriasis on the skin are quite varied. Most often, the disease provokes the appearance of red spots - psoriatic plaques. They are dry to the touch, rise above the surface of the skin and are covered with a white patina.
Types of psoriasis
The disease is divided into two large groups: pustular and non-pustular psoriasis.
Non-pustular psoriasis
- ordinary (vulgar) or simple psoriasis (plaque psoriasis, chronic stable psoriasis)
- psoriatic erythroderma or erythrodermal psoriasis
Pustular psoriasis
- von Tsumbusch pustular psoriasis or generalized pustular psoriasis
- palmoplantar psoriasis (pustular psoriasis of the extremities, chronic persistent palmoplantar pustulosis)
- annular pustular psoriasis
- palmoplantar psoriasis
- herpetiform psoriatic impetigo
In addition, these types of psoriasis are distinguished.
- seborrheic psoriasis
- psoriasis of flexor surfaces and skin folds
- Napkin psoriasis
- drug induced psoriasis
According to the severity, such forms of psoriasis are distinguished.
- Mild: less than 3% of the skin is affected.
- Moderate: 3-10% of the skin is covered with psoriatic plaques.
- Severe: joint lesions are present or more than 10% of the skin is involved.
Causes of psoriasis
To date, there is no single answer to the question: "why does psoriasis appear? " Scientists have put forward several theories.
- Psoriasis is an autoimmune disease. It is based on a malfunction of the immune system. T-killer and T-helper immune cells, whose function is to protect the body from viruses, bacteria and cancer cells, for some reason penetrate the upper layers of the skin. Here they produce inflammatory mediators - substances that "activate" the inflammatory response. It results in increased division of skin cells and their multiplication (proliferation).
- Psoriasis is a disease caused by impaired growth, division and maturation of epithelial cells - keratinocytes. The result of such changes in the skin is an attack by the immune cells of T lymphocytes and macrophages on diseased skin cells.
Factors contributing to the development of psoriasis
Doctors noted a number of factors that can cause the onset of the disease. Of course, psoriasis most often occurs if several of these conditions are acting on the body at the same time.
- Hereditary predisposition.There is a version that the genes responsible for the immune system and T-cell function carry the disease. Therefore, parents suffering from psoriasis are more likely to have children who develop the same symptoms.
- Thin and dry skin. . . It has been noted that people with such skin characteristics get sick more often than those with oily, well-hydrated skin. This is probably due to the protective functions of the sebum and the structural characteristics of the skin.
- External irritants. . . A high percentage of patients are among those people who are constantly in contact with alcoholic solutions, solvents, household chemicals, cosmetics (lotions, hand creams).
- Excessive hygiene- an excessive love of cleansing also undermines the protective properties of the skin. Soaps, shower gels and wipes wash away the natural protective barrier and leave microscopic lesions.
- Bad habits- addiction to alcohol, smoking and drugs is bad for the skin. His nutrition and blood supply are deteriorating.
- HIV- AIDS patients are more prone to psoriasis. Scientists cannot explain this phenomenon. The fact is that psoriasis is caused by the increase in the activity of lymphocytes, and with AIDS, their number decreases.
- medications- taking certain medications can cause disease. Among them: beta-blockers, antidepressants, anticonvulsants and antimalarials, lithium carbonate.
- Infections (fungi and staphylococci). . . Quite often, there have been cases when psoriasis appeared immediately after fungal infections or diseases caused by strep.
- In movement- a climate change or even a season of the year, environmental degradation can be a trigger for this disease.
- Fatigue- strong emotional upheavals or physical stress (prolonged periods of hypothermia, overheating, accidents) precede the appearance of the first symptoms of psoriasis.
- Trauma- constant effect on the skin: pressure, rubbing, scratching. Such regular trauma can cause the first psoriatic plaques to appear in this place.
- Allergic conditions- Allergic rashes and the processes that occur in this case, in all layers of the skin, also increase the risk of the disease.
What are the symptoms and signs of psoriasis?
Psoriasis is a systemic disease that affects not only the skin and nails. It affects joints, tendons and spine, immune, nervous and endocrine systems.
However, the main manifestations of the disease occur on the skin. The name scaly lichen quite accurately conveys the symptoms of psoriasis. The first manifestations are often pink or bright red papules of the correct rounded shape, covered with scales - psoriatic plaques. They are located symmetrically, mainly on the surfaces of the extensors, the lower back and the scalp. But they can affect any part of the skin and genital mucosa. Their size ranges from a few millimeters, in the initial stages, to ten centimeters or more.
Depending on the characteristics of the rash, suchforms of psoriasis:
- Point psoriasis - the size of the elements is smaller than the head of a pin.
- Guttate psoriasis: Papules are teardrop-shaped and reach the size of a lentil grain.
- Coin-operated psoriasis: Plaques grow to 3-5mm and have rounded edges.
They also distinguish the forms of the rash, when its elements are in the form of rings, arches and garlands, geographic maps with irregular edges.
The papules are covered with a scaly coating that can be easily removed. It consists of keratinized cells of the epidermis. Psoriatic plaques begin to become covered with scales from the center, then the plaque spreads to the edges. Its loose and light appearance is due to the fact that keratinized cells are permeated by air-filled spaces. A pink ring can form around the elements - this is an area of inflammation, a zone of plaque growth. The skin around the elements of the rash is not changed.
Scalp psoriasisrepresents psoriatic plaques that rise significantly above the surrounding skin. They are densely covered with dandruff-like scales. In this case, the hair remains unaffected. Rashes can occur not only under the hair, but also on smooth skin, on the neck and behind the ears. Such changes are explained by the active division of keratinocytes in the affected areas.
Psoriasis of the feet and handscauses a strong thickening of the stratum corneum of the skin in these areas of the body. The skin becomes thick, rough. Cracks often penetrate it. This is caused by intense cell division, which multiplies 8 times faster than usual, but is not removed from the skin surface in time.
Nail psoriasisdiffers in a variety of symptoms. But the most important are two main types of nail damage:
- From the type of "thimble". Small pits are formed on the nail plate, similar to needle prick marks.
- From the type of onychomycosis. The lesions resemble nail fungus. Nails thicken, change color, flake off. A psoriatic papule surrounded by a red border is visible through the nail plate. It looks like an oil stain that shines through the nail.
The symptoms and signs of psoriasis depend on the stage of the disease, which are replaced cyclically throughout the year. So most patients have a "winter" type of disease, when the exacerbation occurs in the autumn-winter period. An improvement in the condition in the summer is due to the fact that ultraviolet light from the sun has a therapeutic effect. But some patients suffer from the "summer" type.
There are such stages of the course of psoriasis:
- progressive - the appearance of new elements, the active growth of existing plaques, the implicit pink growth zone around them, intense peeling and itching.
- stationary - arrested growth of papules, the absence of new rashes, fine folding of the upper layer of the skin around the psoriatic plaques.
- regressing - the absence of peeling, the disappearance of plaques and the appearance in their place of areas of pigmentation, indicate the attenuation of the process.
What do skin rashes look like with psoriasis?
Each organism is individual and reacts differently to the disease. Therefore, the nature of the rash can be very diverse. This explains the variety of forms and types of psoriasis.
However, for most people, the symptoms of psoriasis are similar. These are red spots - psoriatic plaques, which rise 1-3 mm above the level of healthy skin. Their appearance is caused by the fact that the cells of the surface layer of the skin - keratinocytes, divide very actively, not having time to mature and turn into full-fledged epithelial cells. Due to this increased pathological growth, some areas of the skin thicken. This is because immune cells release chemicals that cause skin inflammation.
From above, the plates may be covered with a gray, silvery or yellowish bloom, which looks like paraffin. Therefore, they got the name - "paraffin lakes". These are keratinized epithelial cells, the rejection of which is impaired and accumulate on the surface of the affected skin area.
The spots are flaky, warmer than the rest of the skin, and can reach large sizes. Often the patient feels severe itching in this place. This is due to the fact that, against the background of the inflammatory process, a cascade of neuro-reflex reactions and an allergic reaction occurs.
Another type of element are papules. These are small elements of a rash that resemble a tubercle. The size is about 1mm. In the middle there is no cavity full of contents. They are often found on the knee and elbow joints. They also remain during times when the disease recedes.
During exacerbations, the elements of the rash gradually grow in width and merge with neighboring plaques. During periods of improvement (remission), the spots begin to lighten from the center. They gradually take the form of a ring and can dissolve completely. After the plaques, a trace remains on the body - pigmentation. It can be significantly lighter or darker than the surrounding skin. After a person is tanned, their skin tone is usually evened out.
What do nail lesions look like in psoriasis?
Nail psoriasis is similar to a fungal infection of the nail plate. For a correct diagnosis, it is necessary to conduct a laboratory analysis. The changes can affect only one nail or all at once and are very different. They occur in 10-15% of patients. Nail damage is often accompanied by joint pain caused by psoriasis. In this case, there may be no rash.
Nail psoriasis has several stages:
- depressed points - thimble nail
- longitudinal lowered grooves
- transverse compression in the center of the nail, these first signs are associated with damage to the nail root - the nail matrix
- "Oil spots" irregularly shaped pink spots showing across the nail - this is the buildup of serous fluid under the nail
- the nail becomes dull, cloudy, yellow and thickened due to circulatory disturbances
- the nail plate takes on the appearance of a bird claw, which is accompanied by pain. This is due to the fact that the process captures the nerve endings.
Nail lesions start from the edge and gradually move towards the root, covering the entire surface. Disorders of the microcirculation cause dullness of the nail and the change in its color from yellow to bluish.
If you find similar symptoms in yourself, do not diagnose yourself. Similar changes can be caused by other reasons: fungus, trauma and impaired blood supply.
Is psoriasis contagious?
This question is often asked by those who have just been diagnosed with the disease and by acquaintances of the patient. Scientists give an unequivocal answer. Psoriasis is not contagious and a sick person is absolutely safe for others. This is because psoriasis is not caused by viruses or bacteria, but by aggressive white blood cells. These same immune cells, for unknown reasons, attack skin cells, causing skin inflammation. The result of this process are rashes and thickening of the skin in some places (psoriatic plaques).
How is psoriasis treated?
Treatment of psoriasis depends on the form and stage of the disease and the sensitivity to drugs. Traditional medicine focuses on the use of drugs. The treatment is started with local preparations that act on the affected skin. Therefore, they try to avoid the side effects that occur when taking oral medications. More details on the use of local remedies will be described below. Now let's focus on pills and capsules.
There is a technique when, first, the patient is offered gentler medications with the fewest side effects. If they are not effective, they are replaced with more powerful ones and so on. Even if the treatment is suitable for the patient, it is changed after a while. The fact is that the body gradually gets used to the drug, and its effect decreases.
Oral systemic medications are very effective. They are prescribed for moderate and severe stages of the disease. They also help those patients for whom treatment by other means has not given positive results. However, they have significant disadvantages - they can cause serious side effects, and after the abolition of these funds, the condition worsens again.
| Group of drugs | Dosage form and effect of the drug on the body |
| Retinoids - derivatives of vitamin A | It affects the maturation of the surface layer of the skin and eliminates the disturbances in this process caused by psoriasis. Release form - capsules. Dosage according to the scheme, depending on the stage, 30-75 mg / day. It reduces the keratinocyte division rate, promotes normal cell maturation and differentiation. Available in capsules. The daily dose is 25-50 mg. |
| Immunosuppressants - drugs that reduce the activity of the immune system | It reduces the activity of T lymphocytes, which cause more skin cell division. Sterile solution in ampoules. The initial dose when administered into a vein is 3-5 mg / kg per day, for oral administration - 10-15 mg / kg per day. |
| Medicines to treat malignant neoplasms (cytostatics) | It inhibits the overgrowth and reproduction of atypical cells of the epidermis. Available in tablets. Assign 2. 5-5. 0 mg orally, 2-3 times a day, 1 time a week. |
Physiotherapy treatments for psoriasis are very effective. They bring significant relief to patients, stop the progression of the disease and, in some cases, act as a safe substitute for drugs.
| Physiotherapy method | Effects on the body |
| PUVA therapy or photochemotherapy | Combination of long-wave ultraviolet irradiation and an internal photosensitizer. The course is 20-30 procedures. The method is based on the fact that UV rays penetrate deep into the skin. The photosensitizer inhibits the DNA synthesis of skin cells and the rate of their division. For treatment, special installations or cabins are used. |
| Selective phototherapy (S. F. T) | Skin irradiation with ultraviolet rays with a wavelength of 280-320 nm. The course is 15-35 procedures. A special cabin is required for therapy. |
| Monochromatic UV treatment | Exposure to each focus separately with a laser source or UV radiation lamp. It allows you to radiate fires even in hard-to-reach places, without affecting healthy skin. It is prescribed in cases where less than 10% of the skin is affected. The course of treatment is 15-30 procedures. |
| Laser therapy | For the treatment of rashes, laser radiation with different wavelengths is used. The laser promotes the rapid resorption of psoriatic plaques, protects against the appearance of scars in their place. The doctor determines the number of procedures individually for each patient. |
| Electrosleep | The procedure is performed on a device that relies on a mild effect on the brain with weak electrical impulses. Duration 20-60 minutes. The number of procedures is 10-12. Electro sleep has a calming effect. As a result, the activity of the nervous system normalizes, the plaques begin to dissolve, and a period of well-being begins faster. |
| Magnetotherapy | Treatment with magnetic fields has a beneficial effect on the general condition. Itching and inflammation of the skin, swelling and pain in the joints decrease, the psychoemotional state improves. The Betatron apparatus is used for treatment. The duration of the procedure is 20 minutes. Number per course 10-15. |
| Ultrasound therapy | It is used as a pain reliever, anti-itch and decongestant. Promotes resorption of scars. The procedure can be combined with drug administration (phonophoresis). The duration of exposure to one area is 15 minutes. To obtain a therapeutic effect, 7-14 sessions are required. |
| Hyperthermia | Warm the fabrics to a temperature of 40 degrees using special pillows with a thermal mixture. This effect on the body normalizes the functioning of the immune system and reduces the attack on the skin. The duration of the procedure is approximately 2 hours. Their number is determined by the doctor. |
| Bee venom treatment | The substance is introduced into the body by means of an electrophoresis or an ultrasound apparatus. An anti-inflammatory, absorbable and anti-itching effect is obtained. The metabolism is normalized. The minimum number of procedures is 10. |
It is very important that people with scaly lichen eat a diet. Eating disorders can exacerbate the disease. The menu should be rich in vitamins and at the same time simple. It should give the intestines and liver rest, and also not allergize the body.
| Permitted products | Forbidden foods |
| Vegetables (pumpkin, watermelon, beets, carrots, potatoes, radishes) | Animal fats |
| Fruits (apricots, peaches, apples), juices | Alcohol |
| Berries (except red berries: strawberries, raspberries, red currants) | Fatty meat (pork, duck) |
| Fresh herbs | Smoked meats |
| Lean meat (veal, beef, rabbit, turkey) no more than 200 g per day | Red fish |
| Cheese, ricotta, dairy products | Carbonated drinks and coffee |
| Peanuts | Egg |
| Low-fat variety of fish | Ice cream and milkshakes |
| Seaweed | Minimum quantity of confectionery and sugar |
| Wholemeal flour bread | Butter and puff pastry |
To cleanse the body of toxins and metabolic products, it is necessary to carry out fasting days twice a week. They recommend kefir, apple, vegetable.
What ointments are effective in treating psoriasis?
The use of ointments for psoriasis brings the greatest effect in comparison with other external preparations. The components of the ointment do not remain on the surface of the plaque, but soften the scales and penetrate the skin.
There are a large number of ointments available to treat psoriasis. In the early stages, appointnon-hormonal ointments.
In the event that the treatment did not give the expected effect, then prescribehormonal ointments. . . Treatment begins with lighter medications that have minimal side effects. If improvement has not been achieved, stronger ointments with glucocorticosteroids are prescribed.
| Name of the ointment | Pharmacological action | Side effects |
| Weak ointments | Suppresses the increase in the activity of leukocytes, prevents their movement in the skin, eliminates the feeling of tightness and itching. | Swelling of the skin, itching, redness. |
| Moderate ointments | It has anti-inflammatory, anti-allergic, anti-edematous, anti-itching effects. Indicated for patients with exudative forms of psoriasis, it reduces bleeding. Apply in a thin layer on limited areas 2-3 times a day. The treatment lasts 10-14 days. | Steroid acne, skin atrophy and stretching, burning, itching, hypopigmentation. |
| Strong ointments | Local anti-inflammatory, anti-itching and anti-allergic agent. Reduces the moisture in the skin. Apply to the affected area 2-3 times a day for up to two weeks. Used during an exacerbation. | Skin atrophy. |
| Very strong ointments | It has a strong anti-itching and anti-allergic effect. It slows down the processes of cell division and keratinization. Apply 1-2 times a day for no more than two weeks per course. | Acne, hair loss, skin atrophy. Do not use for pustular and diffuse plaque psoriasis. |
Pharmaceutical companies produce many medicines in the form of ointments. The doctor individually selects the drug for the patient and, if necessary, changes it to a stronger one.
Do not forget that in no case with psoriasis you should ignore visits to the doctor. After all, this disease can hide the initial stage of skin cancer.
Choosing a psoriasis treatment regimen is a lengthy process that involves a lot of trial and error. Don't despair if you don't find "your" medicine right away. Remember that many people experience lasting improvement when the disease does not return for years. You can do it too!