Psoriasis: what is this disease?

Although psoriasis is a common and well-known disease, it is still not fully understood. And patients often do not know at all that psoriasis is not a bacterial infection or a fungus, but a non-standard reaction of the immune system, triggered by unknown reasons. Information about the causes and symptoms of psoriasis will be of great use to patients, as they will help to overcome the disease.

What is this disease?

Squamous lichen is another name for psoriasis, and this name perfectly describes this disease. Psoriasis is manifested by the formation of inflamed plaques of various sizes on the skin, they are densely covered with thick scales of skin.

Surely, almost everyone has heard of a disease like psoriasis. And this is not surprising, since the squamous lichen is quite widespread. This disease is diagnosed in 4-10% of the world population. In addition, statisticians collecting information on the prevalence of psoriasis argue that the number of patients is steadily growing.

Squamous lichen has been known to people since ancient times, even the healers of ancient Greece tried to treat this disease. The modern history of the study of psoriasis is about 150 years old. But during this fairly substantial period of time, researchers failed to learn enough about the causes and treatment of psoriasis.

Wide prevalence, uncertainty of etiology (causes of appearance), insufficiently effective treatment: all this characterizes psoriasis as one of the most difficult problems in dermatology.

Today, dermatologists consider psoriasis as a complex systemic disease associated with disorders in the immune system, with a malfunction of metabolic processes and the appearance of trophic disorders. These failures cause specific skin changes.

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

• The genetic theory has many supporters, as psoriasis often acts as a hereditary or familial dermatosis. A careful study of the patient's family history in 60-80% confirms 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 the assignment of these cases to a special group, in which the main reason is not genetic, but phenotypic failures.
• The viral theory, according to which psoriasis develops as a result of 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 "elemental bodies" in the cells of the epidermis. According to this theory, psoriasis develops not only when infected with a virus, but also under certain conditions.

There are other theories that explain psoriasis. For example, endocrine, neurogenic, metabolic, etc. Naturally, all these theories are not without foundation, and their study provides more important information on the disease psoriasis. However, today it is already known for sure that the state of the endocrine and nervous systems, as well as the work of the digestive tract, do not cause psoriasis, but have a significant effect 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 greatly reduced. And this, in turn, can lead to the appearance of various skin appearances, including psoriasis.

Pathologies that affect the liver (hepatitis, primary cirrhosis, etc. ) lead to the rebirth of this organ, that is, the liver is gradually replaced by connective tissue. As a result, the liver stops coping with its cleansing functions. Outwardly, this is manifested by the yellowing of the mucous membranes and skin, and the development of skin diseases, including psoriasis, is possible.

There is also an inverse relationship, psoriasis is often accompanied by fatty degeneration that affects the liver. Therefore, in 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 eliminate alcohol completely.

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

International Ranking

The disease of psoriasis manifests itself in various ways. To make it easier for specialists to navigate, a generally accepted psoriasis classification is used.

Psoriasis was added to the International Classification of Diseases (ICD). To date, ten revisions of the International Disease Registry are in use, hence the abbreviation ICD 10 is used. Work began on ten revisions of the International Classifier of Diseases in 1983 and was completed in 1987.

In essence, ICD 10 is a standard assessment tool used in medical and health administration. The Manual in Revision 10 is used to monitor the prevalence of various diseases and other health problems.

Using version 10 of the ICD, it is possible to compare morbidity and mortality data in different countries, which allows obtaining statistical data and systematizing diagnostic information. By agreement of WHO members, ICD 10 is used to assign codes to various diseases. In the tenth version of the classifier, alphanumeric codes are adopted, with the help of which it is convenient to store information in electronic form.

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:

• Ordinary psoriasis(synonyms: vulgar, simple, plaque-shaped). The disease has been 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 on the surface of the unchanged skin, covered with grayish-white scales of skin. This shape is characterized by a slight peeling of the scales. After its removal, the inflamed red skin opens, which is very easily injured and begins to bleed. As the inflammatory process progresses, the plaques can increase significantly in size.
• Inverse psoriasis. It is a disease that affects the skin folds (flexor surfaces). For this form of the disease, the code L83-4 is adopted in ICD 10. Dermatosis appears with the formation of folds in the skin of soft or minimally scaly spots. Deterioration of the condition is seen when the skin is injured by friction. The disease is often complicated by a streptococcal infection or associated fungus.
• Guttate psoriasis. This form of psoriasis is characterized by the formation on the skin of a large number of small red or purple specks, shaped like droplets of water. According to version 10 of the international classifier, this disease received the code L4. Most often, guttate psoriasis affects the skin on the legs, but rashes may appear on other parts of the body. At the same time, it is known about guttate psoriasis that develops as a complication after streptococcal infections - pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasisis ​​a serious skin form, according to ICD 10 it was assigned the codes L1-3 and L 40. 82. It is characterized by the formation of blisters or pustules. The skin of the lesions is edematous, reddened, inflamed, and peels off easily. If fungi or bacteria penetrate the pustules, the contents of the pustules become purulent. Pustular psoriasis often affects the distal extremities, but in the most severe cases, a generalized process can develop with rashes spreading throughout the body.
• Psoriatic arthritis or arthropathic psoriasis. According to version 10 of the ICD pathology, code L5 was assigned. It manifests itself by inflammation of the joints. Arthropathic psoriasis can affect all types of joints, but in most cases the joints of the phalanges of the fingers and toes become inflamed. The knee, hip, or shoulder joints can be affected. The injuries can be so severe that they will result in the patient's disability. Therefore, you should not think of psoriasis as an exclusively skin disease. Severe types of psoriasis can cause systemic damage, disability, or even death.

• 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 way, all or almost the entire surface of the skin can enter the affected area. The disease is accompanied by severe itching, swelling, and pain.
• Psoriatic onychodystrophy or psoriasis of the nails. According to version 10 of the ICD, the disease was assigned the code L86. The pathology is manifested by changes in the appearance of the nails of the fingers and toes. Nails can change color, thicken, and begin to deteriorate. Complete loss of nails is possible.

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

• localized psoriasis is a disease in which less than 20% of the skin is affected;
• generalized psoriasis affects more than 20% of the body surface;
• if almost the entire surface of the skin is affected, we are talking about universal psoriasis.

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

Flow Stages

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

The following is characteristic of the progressive stage of psoriasis:

• the appearance of new eruptions;
• growth of existing plates;
• the appearance of new elements of the rash at the site of skin lesions (scratches, abrasions);
• abundant peeling of existing plaques.

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

• no new items appear;

• moderate detachment of elements;
• no signs of item growth.

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

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

• decreased intensity of peeling;
• element resolution.

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

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

• winter (aggravated in autumn and winter);
• summer (with exacerbations during the warm period);
• Out-of-season psoriasis is the most serious type, since there is no clear connection between relapses and the seasons of the year, periods of remission can be practically absent.

Diagnostic functions

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

For example, nail psoriasis is often mistaken for nail fungus, as the external manifestations at an early stage of these diseases are very similar. However, nail fungus and psoriasis are completely different in nature, so the treatment should be different.

A layman may mistake psoriasis and fungi for fungi. Since skin mycoses (skin fungi) are manifested by similar symptoms - the formation of scaly plaques. Therefore, if you notice suspicious symptoms on your body or nails, you don't need to get diagnosed and read on to treat the fungus with pharmaceutical or home remedies.

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

When contacting a dermatologist, a fungal analysis will be performed, a scraping of the nail or skin will be taken. Then the resulting material is placed in a nutrient medium. If the fungus is present in the material, a large colony will grow in the test sample after a few days. By the appearance of the material, it will be possible to understand what kind of fungus caused the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, it can be a bacterial infection or a fungus. Therefore, when the clinical picture changes (appearance of purulent discharge, discoloration of plaques, etc. ), patients should undergo regular tests 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, by scraping the element of the eruption.

The psoriatic triad looks like this:

• by scraping the eruption element, the scales are removed in the form of "chips";
• After removing the chips, a thin transparent film similar to polyethylene opens;
• when the film is damaged, a point bleed opens.

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

Interesting Facts About Psoriasis

People have known psoriasis for a long time. Even the very name of the disease came to our language from ancient Greek. At the time of the prosperity of ancient Hellas, the word "psora" meant all skin diseases manifested by flaking and itching.

The first person to write a detailed treatise on psoriasis was a Roman named Cornelius Celz. In the fifth volume of his work "De Medicina" there is an extensive chapter on this disease.

They knew about psoriasis, but this disease was not unequivocally evaluated, as it was called, sometimes "imperial" and then "diabolical" disease.

Of course, ancient healers knew very little about psoriasis. Until the 19th century, this disease was often mixed with other skin ailments. For the first time, psoriasis was identified as an independent nosological form in 1799. This was done by the English dermatologist Robert Villan, who distinguished psoriasis from a large group of skin diseases, which are manifested by itching and scaling.

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

Modern understanding of disease

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

Here are some facts about psoriasis that are beyond question:

• despite the fact that the causes of the disease are not clear, it was possible 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 inherited. However, this is not always the case, even if both parents are sick, the risk of developing the disease in their child is 65%. At the same time, some patients develop psoriasis, although none of their relatives is ill;
• An interesting fact about psoriasis is that this disease is characterized by Kebner's phenomenon. This phenomenon is manifested in the fact that the elements of the rash are formed at the sites of skin lesions: scratches, burns, frostbite. Sometimes psoriasis appears after a while, at the site of the scars;
• An important observation that allows to obtain more information on psoriasis is the relation of this disease with climatic factors. Exacerbations and relapses are often timed to coincide with the change of season;
• Patients have probably noticed the connection between exacerbations and stress in practice. All patients must know with certainty that the disease reappears or worsens its course in a context of tension and nervous experiences;
• A new fact about psoriasis is that the disease can debut at any age, although it was previously believed that lichen squamous appears after the age of 30;
• It is important for all people to know that psoriasis is not a contagious disease. Even with close contact with the patient, there is no risk of infection;
• Almost everyone has heard of the incurability of psoriasis, and this is true, as no cure has been found that will surely defeat the disease. But patients should be aware of the fact that psoriasis can be controlled. Proper and timely treatment allows for a long-term remission.

Modern treatment methods

Speaking of the common disease of psoriasis, one cannot stop talking 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 about the manifestations of psoriasis for a long time, the patient, in close collaboration with the doctor, will have to make an effort. It will be necessary to organize the food properly. Some experts argue that you can forget about psoriasis forever only with the help of a properly composed diet and regular cleansing of the body.

The doctor will draw up a preliminary scheme for the treatment. 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 is 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 that live in hot springs. These little healers effectively remove dead skin scales and disinfect the skin, promoting its faster healing.

Spas may offer other treatments for scaly lichen. For example, leech therapy, baths and healing applications, solar therapy, etc.

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

Popular psoriasis treatments 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 you are in doubt about a recipe or recommendation, it is best not to use it. Consult a doctor before using any treatment method.

You must understand that it will be possible to forget about psoriasis forever only if the patient and their immediate surroundings are positively tuned in. Only faith in success and an optimistic attitude will help to overcome this mysterious and insidious disease.