A common feature of psoriasis is the primacy of the location of papules symmetrically on the skin extensor surface of the hands and feet, as well as the scalp.
Despite the fact that the main role in the development of psoriasis is played, the existence of a genetic predisposition (psoriasis refers to the diseases, infection of transmission by inheritance), the impulse to the onset of the disease can serve a variety of Exo-and endogenous factors (the development of psoriasis in the nervous system, the soil, on the background of endocrine violations, after infectious diseases, etc).
Etiologic factors of the development of the disease
The disease has no sexual predisposition, therefore, the prevalence of psoriasis in men and women is not different. The 12 percent of the patients of the disease first develops it before the age of ten. Twenty years of psoriasis develops the forty-six percent of the patients, and at thirty – sixty percent.
In the development of psoriasis held two peak age:
- twenty-seven and fifty-four years for men;
- fifteen and fifty and four years for women.
Causes of psoriasis in adults
The exact cause of the appearance of the psoriasis is unknown. The main role in the pathogenesis of the disease belongs to genetic predisposition. Also, plays an important role in the appearance immune from instability of lipid, and the presence in the patient of foci of chronic infection.
In favor of the theory of genetic (hereditary causes of psoriasis) is reflected in the fact that the disease is always not only the patient, but also that of their close relatives.
Identify the predisposition to psoriasis can be performed a classic analysis of the genome. In these patients can be detected ten loci of the chromosomes responsible for the hereditary predisposition to the disease (PSORS 1 through 9, as well as the HLA – B27, 17, etc).
The main gene responsible of the maximum expressed by the innate predisposition to the onset of the disease, believe PSORS1.
Also, in the pathogenesis of psoriasis play an important role genetically violations metabolism of carbohydrates and lipids. The majority of patients with psoriasis identified heavy hyperlipidemia, and the metabolic syndrome. In this sense, to sufferers of psoriasis there is a high risk for the development of the heavy early defeat aterosclertica of the vessels and the cardiovascular pathologies.
In addition to hyperlipidemia, points to a violation of the metabolism of the lcd screen (essential fatty acids), increase of the products of free radical compounds that are involved in keratinization of the epidermis, etc
In the study of psoriatic platelets, the glimpse of a large content in them oxidized low-density lipoproteins.
The main markers used to assess the proliferation of keratinocytes in the focus of the psoriasis are the protein Ki67 and keratin six, sixteen and seventeen. It is precisely these markers are responsible expressed by the processes of hyperplasia, disorders of differentiation of cells and development of inflammatory reactions in the dermis.
Because of this, even when it reaches the stage of clinical recovery of psoriasis (disappearance of the inflammation of the epidermis), which can persist in the process of inflammation in the vessels of the dermis.
Also, in the development of inflammation in the focus of the psoriasis to play a role in activated T-lymphocytic cell, mediators of inflammatory reactions, inflammation in the microcirculation bed. In the study of the microflora of the skin in patients with psoriasis identify streptococci, promoters of the development and the intensification of the tear psoriasis.
Immune basis for the development of the pathogenesis of psoriasis is the progression of the cages enabled CD4+ T-lymphocytic cells and cytokines with anti-inflammatory benefits. In favor of this theory is demonstrated by the fact that the monoclonal antibodies in psoriasis, which act against the activated CD4+ T-lymphocytic cells, have a greater therapeutic effect. Also, it is an effective tool for psoriasis are medications aimed at inhibiting the production of tumor necrosis factors.
It is contagious if you psoriasis of the skin to the other
No. Psoriasis is a genetic disease.
It happens the psoriasis from person to person
No. Get psoriasis from one person to another is impossible. Despite the fact that streptococcal infection may be the factor that causes without the genetic predisposition to the onset of the disease, the psoriasis will not occur.
It happens the psoriasis sexually transmitted
No. Psoriasis is not contagious and is not passed on, or the air-leakage, no contact, or sexual, or in any other way.
It happens the psoriasis by inheritance
For the development of psoriasis requires genetic (hereditary) predisposition. Therefore, a common disease in close relatives. If you have psoriasis, the parents, there is a high risk of developing psoriasis and the child.
However, some authors distinguish separately the psoriasis of the second type. It is believed that this option of psoriasis, which develops in patients after forty years of age and affects mainly the joints and nails of the board, is not related with inheritance.
Can you die from psoriasis
No. Psoriasis is not life threatening disease. The prognosis for life of patients favorable.
However, the psoriasis considerably complicates the daily life of the patient, carrying with it the mass of discomfort and reduce social activity.
Also, it should be noted that pustular forms of psoriasis can be very difficult, accompanied by drainage and oozing pustules, with more falling of the skin, type of the lakes". When you do this, it is possible to the development of erythroderma, secondary bacterial complications, injuries of the joints, etc
Factors that can trigger development of psoriasis
Causing factors that contribute to the onset of the complications of psoriasis are:
- the lesion of the epidermis;
- the endocrine system;
- pregnancy;
- the onset of metabolic disorders;
- the use of medications, beta-adrenoblockers, against malaria, see -, etc;
- the presence of foci of chronic infection (particularly streptococcal infection);
- the abuse of alcoholic beverages;
- smoking;
- the excess of heat stroke;
- the consumption of spicy foods, sweets, fats, etc .. of the food;
- acute infectious diseases;
- the exacerbation of allergic diseases;
- the stress, the emotional overload (psoriasis in the nervous system to soil is compounded more frequently).
Classification of psoriasis
Money is distinguished from the form of psoriasis:
- vulgar (ordinary shares in the form of psoriasis);
- exudative;
- inveterate ladonno-plantar;
- warty;
- follicular;
- nails;
- pustular;
The course of the disease may be progressive, fixed in nature.
The prevalence of defeat distinguishes limited, generalized, and disorder of the current.
It may also be noted the seasonality of the acute episodes: winter, summer, and null (not related to the season of exacerbation of psoriasis.
The picture, the symptoms and treatment of psoriasis in adults
For psoriasis characterized by the appearance of pink-red or red papules, covered, silver, color whitish scales, tightening the consistency. Itchy skin may be missing. Many patients notice the appearance of the sensation of tightness of the skin.
Intense itching characteristic, as a general rule, to psoriatic lesions of the skin of the scalp and crotch.
The appearance of pain in the joints, it is pointed out that, in the development of psoriatic arthritis.
The most characteristic feature of the manifestation of psoriasis is the triad of specific symptoms :
- the emergence of the phenomenon of the stearic acid stain (gain peeling at the time of making the diagnosis of psoriatic papules, which makes it similar to the stearic acid gout);
- the emergence of the terminal of the film (the appearance of the most transparent thin film that remains after as if poskablivanii separate all husked);
- the appearance of blood spray or the appearance of a map of the hemorrhage on the place of rejection of the terminal films.
Psoriatic papules can be isolated from nature or merge. The size can vary from the small to the proof of the vast surface of the skin. The most common localization of papules are the elbows, the knees, the head (hairy part) and back.
In rare cases, the plaques can affect the mucosa of the lips and the oral cavity.
Children, the elderly and people who suffer from diabetes, it can develop into a folded form of the disease. In this case, it is surprising the skin behind the ears, in the armpits, groin, gluteal folds, around the navel and under the breasts.
In patients with psoriasis may be missing and broken. The surface of the psoriatic foci can be completely smooth, bright red in color. In some cases, it is possible the appearance of the maceration of the folds.
In some patients the only manifestation of the disease may be the plaque in the skin and the mucous membrane of the genital organs.
As a general rule, psoriatic skin lesions are symmetrical in nature, however some patients may notice unilateral of the precipitation. It is also possible the emergence of forms of psoriatic foci (annular, arcuate, geographical, etc).
In patients with duration flows a disease of long-term existing of the plaque in the skin lumbar and the gluteal region can be accompanied by the appearance in them warty growths.
In addition, the causes of the occurrence of warty forms of psoriasis may be helpful:
- the contrast of the infection of the epidermis;
- incorrect external treatment (usually, self-treatment);
- the excess of weight.
When warty forms of the disease, the scales begin to stick to each other, forming on the surface of platelets yellow gold.
In some patients may occur in isolation flows ladonno-plantar psoriasis. In this case, the patient bother painful cracks, pustules, papules, erythematous-squamous plaque on the palms of the hands and feet.
Frequent manifestation of psoriasis is the defeat of nail plates. In most cases, we observe the appearance of the maps of the cavities in the surface of the nail (dystrophy). Also can appear the deformation of the nail bed, longitudinal and transverse ridges, thickening of the nail plate, the fluffy and the color change, bleeding under the nail plate.
When psoriatic erythroderma, which develops, generally, at the bottom of the stroke excessive or incorrect outside of therapy, expressed swelling of the skin, congestion, itching and desquamation, the fever, the weakness, the violation of appetite. When the heavy weight of the power of the possible onset of anemia, heart failure and renal dysfunction and liver, dehydration occurs, the alopecia areata.
Psoriasis and pregnancy – a threat to the child, the characteristics of the
Psoriasis does not violate the reproductive function, and is not a contraindication for pregnancy. It should be noted that the majority of women during pregnancy, the disease goes it is easier than usual. However, in approximately twenty percent of women could be expressed by the aggravation of the disease.
In general, psoriasis does not hinder the course of the pregnancy is not put at risk the life of a child. However, in patients with arthritis, by increasing the pressure on the joints, can be detected with a significant impairment of state. When generalized forms of pustular psoriasis it is possible the occurrence of complications secondary bacterial.
It should be noted that, given that the psoriasis does not refer to the infectious disease, the mother is free to enter in contact with the baby and breastfeed. The probability of development of the psoriasis of the child in the future is around 15% to 20%, if the sick is only one of the parents and around 50%, and if you are sick of both parents.
The main difficulty in the psoriasis in pregnant patients is that it is contraindicated in the majority of those appointed by the medications. Therefore, when planning pregnancy should alert their primary care physician, so that advance changed the treatment.
The self-categorically is not valid and can cause significant damage in both the mother and the baby (some medications have toxic effects on the fetus).
The diagnosis of the disease
The diagnosis is base-specific symptoms (psoriatic triad). As well as, when appropriate, data histological, immunological, radiological research.