Psoriasis is a chronic non-communicable disease that until recently was simply considered a skin disease. The peculiarity of the inflammatory process in some areas of the skin in patients with psoriasis is that the life cycle of normal skin cells is about 30-40 days, while, as in psoriasis, it is 4-5 days, i. e. after 4 daysskin cells gradually die forming plaques, dryness, peeling of the skin and so on.
The problem of treating this complex and difficult to cure disease today is urgent not only for dermatologists, many doctors of other specialties are often involved in determining the causes of psoriasis in a patient, and are also directly involved in the complex treatment ofthis disease. Today, medicine considers psoriasis in terms of a systemic failure in the body and not just as an inflammatory process of the skin.
Even its name has changed, it is now a psoriatic disease. Why is psoriasis a systemic disease? Because in patients, several disturbances in the work of the body as a whole are found simultaneously: in the nervous, endocrine, immune system. In medicine there are several types of psoriasis, there are also a large number of reasons for the occurrence of this ailment, mainly these are theories, since there is no convincing evidence of these alleged causes, we will consider them in more detail.
Some facts:Psoriasis is not contagious as it is believed to be caused by a malfunction of the human immune system, namely the hyperactive T lymphocytes on the skin. Psoriasis is classified as a hereditary disease, with psoriasis in 1 of the parents, the risk of developing psoriasis in a child is 25%, if both parents have 65%. In addition to the hereditary factor, the triggering mechanism for the onset of psoriasis or relapses is the intake of antibiotics, NSAIDs, B vitamins, stress, alcohol and skin lesions.
Viral theory of the cause of psoriasis
Numerous studies in patients with psoriasis have found various changes in the peripheral lymph nodes, which may indicate the viral nature of the development of this disease. It is suspected that retroviruses, which are genetically transmitted by inheritance, may be one of the causes of psoriasis, but to prove the viral nature of the origin of psoriasis it is necessary to identify the virus, isolate it and select the habitat, and so far no one canto do it.
The fact is that retroviruses have the ability to change the genetic code of the host, they, with the help of the reverse transcriptase enzyme, have the ability to synthesize DNA and a "false program is formed in the cells"That changes the human genome. However, it has been established that even with blood transfusions from psoriasis patients to healthy people, infection or transmission of the disease has never been noted. Therefore, the version about the viral cause of psoriasis has not yet been proven.
The immune cause of psoriasis
This is one of the generally accepted theories about the causes of psoriasis, since cellular immunity disorders are considered to be the main trigger of the disease. It was noted long ago that in people with a genetic predisposition to psoriatic disease, chronic foci of infection - tonsillitis, sinusitis, indicating impaired immunity - are provoking factors for the onset of psoriasis.
When a major outbreak of psoriasis occurs, medicine also suggests that the damage to the epidermis is caused by autoimmune aggression. In numerous studies of patients with psoriasis, abnormalities in immune complexes, antibodies, immunoglobulins, which cause Munro microabscesses have been identified.
In the process of activating inflammation of psoriasis, hypersensitivity of the skin increases significantly, therefore, in places of physical or chemical irritation, rashes characteristic of psoriasis appear. During the examination of skin scales, antigenic components and autoantibodies were found in the blood, which are not found in healthy people either on the skin or in the blood.
This fact gives reason to say that the autoimmune process plays an important role in the cause of psoriasis. But any process, even immune reactions, take place in the body as in an integral system, therefore, a combination of other factors should be taken into account, such as endocrine influence, hereditary factors, metabolic disorders.
Infectious theory of the development of psoriasis
A hundred years ago, many researchers stubbornly searched for an infectious agent of psoriatic disease, and streptococci, spirochetes and epidermophytes were considered guilty of its emergence. However, none of these pathogenic microorganisms, fungi, after research, were not found to be the cause of psoriasis.
However, infectious diseases, tonsillitis, influenza ARVI affect the exacerbation or trigger the primary onset of psoriasis, this is especially noticeable in the cold season, when the immune system weakens and patients with psoriasis are often hospitalized.
Some authors believe that the development of psoriasis against the background of acute and chronic infections is explained by the influx of impulses from the center of the infection into the endocrine system and the vegetative section, which leads to the restructuring of the body's reactivity. Most often, that is, in 90% of cases, chronic tonsillitis accompanies psoriasis, which confirms the influence of infectious processes and reduced immunity on the development of psoriasis.
Also, according to many experts, there is an infectious allergic cause of psoriasis. Its proponents believe that psoriasis is an allergic reaction of tissues to viruses, streptococci and their metabolic products. However, neither the viral nor the infectious theory has yet been confirmed.
Genetic cause
This cause is based on a familial manifestation of psoriasis among close and distant relatives. However, psoriasis should not be considered a strictly hereditary disease, as well as diabetes, cancer, ischemic heart disease, since psoriasis itself is not inherited, but only a genetic predisposition to it. Yes, 60% of patients with psoriasis have ancestors or close relatives who suffer from this disease and if one of the parents is sick, according to the theoretical probability, the child's risk of developing psoriasis increases by 25% and if both parents aresick, up to 75%.
However, not always with psoriasis, the cause is only a genetic factor. This disease has recently become very common in clinical practice and there is not always a direct dependence on the related predisposition. In psoriasis, the causes of onset are so multifactorial that it is impossible to unequivocally indicate a specific cause. Since pathogenic factors are violations of protein or carbohydrate metabolism and changes in lipid, enzymatic metabolism, a combination with foci of streptococcal infection or viral nature.
Metabolic disorders as factors in the development of psoriasis
If we consider metabolic disorders in psoriasis, then in many patients there is a slight decrease in body temperature, and this is one of the symptoms of a slowed metabolism, an increase in cholesterol content is also noted, which indicates changes in thelipid metabolism. Given the high level of cholesterol, many researchers consider psoriasis to be a cholesterol diathesis and consider its increase as the initial manifestation of dermatosis, since a violation of lipid metabolism stimulates the formation of keratinization of the skin.
Also, in psoriasis, the metabolism of vitamins is disturbed, especially vitamin C, A, B12, B6, while the vitamin C content in the skin is increased. In addition, changes in the content of iron, copper, zinc were noted, which significantly reduces the adaptive properties of the human body. Almost 25% of patients with psoriasis also suffer from diabetes mellitus, however, some researchers consider this fact not as the cause of psoriasis, but, on the contrary, as a manifestation of psoriatic disease.
With the progression of the disease, the basal metabolic rate in patients with psoriasis is more often increased, and in those patients who have a reduced metabolism, symptoms of hypothyroidism, endocrine glands, gonads often occur, in 60% of patients with psoriasis, thegeneral carbohydrate metabolism is disturbed. Low-calorie food, or even moderate fasting, reduces the body's self-poisoning, so a diet for psoriasis therapy improves the patient's condition.
Factors that cause psoriasis
In the current state of medical research in the field of determining the cause of psoriasis, it can be said that it is a constantly recurrent systemic disease that appears in genetically predisposed people, with concomitant disorders of various metabolism of the central nervous system.
Stress
For both the onset of psoriasis and the exacerbation of existing chronic psoriasis, the main triggers are most often stress, psychological trauma, prolonged fatigue and nervous tension.
Stress triggers immunological and biochemical reactions that contribute to the development of psoriasis. However, sometimes negative emotions serve, on the contrary, to complement the clinical symptoms of psoriasis. According to a survey of patients with psoriasis, this provoking factor causes the onset of the disease in 49% of patients and in 41% gives a relapse of psoriasis.
Infectious diseases, vaccinations, chronic foci of infection
Tonsillitis, sinusitis, sexually transmitted diseases, otitis media and so on are often detected, especially highly virulent streptococcus. For the exacerbation of the disease, this factor is relevant in 21% of patients, and for the onset of psoriasis development, infection is a trigger mechanism in 15% of patients.
Hormonal changes in women
During pregnancy, breastfeeding, during menopause or during adolescence - in 6% of the patients surveyed, this was also a provocative factor in the development of psoriasis.
Wounds, bites, burns
Any trauma to the skin: in 12-14% of patients, the appearance of psoriasis is caused by physical trauma.
Prolonged hypothermia
It is the cause of psoriasis or its exacerbation in 5% of patients.
Drugs
Like any type of antibiotic, NSAID. Vitamin therapy - especially vitamins C, B, beta-blockers, cytostatics, vaccination, the use of herbal remedies in the treatment - this provokes the onset of psoriasis in 6% of patients.
Food poisoning, abuse of certain foods
Chocolate, citrus and other products: According to a survey of patients, this is the cause of psoriasis in 4% of patients.
Drinking alcohol
In addition, a provocative factor that causes the generalization of the inflammatory process shortens the period of remission and increases the risk of complications, this is indicated by 3% of the respondents.
Climate change
High humidity, prolonged exposure to intense ultraviolet radiation, sudden changes in temperature and humidity - causes an aggravation in 2% of patients.
The first symptoms of incipient psoriasis can occur regardless of age, it appears just as often in infants and people of 20-40 years old, even in old age, psoriasis can begin to develop. Of course, the earlier it appears, the more serious the consequences it causes in the patient. If psoriasis begins in a person after 30 years, it is usually accompanied by gastritis, liver disease, overweight, various neuroses, diabetes, arthritis and other diseases.