Psoriasis: what type of disease is it?

Although psoriasis is a common and long-known disease, it has not yet been fully studied.And patients very often do not know at all that psoriasis is not a bacterial or fungal infection, but an abnormal reaction of the immune system, caused by unknown reasons.Information about the causes and symptoms of psoriasis will be very useful for patients, as it will help to overcome the disease.

What kind of disease is this?

Lichen squamosus is another name for psoriasis and this name perfectly characterizes this disease.Psoriasis is manifested by the formation of inflamed plaques of various sizes on the skin, densely covered with thick skin scales.

Surely almost everyone has heard of such a disease as psoriasis.And this is not surprising, since scaly lichen is quite widespread.This disease is diagnosed in 4-10% of the world's population.In addition, statisticians who collect information on the prevalence of psoriasis say that the number of patients is constantly increasing.

Scaly lichen has been known to people since ancient times;ancient Greek healers also tried to cure this disease.The modern history of the study of psoriasis dates back approximately 150 years.But during this fairly significant period of time, researchers have failed to learn enough about the causes and treatment of psoriasis.

Widespread prevalence, uncertainty of etiology (causes of occurrence), insufficiently effective treatment - all this characterizes psoriasis as one of the most difficult problems of dermatology.

Today, dermatologists consider psoriasis as a complex systemic disease associated with disorders in the functioning of the immune system, with the failure of metabolic processes and the appearance of trophic disorders.The result of these failures are specific skin changes.

Therefore, answering the question of what is psoriasis, a modern dermatologist will answer that these are disorders of trophism and metabolic processes of the skin caused by a malfunction of body systems.Today, two theories of the etiology of psoriasis are considered the most probable: genetic and viral.

• The genetic theory has many supporters, as psoriasis often acts as a hereditary or familial dermatosis.A thorough examination of the patient's family history confirms in 60-80% the presence of psoriasis in one form or another in the patient's relatives.However, in some patients it is not possible to confirm the hereditary origin of psoriasis.This circumstance is the reason for separating these cases into a special group, where the main cause is not genetic failures, but phenotypic ones.
• The viral theory, according to which psoriasis develops due to infection, has its supporters.Confirmation of information about the viral origin of psoriasis is the detection of antibodies in the blood of patients, as well as “elementary bodies” in the cells of the epidermis.According to this theory, psoriasis develops not only in case of virus infection, but also in the presence of certain conditions.

There are other theories that explain the appearance of psoriasis.For example, endocrine, neurogenic, metabolic, etc.Of course, all these theories are not without foundation and their study allows us to obtain more important information on the psoriasis disease.However, today it is already known for certain that the state of the endocrine and nervous systems, as well as the functioning of the gastrointestinal tract, do not cause psoriasis, but have a significant impact on the course of this disease.

For example, pathologies affecting the liver lead to the fact that the quality of blood purification carried out by this organ is significantly reduced.And this, in turn, can provoke the appearance of various skin lesions, including psoriasis.

Pathologies that affect the liver (hepatitis, primary cirrhosis, etc.) lead to the degeneration of the tissues of this organ, i.e. the liver is gradually replaced by connective tissue.As a result, the liver ceases to cope with its cleansing functions.Externally, this is manifested by yellowing of the mucous membranes and skin, and the development of skin diseases, including psoriasis, is also possible.

There is also an inverse relationship: psoriasis is often accompanied by fatty degeneration that affects the liver.Therefore, when treating this skin disease, it is important to follow a diet so as not to unnecessarily overload the liver.Patients are advised to limit fatty foods and completely eliminate alcohol.

Therefore, despite numerous studies, it has not been possible to get an exact answer to the question of what psoriasis is.However, work continues, so there is a possibility that the mystery of this mysterious disease will be solved and we will learn a lot about psoriasis, a skin disease.

Classification according to the international system

Psoriasis disease manifests itself in various forms.To facilitate navigation for specialists, a generally accepted classification of psoriasis is used.

Psoriasis is also included in the International Classification of Diseases (ICD) system.Today, the 10th revision of the International Disease Registry is already in use, which is why the abbreviation ICD 10 is used. Work on the 10th revision of the International Classification of Diseases began in 1983 and was completed in 1987.

In essence, ICD 10 is the standard assessment tool used in medicine and healthcare management.The 10th revision of the reference book is used to monitor the prevalence of various diseases and other public health problems.

Using ICD version 10, it is possible to compare data on morbidity and mortality in different countries, which allows you to obtain statistical data and systematize diagnostic information.As agreed by WHO members, ICD 10 is used to assign codes to various diseases.In version 10 of the classifier, alphanumeric codes are adopted, with the help of which it is convenient to store information in electronic format.

All types of psoriasis are included in ICD 10 and each of them is assigned a specific code.In dermatology, the following forms and types of psoriasis are distinguished:

• Common psoriasis(synonyms: vulgar, simple, plaque).The disease was assigned a code according to ICD 10 – L-40.0.This is the most common form, it is observed in 80-90% of patients.The main symptoms are the formation of raised plaques above the surface of the unchanged skin, covered with gray-white skin flakes.This form is characterized by a slight flaking of the scales.After their removal, inflamed red skin is revealed, which is very easily injured and begins to bleed.As the inflammatory process progresses, plaques can significantly increase in size.
• Inverse psoriasis.This is a disease that affects the skin folds (bending surfaces).For this form of the disease, the ICD 10 code is L83-4.Dermatosis appears with the formation of folds of smooth or minimally scaly spots on the skin.The condition worsens when the skin becomes damaged by friction.The disease is often complicated by a streptococcal infection or an associated fungus.
• Guttate psoriasis.This form of psoriasis is characterized by the formation of a large number of small red or purple spots on the skin, shaped like water droplets.According to the tenth version of the international classifier, this disease received the code L4.Most often, guttate psoriasis affects the skin on the legs, but rashes can also occur on other parts of the body.At the same time, guttate psoriasis is known to develop as a complication after streptococcal infections: pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasis– it is a severe cutaneous form, according to ICD 10 it is assigned the code L1-3 and L 40.82.Characterized by the formation of blisters or pustules.The skin of the lesions is swollen, red, inflamed and peels off easily.If fungi or bacteria enter the pustules, the contents of the pustules become purulent.Pustular psoriasis most often affects the distal parts of the extremities, but in severe cases a generalized process may develop with the rash spreading throughout the body.
• Psoriatic arthritis or arthropathic psoriasis.According to the 10th version of the ICD, the pathology is coded L5.Manifested by inflammation of the joints.Arthropathic psoriasis can affect all types of joints, but in most cases the joints of the phalanges of the toes and hands are inflamed.The knee, hip or shoulder joints may be affected.Injuries can be so severe that they lead to patient disability.Therefore, you should not think of psoriasis as being exclusively a skin disease.Severe types of psoriasis can lead to systemic injury, disability, or even death of the patient.

• Erythrodermic psoriasis.A rare but serious type of psoriasis, according to ICD 10 this disease received the code L85.Erythrodermic psoriasis often manifests itself in a generalized manner;the affected area may include all or almost all of the skin's surface.The disease is accompanied by severe itching, swelling and pain.
• Psoriatic onychodystrophy or nail psoriasis.According to ICD version 10, the disease is coded L86.The pathology is manifested by changes in the appearance of the nails of the toes and hands.Nails may change color, become thicker and begin to crack.Possible complete loss of nails.

In psoriasis, the classification of the disease takes into account not only the type of disease, but also the severity of the symptoms:

• limited psoriasis is a disease in which less than 20% of the skin is affected;
• diffuse psoriasis affects more than 20% of the body surface;
• When almost the entire surface of the skin is affected, it is called universal psoriasis.

If we consider all types of disease, diffuse psoriasis is more common than other forms.

Phases of the flow

Limited or diffuse psoriasis goes through three phases in its course: progressive, stable and regressive.

The progressive stage of psoriasis is characterized by the following:

• the appearance of new skin rashes;
• growth of existing plaques;
• the appearance of new elements of the rash at the site of skin lesions (scratches, abrasions);
• excessive detachment of existing plaques.

The following symptoms are characteristic of the stationary stage of psoriasis:

• failure to emerge new elements;

• moderate flaking of the elements;
• no sign of growth of the elements.

The appearance of folds in the stratum corneum around the elements is a sign of the transition from the stationary to the regressive stage.

The regression phase is characterized by the following types of symptoms:

• reduce the intensity of peeling;
• element resolution.

After resolution of the psoriatic plaques, hypo- or hyperpigmented patches remain in place.

Lichen squamosus is characterized by a long course with periodic exacerbations.The following types of psoriasis are distinguished:

• winter (with worsening in autumn and winter);
• summer (with flare-ups in the hot period);
• non-seasonal psoriasis is the most serious type, since there is no clear connection between relapses and the seasons of the year, periods of remission may be practically absent.

Diagnostic features

If psoriasis has a typical clinical picture, the diagnosis will not be so difficult.However, this disease is often masked by other pathologies.

For example, nail psoriasis is often confused with nail fungus, since the external manifestations in the initial stages of these diseases are very similar.However, nail fungus and psoriasis are completely different in nature, so the treatment should be different.

A non-specialist might confuse it with fungal or skin psoriasis.Since cutaneous mycoses (skin fungi) are manifested by similar symptoms: the formation of scaly plaques.Therefore, if you notice suspicious symptoms on your body or nails, it is not necessary to make a diagnosis yourself and start treating the fungus using pharmaceutical or folk remedies.

If the diagnosis is incorrect and, in fact, the cause of the symptoms is not a fungus, but psoriasis, the treatment will not bring benefits, but, on the contrary, will aggravate the symptoms.

When contacting a dermatologist, a fungal test will be performed and a scraping will be taken from the nail or skin.Then the resulting material is placed in the nutrient media.If the fungus is present in the material, a large colony will grow in the test sample within a few days.From the appearance of the material it will be possible to understand which type of fungus caused the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, which can be a bacterial infection or a fungus.Therefore, patients who change the clinical picture (appearance of purulent secretions, change in color of plaques, etc.)You will need to be periodically tested for fungi and other infectious agents.

In the diagnostic process, a certain role is assigned to a set of phenomena called the psoriatic triad.The phenomena appear sequentially when an element of the rash is scraped.

The psoriatic triad manifests itself as follows:

• when an element of the rash is scraped, the scales are removed in the form of “splinters”;
• after removing the chips, a thin transparent film similar to polyethylene is visible;
• When the film is damaged, pinpoint bleeding occurs.

A dermatologist diagnoses psoriasis, but, if necessary, the doctor can refer the patient for consultations with other specialists: a rheumatologist, a gastroenterologist, a surgeon, etc.

Interesting facts about psoriasis

People have known the disease psoriasis since ancient times.The name of the disease also entered our language from ancient Greek.During the prosperity of ancient Greece, the word "psora" denoted all skin diseases that manifested themselves as flaking and itching.

The first person to write a detailed treatise on psoriasis was a Roman named Cornelius Celsus.In the fifth volume of his work “De medicina” there is a large chapter dedicated to this disease.

They knew about psoriasis, but this disease was not evaluated unambiguously, as it was called the “imperial” or “devil's” disease.

Of course, ancient healers knew very little about psoriasis.Until the 19th century, this disease was often confused with other skin disorders.Psoriasis was first identified as an independent nosological form in 1799. This was done by the English dermatologist Robert Willan, who identified psoriasis from a large group of skin diseases manifested by itching and peeling.

Not only ordinary people, but also important political figures knew about psoriasis firsthand.For example, Winston Churchill, who suffered from this disease, promised to erect a monument of pure gold to a person who could learn everything about psoriasis and offer effective treatment for this disease.

Modern ideas about disease

It must be said that modern science does not know much about this mysterious disease.There are various theories about the origin, course and treatment of psoriasis.

Here are some facts about psoriasis that are beyond doubt among experts:

• Although the causes of the disease are unclear, we have managed to discover the nature of psoriasis.This disease is autoimmune, that is, it is caused by a malfunction of the immune system;
• Another established fact about psoriasis: the disease can be hereditary.However, this is not always the case;even if both parents are ill, the risk of the child developing the disease is 65%.At the same time, some patients develop psoriasis, although none of their relatives are sick;
• An interesting fact about psoriasis is that this disease is characterized by the Koebner phenomenon.This phenomenon is manifested in the fact that elements of the rash are formed at sites of skin damage: scratches, burns, frostbite.Sometimes psoriasis appears after some time, at the site of the scars;
• An important observation that allows us to obtain more information about psoriasis is the connection of this disease with climatic factors.Flare-ups and relapses are often timed to coincide with the change in season;
• Patients have probably noticed the connection between flare-ups and stress in practice.All patients should know for sure that the disease recurs or worsens its course in a context of nervous tension and anxiety;
• A new fact about psoriasis is that the disease can begin at any age, although it was previously believed that pityriasis versicolor appeared after the age of 30;
• It is important for all people to know that psoriasis is not a contagious disease.Even in case of close contact with the patient there is no risk of infection;
• Almost everyone has heard about the incurability of psoriasis, and this is true, since no treatment has been found that can guarantee the defeat of the disease.But patients should know that psoriasis can be controlled.Adequate and timely treatment allows you to achieve long-term remission.

Modern methods of treatment

Talking about the common disease of psoriasis, we cannot fail to talk about the treatment of this common disease.It must be said that it is impossible to cure psoriasis only with tablets or ointments.

To forget the manifestations of psoriasis for a long time, the patient, in close collaboration with the doctor, will have to make efforts.It will be necessary to properly organize the food.Some experts say that you can forget about psoriasis forever only with the help of a properly formulated diet and regular cleansing of the body.

The doctor will draw up a preliminary regimen according to which the treatment will be carried out.As a rule, external (ointments, creams) and systemic (tablets, injections) therapy methods are used.In addition, physiotherapeutic methods will be used and treatment in resorts will be recommended.It is recommended to treat psoriasis with healing mud, mineral and thermal water.

Resorts may also offer non-traditional treatment methods.For example, with the help of fish living in hot springs.These little healers effectively remove dead skin flakes and disinfect the skin, promoting faster healing.

Resorts may offer other methods of lichen planus treatment.For example leech therapy, baths and healing applications, sun treatments, etc.

You will need to be prepared for the fact that the treatment regimen will change periodically.Since not all methods are suitable for a specific patient.If the chosen treatment methods are ineffective, they will need to be replaced.

Traditional methods of treating psoriasis are also widely advertised.In fact, some of them can help you achieve remission.However, when choosing a method, you need to remember common sense so as not to harm your health.If any recipe or recommendation is in doubt, it is better not to use it.Consult your doctor before using any treatment method.

You need to understand that it will be possible to forget about psoriasis forever only if the patient himself and his immediate environment are in a positive mood.Only faith in success and an optimistic attitude will help defeat this mysterious and insidious disease.