Psoriasis: types, treatment, tips for the doctor

Psoriasis is a chronic skin disease with an unknown cause, manifested by the appearance of red peeling spots on the skin.

The treatment is carried out by a dermatologist.Synonym - squamous lichen.Code MKB 10: L40.According to the international classification, it refers to diseases of Papulloskmous skin skin.

Psoriasis as a disease is designed for about 200 years.Before this period, such patients were considered patients with leprosy and consequently treated them as lepers.Difference: leprosy (lepra) - infectious disease (pathogen - Mycobacterium leprae).Psoriasis is not infectious.

Symptoms

The main symptom of psoriasis: the appearance of red-red spots on the skin, whose surface is covered by silver stairs of the keratinizing layer of the skin (epidermis).

1. The symptom of the "Stearin Punto".This is a patognomonic signal (i.e. characteristic only for a certain disease).Speaking (scratch) of the psorial points.It is produced with an opaque scalpel or an object glass (not with a nail !!).With a slight harness, the surface of the point becomes white, as if it were covered with wax - this is a symptom of the "stearin point".
2. Symptom of "psoriatic film".Another patognomonic symptom for psoriasis.With an additional scrap, it neatly removes the stairs from a psoriatic plaque, a brilliant surface is visible under the stairs - the symptom so called psorial or terminal.
3. The symptom of "Blood Dew Poltebnov" (Auspitz symptom).Another patognomonic symptom for psoriasis.With a further propagation (grottowing) of plates, that is, when the terminal film is manifested, the bleeding of the point is manifested, which do not merge with each other.This is the symptom of "Blood Dew".
4. Pilnov symptom.Feature for the initial stage and the stage of progression.A rounded pink point without peeling, with clear boundaries.With the progression of the disease along the periphery, the spots (plates) marks the edge of the red skin, not yet covered with stairs.
5. Kebner's symptom.Psorial foci appear on the skin in places of injury - in places of scratches, rubbing, in places of friction for clothes.
6. Symptom of Kartamyshev.When the fingers are examined (palpate) plates on the scalp (HCH), there is a light edge of the plates with the fingers.Unlike seborrheic dermatitis, when there is no light border between stains and healthy skin on palpation.
7. Voronov's symptom is a symptom of regressive points (passages).For some time, the wrinkled skin remains along the outskirts of the psoriatic point, lighter and bright than healthy skin.
8. The symptom of the "Dital" on the nails is a sign of damage to the nails.The nail is all in question, like a dietale.
9. The symptom of the "oil point" on the nails: a yellow-brown stain under the nail plate is also a sign of nail psoriasis.
10. Onichogrifosis - deformation of the nail plate with nail psoriasis.The nail acquires bad shapes, sometimes similar to a bird claw.
11. Bo-Rile line.The longitudinal line that passes through the entire nail is a sign of violation of the nail plate.

Types of psoriasis and clinic

Generalized pustular psoriasis (L40.1) and Pustulose Palmar and Plantar (L40.3)

These two forms of the disease differ only in the prevalence of the process.The mechanisms of pathogenesis are the same.The forms of pusture are found in 1% of patients with psoriasis.The bladder (bubbles) and the pustules (pustules) appear on the skin, which can merge together, forming "purulent lakes".Around there may be peeling of the skin.It can be disturbed by the itching of the skin.The skin around the pustules is red, inflamed, warm to the touch.

Improve body temperature.In the blood - an increase in leukocytes (leukocytosis).These are rare and more serious types of psoriasis.But they require an immediate examination of the doctor and prescribe a complex treatment.And generalized pustular psoriasis requires hospital treatment.In very rare cases, when the bacterial infection is united, the cases of sepsis and deaths are also described in the literature.

One of the varieties of pustular psoriasis is an exudative form.At the same time, there are no abscesses and bubbles on the skin, but there is a crying of affected skin, the formation of crusts and itching of the skin.

Acrodermite is persistent allopo

Code MKB 10: L40.2.

Pustolous (pustling) and peeling psorial changes appear on the skin of the fingers and legs.The process involves the nail plates.The nails are deformed, exfoliate in some places by the nail bed, have pointspasses.

A lighter form is the psoriasis of nails without pustular changes, that is, without abscesses on the skin.

Psoriasis is rocky

Code MKB 10: L40.4

Above alide survived with a dimension of rose with peeling appear on the skin.There may be itching of light skin.Location: the whole body is on the body, on the arms and on the legs.Rarely - on the face.

Often a drop -shaped shape appears after infectious diseases (tonsillitis, acute respiratory viral infections).

Psoriasis is arthropathic

Code MKB 10: L40.5

Other names are the psoriasis of the joints, psoriatic arthropathy, psoriatic arthritis.

It develops in 10% of patients with psoriasis.The joint surfaces and periarticular tissues are interested: ligaments, tendons, joint bags.

Location: all the joints, but the small joints of interfaces of the fingers are mainly affected.However, there are cases, for example, psorial spondylitis - damage to intervertebral or psoriatic coxartrosis - damage to the hip joint.

Patient complaints: pain, rigidity in the joints.Swelling and redness of the skin appears in the joints.There are frequent cases in which patients do not disturb anything, however, radiographs indicate changes similar to arthrosium on joint surfaces.

The joint pain and the restriction of the movement in the joints lead to the disability of patients.These patients must be directed to the AIU examination to determine the disability group.

Another psoriasis

Code MKB 10: L40.8

This type includes psoriasis on the contrary (reverse, interstigonic).

Location - on the contrary - not on the extensor surfaces, but on flexion.The curves of the elbow, the poplitei wells, the axillary cavities, the inguinal folds, under the mammary glands.At the same time, there are no rashes in the rest of the body.

It develops in patients with obesity and diabetes.
EVENT: the red spots appear on the skin, almost without peeling, slightly raised above the surrounding skin.

Psoriasis is not suitable

Code MKB 10: L40.9

All the other species that, from one or the other, cannot be attributed to the above species, are attributed to this group.

Seasonal forms of psoriasis

1. Winter shape (photosensitive psoriasis).Cutaneous eruptions appear in the cold season.Well treated with ultraviolet radiation.
2. Summer form (phototoxic psoriasis).The exacerbations occur in the summer.Ufo prostration leads to an exacerbation of the disease.

Diagnostics

The diagnosis is made on the basis of clinical symptoms and patient complaints.

• The presence of some symptoms of damage to the skin, nails, joints, etc.- See above.
• In difficult cases - a biopsy of the skin for verification (installation of an accurate diagnosis).At the same time, the infiltration of lymphocytes, neutrophils and macrophages, thickening of the capillaries of the skin, immature keratinocytes are in the thickness of the skin.
• Joint radiography - ideally, all patients should be performed.But very often it is performed according to the indications, in the presence of complaints about pain in the joints.
• A general blood test is often normal.Inflammatory changes are detected only in the serious course of the disease.
  Recently, it is common to diagnose blood tests under a microscope.This does not matter for the diagnosis of psoriasis!

The differential diagnosis of psoriasis is carried out with diseases:

• Red dishes 
• Pink lichen 
• Parapsor,
• Atopic dermatitis
• Eczema
• Papular syphilis
• Seborrheic dermatitis on the head
• Dermatophitia in the lead
• Reuters disease, rheumatoid arthritis, arthrosis
• Medicinal allergic dermatosis
• Urticaria

Treatment of psoriasis

Remember: it is impossible to completely take care of psoriasis.Only long -term remission can be obtained.

Local treatment

ATTENTION: if Pustoles appeared from the ONGUENTO, then the overstacing should be canceled and consult the doctor to correct the treatment!

1. Ointments and creams with vitamin D. For example, drugs containing substances that summarize vitamin D.
2. Corticosteroid ointments and creams.These drugs reduce the immune response in the skin, reduce the activity of inflammation.
3. Combinations in a composition of vitamin D preparations and corticosteroids.
4. Noftalan -based prepared.Lubricate the affected area of the skin 2-3 times a day-4 weeks.
5. Birch Tar and drugs based on it.Berritina, Birch Tar.Lubricate the affected areas and give an extract for 15-30 minutes, then washed with hot water and soap.
6. Cream and solid -based ointments.You can use the solid itself, but you have to find the old Soviet solid and not the solid that is now sold in car shops with different additives.Creams and ointments.Solid and creams based on it help in half cases with psoriasis.The itch decreases on the 3rd day, the peeled leaves and the point itself gradually decreases.
7. Chernatic ointments and creams (exfoliating).Used unstable!Just to remove excessive peeling.Often - in combination with corticosteroid preparations to reduce itching and inflammation.You can't use with exudative psoriasis!Salicylic acid of the keratolytic agent.
8. Zinc drugs.  It reduces irritation and redness of the skin, dries the skin.It does not contain hormones.
   ATTENTION: Do not use Quar and salicylic acid on "Dabili Plazi"!The irritation of the on -duty plates can further cause the diffusion of pathological eruptions on the skin.

Instrumental treatment methods

Photographic wardrobe for bullet therapy

We watch the video how Puva therapy is performed:

• Laser Eximer.

Treatment with a psoriasis laser psoriasis of the scalp:

• Plasmaferesi, emosorption - purification of blood plasma on a special apparatus.At the same time, toxic immune complexes occur with blood, which lead to skin infiltrations with lymphocytes.The effectiveness of the procedure is high, especially in the serious course of the disease.But the procedure is expensive and is essentially aimed at eliminating the mechanisms of the development of the disease and not its causes.According to patients, plasmaferesis is satisfactorily tolerated, the effect appears from different procedures.

Diet with psoriasis

Exclude:

Citrus fruits, tomatoes, pineapple and other fruits abroad, honey, sweets, sugar, biscuits, spices, alcohol, spicy and savory dishes, coffee, white bread, smoked meats, products with dyes and repairs of sugar, potatoes and semolina.

Don't eat too much!

Necessarily:

Porridge (buckwheat, oatmeal), vegetable oils (sunflower, olive), fruit and vegetables - apples, carrots, beets, cabbage, cucumbers, boiled meat, fish, one day per week (usually Saturday) - post (or even hunger).On this day, drink only water or eats a porridge of buckwheat flooded with water.

Popular remedies

At home, you can use various popular remedies for psoriasis.But the effect of them is minimal or zero.

Remember: independent treatment at home in half of the cases leads to the progression of the disease and the transition in a more serious form.

List of popular remedies from psoriasis used in patient reviews:

1. Solid.
2. Therapeutic mud of savory lakes.
3. Bathrooms with sea salt.
4. Birch Tar.
5. NAFTALAN oil.
6. A decoction of a series - compresses (applications) to the affected areas of the skin.
7. A decoction of curtain herbs.
8. A decoction of nettles.
9. Aloe juice.
10. Dripid baths.
11. Hunger.
12. Faction Asd 3.
13. Flax seed oil.
14. Milk Thistle.
15. Bades and antielminic drugs.Ineffective or with zero efficiency.In the best cases, they contain ordinary herbs or even ordinary starch with vitamins and trace elements.Very expensive and brings a good profit to producers and sections of food supplements.I'm not a medicine, so you can't expect help from them in the treatment of psoriasis.
16. Ointment from psoriasis.In fact, the current remedy is solid.At the same time, there are many more herbs extracts, bees products that can cause an allergic and exacerbation reaction of the disease.
17. Chinese lotion.The drug contains acids that can lead to skin irritation and the progression of the disease.

Exotic types of treatment

Ichthyotherapy.
In Black Mru there are race-RUF fish.They pinch the dead areas from human skin and contribute to "rejuvenating" the skin.This effect is also used in the treatment of patients with psoriasis.

The effect of ichthyotherapy is positive only with in -depth compliance with the technique and the choice exactly of the same fish.There are similar fish fish: scales with sharp teeth stand out, wounds so psorial plates.The effect of the exposure of chin-processing fish is exactly the opposite diffusion of the plates for the type of Kebner phenomenon.

Failure to comply with hygiene in some Spa channels can lead to the appearance of fungal or viral lesions on the skin (mycosis, warts).

Registration prevention

• Exclude the risk factors!
• Observe the day of the day, the work regime and the rest
• Adequate nutrition
• Timely treatment of infectious and endocrine diseases
• UFO and PUVA therapy courses
• Complex vitamins
• Treatment of the sanatorium-resort, swimming on the sea
• A healthy lifestyle!

It is psoriasis

No, not contradictory!This is a non -infectious disease.