Having appeared, psoriasis in most patients does not disappear on its own, but progresses and becomes more extensive, spreading to the skin.
However, with timely diagnosis, it becomes easier to cure it and recovery occurs much faster.
The main thing here is to pay attention to the first signs of psoriasis over time and immediately make an appointment with a dermatologist.
Characteristic signs of psoriasis
Early psoriasis can present as small, reddish, scaly patches.
The place of appearance of such rashes has a direct dependence on the form in which the disease proceeds.
In most cases, you can see them:
- in the elbows and knees;
- on the head (in the hairy area);
- on palms and feet;
- in the fold area (buttocks, armpits, areas under the breasts in women).
Primary eruptions (papules) are very small in size: their diameter does not exceed 4 millimeters.
However, as the disease progresses, they enlarge and merge with each other, forming plaques that do not have a clear shape.
Most often, the appearance of papules is not accompanied by pain or itching. The feeling of discomfort increases with the development of psoriasis and with the increase in size of the affected skin areas.
The affected area starts to ache and itch and a strong burning sensation is felt.
These signs of psoriasis are complemented by emotional inconveniences that can significantly increase the rate at which the disease spreads.
It is not appropriate, when such rashes are found, to start self-treatment, since psoriasis in the early stages of development has similarities with other skin diseases.
As a result, the wrong choice of drugs will not lead to positive results, but will only worsen the situation.
Cumulative symptoms
Squamous lichen belongs to the category of systemic diseases.
This means that it occurs not only on the skin and nails, but can also affect the spine, joints and tendons, some systems of the body (for example, endocrine, immune and nervous).
There have been cases where the disease affects the digestive (liver) and urinary (kidney) systems.
The first symptoms of psoriasis
- constant feeling of tiredness;
- weakness;
- a state of depression (up to depression).
Due to the complex effect of the disease on the body, experts find it appropriate to call it psoriatic disease.
But, despite this, the key aspects of the disease are based on the damage to the skin.
As mentioned above, the first call at the beginning of the development of the pathology are small papules in the range of colors between pale pink and red.
They differ in a symmetrical location on the surface of the skin (folds, lower back, area of the head covered with hair), sometimes - on the mucous membrane of the external genital organs.
The size of the papules in the further course of the disease can exceed 10 centimeters.
Psoriatic eruptions, according to their characteristics, are divided into:
- dotted (their size is not greater than the tip of a pin);
- teardrop-shaped (similar in shape to a tear, equivalent in size to a lentil grain); coin-shaped
- (5 mm diameter plates, with rounded edges);
- Seldom arched, annular or map-like.
Above the papules are covered with scaly plaques, which are formed from keratinized cells of the epidermis and are removed without much effort. Initially, they appear in the center of the plaque and gradually spread more and more.
The keratinous cells have air spaces, which results in a visual friability and a slight shadow.
Sometimes elements are surrounded by a pink ring which serves as an area of plaque growth and inflammation. In this case, the state of the surrounding skin does not change.
Removing the plaque reveals a shiny, dark red surface based on the capillaries, which themselves have very thin walls.
The presence of such small vessels in diameter is due to damage in the structure of the upper layers of the skin, the structure of which is disturbed due to the incomplete process of maturation of epidermal cells (keratinocytes), which makes their correct differentiation impossible.
Symptoms of different forms of psoriasis
Common psoriasis has quite specific symptoms, so it won't be difficult to diagnose.
Appears as scaly, rounded areas that protrude above normal skin and are pink or red.
Sometimes, in the early stages of the disease, there are no typical plaques: before they appear on the scalp and in the area of the joints (ankle, elbows and knees), small papules can be observed.
They are able to persist for a sufficiently long period of time and not cause any discomfort to the patient: no itching and pain or no pain, or they are practically not felt, the papules themselves are almost impossible to notice.
They do not flake off, but if lightly scraped, the scales appear immediately. Such rosy seals can disappear or significantly decrease in size in the summer, as solar radiation affects the skin.
The acute form of common psoriasis manifests itself in the form of multiple constantly itchy rashes of brightly colored papules and is the result of the influence of factors that activate the disease.
To avoid mistaking it for an allergic reaction, it is necessary to scrape the surface of the plaque a little before the characteristic phenomena appear.
Seborrheic psoriasis starts on the scalp (in the area covered with hair) and then spreads to the face and shoulders.
It is characterized by severe peeling of the skin of the corresponding area, which is often regarded by patients as dandruff, so they do not rush to a dermatologist.
This fact allows the disease to calmly reach the stage of development when the forehead and the areas behind the ears are peeled. And only after the plaques are formed.
The lesion of the skin folds with psoriatic disease (armpits, genitals and groin, under the breasts in women) is often confused with ordinary irritation caused by friction or sweat.
This type of disease is characterized by smooth plaques that look like spots. Peeling is not observed, but they often get wet. The rashes themselves are bright red in color, they are even and shiny.
In case of damage to the genitals, the characteristic signs of psoriasis can be mistakenly interpreted as balanoposthitis (lesion with eruptions of the glans penis, as well as of the foreskin in its inner part) in men and vulvitis (rashes localized on the labia minora) in women.
The palmar-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 areas are chapped and painful. With this form of the disease, it is difficult to induce the appearance of a terminal film and bloody dew by scraping.
Nail psoriasis begins with psoriatic onychodystrophy, which is one of the main symptoms of this form of the disease and occurs long before skin rashes.
In the early stages, the edge of the nail is covered with grooves and small depressed areas.
With the development of the disease, they spread, reaching the root, after which changes in its color are observed. The nail dulls and thickens. Due to errors in blood circulation, the manifestation of the disease increases.
The epidermal cells accumulate under the nail plate and is bordered by red tissues 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. Most often, this disease is mistaken for a fungus.
The joints of the bones (joints) in motion are often affected. They are deformed, the joint capsule undergoes dystrophic changes.
Psoriatic arthritis begins with an increase in joint volume, which is accompanied by pain.
The fingers and toes are the most prone to this type of psoriasis.
In severe forms, the shoulder and elbow, hip and knee joints, as well as parts of the spine, are exposed to the disease.
Effect on the manifestation of symptoms of the stages of psoriasis
The symptoms of psoriasis are directly proportional to the season of the year and the stage of the disease.
Very often, in the spring-summer period, there is a noticeable decrease in the activity of the disease, facilitated by ultraviolet rays.
As a result, in the autumn-winter period due to a lack of sun, the disease is rapidly gaining momentum. There are practically no patients with summer exacerbations.
There are three stages of psoriasis:
- progressive- characterized by the continuous appearance of new rashes, an increase in the size of previously appeared plaques and their surroundings with pink edges, the affected area is very itchy and peeling;
- stationary- new rashes no longer appear and old ones do not grow; the upper layer of the skin in the plaque area becomes wrinkled;
- regressive- the skin does not peel off, the plaques disappear, leaving behind highly pigmented areas.
Psoriasis diagnostics
Diagnosis of psoriasis is made on the basis of information received from a medical examination by interviewing a patient, as well as about the symptoms inherent in one form or another of the disease.
The earlier a disease is detected, the faster the treatment process begins. As a result, more tangible results will be achieved.
Since the picture of the disease is extremely specific, the diagnosis of psoriasis can be limited to a simple examination by a dermatologist.
But in some cases difficulties may arise due to implicitness or absence of symptoms, which happens if the disease does not manifest itself in any way or appears unusual. This situation requires further research procedures.
A specific method is used to make a diagnosis, which consists of gradual scraping of the papules along the layer.
As a result of such manipulation, it is possible to identify the characteristic signs (psoriatic triad) to differentiate psoriasis from other diseases and make a final diagnosis:
- stearin staining;
- terminal film (pink epidermal cells);
- blood dew (droplets of blood appear on the surface of the plaque due to the rupture of the capillaries).
If necessary, the patient is tested in the form of samples of affected tissues.
X-rays are done if psoriasis-related arthritis is suspected.
If psoriasis is at an early stage, its diagnosis is not difficult: the picture of osteoporosis is clearly visible.
In later periods, there is a narrowing of the joint space, erosion of the tissues that form bones, osteosclerosis and periostitis.
If the disease is severe, the wrist and metatarsal joints are destroyed, as a result, the joint completely loses its mobility.
It should be noted that all the tests carried out are necessary not only for the final diagnosis, but also for the differentiation with other diseases, which at first glance are identical.
These diseases include: parapsoriasis, seborrheic eczema, lichen rosacea, atopic dermatitis, lupus erythematosus, rheumatoid arthritis and others.