PsoriasisIt is a chronic disease that affects the skin, sometimes nails, joints, and internal organs. It is manifested by itching and the appearance of pinkish-red rashes, papules, which can merge into larger plaques. These papules rise above the surface of the skin. They are covered in silver flakes that easily peel off.
Most often, the disease is combined with impotence, accelerated ejaculation, and Reiter's syndrome. With extensive psoriasis, psoriatic arthritis can occur.
Risk factor's
Causes of psoriasisthey have not yet been fully identified. Risk factors for developing the disease include:
- microbial factor - various types of fungi, mycoplasma;
- neuropsychic trauma, stress;
- endocrine diseases: diabetes mellitus, thyroid disease;
- foci of chronic infection, especially streptococcal;
- immunodeficiency states;
- lipid and protein metabolism disorders;
- skin and joint injuries.
Is psoriasis transmitted?
Psoriasis is not contagious. Many researchers pay attention to the familial nature of psoriasis and acknowledge its genetic nature. In addition, it is not the disease itself that is inherited, but a predisposition to suffer from it.
If you find similar symptoms, see your doctor. Do not self-medicate, it is dangerous for your health!
Symptoms of psoriasis
The first symptoms of psoriasis:skin rash in the form of bright pink patches with a scaly surface. The plates are unique, they rise above the level of healthy skin, they are located on the elbows and in the popliteal recesses.
Psoriatic plaques most often appear on the skin of the knees, elbows, chest, abdomen, back, and scalp, but with disease progression, they can appear in any other, more unexpected place in the integument.
Initially, the papules are small - 3-5 mm, the color is bright pink. Gradually increasing in size, they become covered with silvery scales and merge into larger formations called plates.
The fresh elements of the papules, as a rule, are bright in color, up to red, the "old" ones are more discolored. In the initial stage of psoriasis, the edges of the papules do not peel off. They represent a hyperemic border -growth corolla. . .
The hallmark of psoriasis is the Auspitz triad. This triad can be observed by scraping the surface of the papule with a pointed object. It includes three phenomena:
- stearin stain phenomenon- layers of a large number of silvery-white flakes, which are easily separated when scraped off;
- psoriatic film symptom- exudate surface, made with a spiny layer, which opens after peeling off the lower layers of the stratum corneum;
- blood spray phenomenon- Exposure of superficial capillaries in the form of small blood spots after detachment of the psoriatic film.
Signs of different types of psoriasis.
Clinical types of psoriasis:
- Spotted psoriasis- represented by weakly infiltrated pale pink spots. It looks like toxidermy.
- Irritated psoriasis- occurs due to the exposure of the skin to aggressive environmental factors (sunlight, cold, heat) and irritating drugs. The color of the plaque becomes more intense, increases in size, rises higher above the surface of the skin, a belt forms at the edges in the form of redness.
- Seborrheic psoriasis- often develops in patients with seborrhea. The clinical picture is very similar to seborrheic eczema.
- Exudative psoriasis- happens quite often. It occurs due to the excessive secretion of an inflammatory fluid - the exudate. It impregnates the accumulations of scales, turning them into scale-scabs.
- Psoriasis of palms and soles- is represented by common plaques and papules, or hyperkeratotic formations, similar to corns and calluses.
- Follicular psoriasis- a rare form of the disease. The rash consists of white miliary nodules with a funnel-shaped depression in the center.
- Mucous membrane psoriasis- a rare form of the disease. It occurs in the mucous membrane of the mouth and bladder. It appears as grayish-white areas with a red border.
Frequency of psoriatic manifestations
Cyclical exacerbations are characteristic of psoriasis. Most of the time they occur in the fall and spring.
Pathogenesis of psoriasis
Dermatosis is an inflammatory process associated with the work of immune T cells. As a result of this inflammation, the proliferation of keratinocytes, the main cells of the epidermis, is accelerated.
Psoriasis, a type of dermatosis, is a chronic inflammatory disease. It proceeds with the participation of microbial pathogens that can bind to the surface of the skin.
Everything that happens on the skin under the influence of the pathogen is a classic inflammatory reaction according to the principle of RTCDF:
- Blush - redness;
- Tumor: tubercle, edema;
- Heat - fever, fever;
- Pain pain;
- Functia laesa - dysfunction.
Redness and thickening of the skin at the sites of injury, itching, increased keratinization followed by the formation of scales - all these are manifestations of the inflammatory process, a protective reaction of the body aimed at fighting the microbial pathogen. Without timely outside help, the body is often defeated.
Some scientists adhere to the theory of a genetic predisposition to a violation of the process of cell division. With such a violation, further death and keratinization of cells occurs, followed by their growth and the appearance of a large number of incompletely keratinized epithelial cells. But this theory does not in the least contradict the previous microbial.
Classification and stages of development of psoriasis.
There is no generally accepted classification of psoriasis.
Traditionallythere are four types of disease:
- vulgar psoriasis - seborrheic, follicular, warty, exudative, blistering, psoriasis of the palms and soles, psoriasis of the mucous membranes;
- pustular psoriasis;
- psoriatic erythroderma;
- psoriasic arthritis.
According to the ICD-10, there are:
- L40. 0 Psoriasis vulgaris (plaque and coin psoriasis);
- L40. 1 Generalized pustular psoriasis (impetigo herpetiformis, Tsumbusch's disease);
- L40. 2 Persistent acrodermatitis;
- L40. 3 Palmar and plantar pustulosis;
- L40. 4 Psoriasis tear;
- L40. 5 Arthropathic psoriasis;
- L40. 8 Other psoriasis;
- L40. 9 Psoriasis, unspecified
Complications of psoriasis
Without timely and competent treatment, psoriasis begins to adversely affect vital organs and systems: joints, heart, kidneys, and nervous system. These conditions can lead to disability and even death.
What is psoriatic arthritis?
Psoriatic arthritis is the most serious form of psoriasis, as it often causes disability.
Doctors face this complication more often. It occurs as a result of inflammatory changes in the joints.
The joints of the hands, wrists, feet and knees are the most affected. Over time, the disease can spread to the hip, shoulder, and spine joints. With further progression, the muscles begin to ache near the affected joints. Patients complain of stiffness of movement, especially in the morning. Your body temperature often rises throughout the day.
The clinical picture of psoriatic arthritis develops in the manner of ordinary arthritis: first, there is pain, then swelling, stiffness, and limited mobility. A characteristic symptom of this complication is a sausage finger. It appears due to the defeat of all interphalangeal surfaces.
Other complications of psoriasis
A little less commonpsoriatic erythroderma. . .This condition occurs when the skin is completely affected. Patients are concerned about itching and burning, profuse peeling of dead tissue, a strong reaction of the skin to a change in temperature.
The next most frequent occurrence ispustular psoriasis. . .This complication is associated with the addition of a secondary infection - staphylococci and streptococci. Clinically, pustular psoriasis is accompanied by the appearance of pustules, pustules the size of a buckwheat grain. Pustules appear in different places. They rise above the surface of the skin, are characterized by rapid growth and a tendency to merge. A high fever and signs of severe poisoning are added to the existing symptoms.
Internal organ injurieswith psoriasis are now extremely rare. As a general rule, people who lead an asocial lifestyle are susceptible to them. The genitourinary system is most often affected: the kidneys, the mucous membrane of the bladder and the urethra. This leads to the development of pyelonephritis, glomerulonephritis, cystitis, and urethritis.
On the part of the heart, psoriasis can cause damage to the mitral valves, inflammation of the heart muscle and the outer lining of the heart: myocarditis and pericarditis. With damage to the nervous system, patients complain of a feeling of chills, increased irritability or depression, constant fatigue, drowsiness, and listlessness.
Psoriasis diagnosis
When to see a doctor
It is necessary to consult a doctor at the first symptoms of psoriasis - the appearance on the skin of bright pink plaques with a scaly surface.
Preparing to visit a doctor
Three days before visiting a doctor, you need to stop applying medicinal ointments to the skin. No other special training is required.
Psoriasis is such a recognizable disease that it will not be difficult to diagnose it based on external signs. Often times, patients can be diagnosed, as they say, "out of the box. "If necessary, the doctor scrapes the surface of the skin to detect Auspitz's triad.
OV Terletskiy, Candidate of Medical Sciences, together with co-authors, proposed a diagnostic scheme developed on the basis of data from the American Rheumatological Association. It includes the following exams:
- complete blood count (with platelets);
- general urinalysis;
- blood chemistry;
- acute phase reactions of the body: C-reactive protein and rheumatoid factor;
- immunoglobulins - IgA, IgG, IgM, IgE)
- complement binding reaction with gonococcal and chlamydial antigen;
- the Wright and Heddelson reactions;
- coagulogram: evaluation of blood clotting;
- blood tests for borreliosis and toxoplasmosis (as directed);
- blood test for HLA.
However, there are many diseases under the guise of psoriasis. In this sense, it is necessary to carry outdifferential diagnosis, particularly among papular syphilis, Reiter's syndrome, neurodermatitis, lichen rosacea, systemic lupus erythematosus, and seborrheic eczema. To do this, use:
- biopsy - pinching a piece of skin with subsequent histological examination;
- laboratory diagnosis - often used to distinguish psoriasis from papular syphilis;
- blood tests for other hidden infections for a better selection of antibiotics.
Instrumental diagnostic methodsIt is used primarily for complicated forms of psoriasis associated with joint and internal organ damage. These include: X-rays of the joints, ultrasound of the heart, kidneys and bladder.
Psoriasis treatment
Is there an effective treatment for psoriasis?
Despite the fact that psoriasis is a persistent and recurrent disease, it can be completely eliminated as long as a dermatologist is consulted in a timely manner, who will be able to identify the true causes of psoriasis. During the last decade, many drugs of systemic and local action have appeared, aimed at eliminating the cause and suppressing the mechanism of the development of the disease. Drugs that interact with each other through chemical signals (cytokines) have been shown to be effective. They eliminate the increased proliferation of cutaneous creatinocytes.
Phototherapy
In 1994, the team from the MAPO SPb Department of Dermatovenereology introduced a method of treating psoriasis usingUfo blood- photomodification of blood with ultraviolet light.
The ability of sunlight to have a beneficial effect on the skin for numerous diseases, including psoriasis, has been known since time immemorial. At the beginning of the 20th century, a group of German scientists suggested that since ultraviolet light has a healing effect on exposed skin, this effect is likely to occur when ultraviolet radiation is applied to the blood. After all, this is also a kind of weaving. This assumption was confirmed by the first UV exposure session on blood, which took place in Germany in 1924.
The therapeutic effect of ultraviolet rays in the blood is associated with profound structural changes at the molecular-atomic level, which are captured by immunocompetent organs: the liver, spleen, bone marrow and lymphoid tissue. These changes are considered by the organs as an alarm signal and, therefore, produce tens of times more immune complexes. In this case, ultraviolet light is a kind of "whip" that forces the body to drastically increase its defenses to fight the disease.
Also noteworthy is the PT effect:uncoated ultraviolet therapy. . . This method of treatment is important, given the chronic nature of psoriasis, associated with numerous complications of the internal organs caused by a variety of microbial pathogens. The longer microbes are in the body, the more extensive their habitat becomes. These microscopic creatures increasingly capture anatomical areas through blood and lymphatic flow. Once in the tissues, they strive to penetrate as deeply as possible into the intercellular spaces. There they form microcolonies, protected by the remains of dead and destroyed cells and a leukocyte axis. Because of this, microorganisms can be out of the reach of antibiotics for years. They easily compensate for the lack of nutrients by entering a state of suspended animation, something between life and death.
The ability of ultraviolet rays helps destroy microbial "shelters. "They create favorable conditions for the penetration of antibiotics and other drugs that affect the cause of psoriasis.
The cutaneous application of ultraviolet radiation is also relevant. The most famous treatment method that uses this principle isPUVA therapy. . . Although it is less effective than ultraviolet blood irradiation. The therapeutic effect does not last long, a relapse can occur two weeks after the end of treatment.
Drug treatment
Of the medications, the following have worked well:
- derivatives of vitamin A, which reduce the rate of maturation of keratinocytes and normalize cell differentiation;
- immunosuppressants that reduce the activity of T lymphocytes, which help to increase the division of epidermal cells;
- medicines for the treatment of malignant tumors that inhibit the reproduction and growth of atypical skin cells.
What ointments and creams are effective in treating psoriasis?
Ointments and creams with anti-inflammatory components will help to alleviate the patient's condition.
How to treat scalp psoriasis
Ointments are not effective in treating scalp psoriasis. In addition to medication and UV treatment, a special shampoo can be used.
How to treat psoriasis on elbows and arms
Psoriasis on the elbows and arms is treated with the same methods as the rest of the body. The peculiarity of the course of psoriasis in this area is that the skin of the hands is subject to physical, mechanical and chemical influences, which is considered an aggravating factor in the course of the disease.
Is monoclonal antibody treatment effective for psoriasis?
Monoclonal antibody therapy for psoriasis is very effective. Monoclonal antibody drugs are laboratory-made antibodies similar to those made by human immune cells. Monoclonal antibodies selectively target the targets responsible for the development of the disease.
How to recognize and treat psoriasis in children.
In children, psoriasis often progresses more violently and is disguised as other diseases (eczema, erysipelas, herpes), which complicates the diagnosis. The therapy methods are similar to those of adults: phototherapy, medication, and topical treatment.
What baths to take with psoriasis
Aloe baths can help reduce inflammation and itching.
How to treat psoriasis according to Pegano
The Pegano method of treating psoriasis involves intestinal cleansing, diet, and herbal teas. The effectiveness of this method has not been proven by clinical studies.
Role of nutrition in treatment
Nutrition greatly affects the course of psoriasis. When treating, it is necessary to exclude alcohol, salty, spicy, pickled, nuts, citrus, honey, chocolate and smoked meats.
What sanatoriums show rest for the treatment of psoriasis?
For psoriasis, the spa treatment is preferable to being done at sea in a region with a hot, dry climate and many sunny days. Most suitable for this are the Crimean resorts.
Popular ways
Some home remedies can help reduce itching and flaking of the skin in patients with mild to moderate psoriasis. These methods include:
- cream with aloe extract;
- fish oil applied to the skin with a coated bandage for six hours a day for four weeks;
- cream with Oregon grape extract.
Forecast. Prevention
Psoriasis is not a sentence. If the patient has timely requested qualified help from a specialist who can establish the real causes of the disease and prescribe effective treatment, the disease will be defeated.
The simple form of psoriasis is manifested only by a skin defect. Therefore, the patient does not need special conditions to work. The exception is work in a chemical plant: in this case, stay in the workplace should be excluded.
It is worth remembering that psoriasis can cause complications. Most often, psoriatic arthritis develops. Its severe forms can limit the performance of duties at work and, in the future, lead to complete disability.
The prevention of psoriasis is an integral part of the therapeutic measures to eliminate one of the most serious skin diseases. After recovery, the patient should completely review his lifestyle, eliminate bad habits, pay attention to the treatment of chronic diseases of other organs, adjust nutrition, include walks in the fresh air and sports in the daily routine.
Are they carried with psoriasis in the military?
Severe forms of psoriasis are sufficient grounds to declare a conscript unfit for military service, mild forms of limited suitability.