Symptoms and first signs of psoriasis

The species-specific characteristic signs of psoriasis play a decisive role in diagnosis and treatment.

The most common type of chronic dermatosis, according to statistics, is psoriasis. This is a complex and multifaceted disease of polyetiological origin. For a variety of reasons, numerous different types have been identified that exhibit their own characteristic signs of psoriasis. The need to distinguish types based on symptoms arose due to the ambiguous reaction of the skin to drugs and other methods of exposure.

Until recently, the disease was considered non-threatening to health and life, until cases of death were recorded due to incorrect identification of the cause, type and treatment. In addition, a person can be affected by several forms of the disease simultaneously, the symptoms of which must be taken into account when prescribing treatment.

The disease affects people regardless of gender and age category. The first symptoms of psoriasis can appear in both infants and adults for no apparent reason. Depending on the type, not only the onset but also the development of the disease differs, which can be rapid or slow, with a gradual increase in symptoms.

Early warning of the initial symptoms and signs of psoriasis is key to effective treatment, this will allow:

• Do not allow the disease to invade large areas of the skin;
• Quickly eliminate the external symptoms of the disease and prevent damage to internal organs;
• Adopt timely measures to prevent relapses and prolong the quiet periods of the disease.

The terms "symptoms" and "signs", although similar in meaning, have significant differences. Symptoms are subjective feelings of a person that can be confirmed or refuted by examination data.

Signs are objective tests and examination data with which the doctor makes a diagnosis.
For example, pain is purely a symptom, while rashes are a symptom.

This is important to remember, since feeling only the symptoms it is impossible to make a correct diagnosis, and only a specialist can determine the signs of psoriasis, its specific type and form.

General signs

Regardless of whether the disease appeared suddenly and began to develop rapidly or the initial manifestations were gradual, doctors consider the beginning of the formation of papules in various areas of the skin: small scaly nodules of dark pink color, dense to the touch and protruding above the surface.

The first thing a patient may notice is the formation of a rash in those places that are more exposed to friction than others, and the skin on them is the driest, this is:

• On the hands, areas of the palms or elbows;
• Below the knees;
• In the inguinal folds;
• On the sides of the lower back;
• On the shin;
• On the scalp under the hair.

The location of the lesion directly depends on the form of the disease. Psoriasis vulgaris prefers to appear on the elbows, and the teardrop type begins to spread from the lower back, skin areas under the chest, and shoulder blades.
The first rashes are usually barely noticeable, do not form clusters and do not cause any discomfort. But if you do not consult a specialist at this stage and ignore the onset of the disease, damage to the fingernails and toenails will gradually begin, then the disease will spread to the mucous membranes, and then to the joints.

The appearance of the first signs of psoriasis can vary depending on gender or age. In newborns, psoriatic rash most often begins with the inguinal folds and resembles the signs of miliaria. In adults the onset can be of two types:

1. Round rashes of various sizes, deep pink or red in color, with many visible whitish scales. Gradually, although each patient has his own way, the areas of the rash thicken and noticeably rise above the surface of the skin. Rashes form psoriatic plaques, resembling drops from a paraffin candle.
2. Small, dense papules form small clusters on the elbows, palms, and sometimes along the knee joints and ankles. These signs are so insignificant that a person simply does not pay attention to them, confusing them with normal irritation. It is important to listen to yourself to see if the characteristic symptoms of psoriasis have appeared, such as itching and pain when touched. If you miss the initial symptoms of psoriasis, individual papules quickly turn into plaques, which are very difficult to get rid of.

You can differentiate psoriasis from other skin diseases using a triad of characteristic symptoms, these are:

1. "Stearic stain effect". When scraping the surface of the plaque, small transparent scales come off easily.
2. "Terminal film effect". If you remove the exfoliated scales, in their place there will be a thin shiny surface of the skin, bright in color.
3. "Bloody Dew Effect". At the site of the curettage, microscopic droplets of blood appear after a short period of time.

The classification of specific forms of psoriasis is of great importance in determining the disease. A unique system has not yet been developed; experts distinguish the main groups based on characteristic symptoms and signs.

Classification

The main division of the disease is into two large groups depending on the nature of the rashes, these are:

1. Non-pustular forms, which are characterized by distribution over the entire surface of the skin, including types such as:
   • Simple (vulgar) or ordinary psoriasis, characterized by a stable chronic course with the development of plaques. The vulgar type of the disease is the most common, it occurs in 85% of cases.
   • Psoriatic erythroderma. A dangerous form, which always manifests itself in a severe form, compromising the thermoregulatory and barrier capabilities of the skin. Most often, erythrodermic psoriasis ends in pyoderma or sepsis.
2. Pustular forms, which are characterized by the formation not of papules, but of pustules - blisters of inflamed skin filled with serological fluid. These forms of the disease in their course can be generalized (distributed over the entire skin surface) or localized, mainly in the area of the palms and soles of the feet.
   • Tsumbusha type generalized psoriasis;
   • Ring type of erythema;
   • Barber's palmoplantar type (chronic pustulosis of the extremities);
   • Annular type of pustular psoriasis;
   • Persistent acrodermatitis (psoriasis of the soles and palms);
   • Psoriatic impetigo herpetiformis.

This classification system has not yet included such types of diseases as:

• Seborrheic;
• exudative;
• Drug-dependent form;
• Inverse psoriasis of the surfaces of the skin folds and folds.

Characteristic signs of different types of psoriasis

The general symptoms of psoriasis fully characterize only the vulgar form of the disease, which is the most common among all known forms of the disease. A characteristic feature of plaque psoriasis are the places where the first rashes appear, these are:

• Bends over arms and legs;
• The border between the forehead and the scalp;
• Back of the hands.

drop type

A distinctive feature of this type of disease is the formation of single, drop-shaped papules. The first signs of guttate psoriasis appear on the thighs and then spread across the entire skin surface. In the vast majority of cases, guttate psoriasis develops against the background of infectious diseases caused by streptococci.

Atypical appearance

This form is characterized by the formation of the first manifestations in places atypical for psoriasis, these are:

• skin folds,
• Lateral surfaces of the body
• Armpits.

Pustular (exudative) appearance.

The onset of the disease is characterized by the appearance on the surface of the palms of the hands, feet or legs of small vesicles (papules) filled with non-infectious serous fluid. The skin around the papules is always inflamed and the blisters themselves are very unstable and are open doors for infection.

In most cases, exudative psoriasis develops in patients suffering from endocrine diseases, metabolic disorders and obesity.

Psoriasis of the fold surfaces

Distinctive features of this form are the appearance of manifestations on the skin. The rash appears in the form of large red spots that are not covered with scales and do not protrude above the surface. This species covers areas with intense sweat glands, such as:

• Bend the joints of the arms and under the knees;
• Armpits and inguinal folds;
• External genitalia;
• The area of skin under the breast in women.

Most often this form is complicated by the addition of a fungal or streptococcal infection.

Psoriatic arthritis

One of the most insidious forms of the disease, characterized by a long latent course. The patient notices the first symptoms of psoriasis when the damage to the joints has become total. Signs of this type of psoriasis are expressed in pain and swelling of the joints and their subsequent deformation.

Seborrheic appearance

The localization of rashes of this type is initially concentrated on the face, the first signs appear in the area of the nasolabial triangle, behind the ears, along the edge of hair growth. Further distribution occurs along the shoulder blades on the back and along the chest. The rashes are covered with yellowish scales, and the boundaries with healthy skin are blurred.

Onychodystrophy, nail psoriasis

This type is almost incurable. The pathology affects exclusively the nails, which change color to dark yellow or grey. The nail structure becomes thinner and the cuticle area becomes inflamed for no apparent reason.

Conclusion

It is important to always remember that psoriasis is not only a skin disease, but also a very serious disorder of the body's internal systems. In no case should you self-medicate or turn to healers. The choice of an effective treatment regimen can only be made by an experienced specialist after careful examination.