Psoriasis is a common non-contagious skin disease that is associated with inflammatory lesions. It is chronic (the acute period is followed by periods of relief or disappearance of symptoms) and is caused by a combination of several factors.
The disease is widespread and occurs more frequently in women than in men. It is not completely cured, but it is possible to alleviate the symptoms and improve the quality of life of the patient.
Psoriasis can lead to arthritis, an inflammation of the joints.
Russian Synonyms
Squamous lichen.
Synonyms in English
Psoriasis
Symptoms
The symptoms and signs of psoriasis depend on the type of psoriasis.
- Plaque psoriasis. It is accompanied by specific inflammatory skin formations: raised reddened lesions, oval, markedly delineated, scaly and covered with silver scales. Most often, the formations appear on the outer surface of the elbows, knees, scalp and trunk. The elements of a skin rash can be painful and itchy. In severe cases, the skin near the joints of the affected areas cracks and bleeds.
- Guttate psoriasis. This type is associated with the appearance on the body of numerous pink-orange papules (nodules), 1 to 10 mm in size. The rash usually appears on the torso, shoulders, and thighs, but can be found all over the body. As a rule, it affects people under 30 years of age, as well as 2-3 weeks after suffering from infectious diseases of the upper respiratory tract, after superficial bacterial infections in the anus.
- Nail psoriasis. It is characterized by compaction, exfoliation, discoloration of the nail plates, discoloration, yellowing of the nails, presence of spots on them, formation of holes, cracks, damage to the nails. Nail plates are destroyed, nail growth is disturbed, they can be separated from the nail bed. It occurs in 30-50% of psoriasis patients.
- Large-fold psoriasis. In this case, skin lesions in the form of inflammatory red spots appear in the area of the armpit folds, under the mammary glands, in the cervical folds, in the genital area, on the foreskin. Cracks may appear along the edges and in the center of the lesions. Most often, large-fold psoriasis occurs in people who are overweight and obese. Sweating and friction make the disease worse.
- Head psoriasis. It is accompanied by redness of the scalp, itching, flaking of the scalp with the appearance of white scales on the hair and shoulders, dead skin particles.
- Psoriasic arthritis. Skin lesions are accompanied by joint pain, swelling, curvature and deformation of the joints. The joints of the fingers, wrists, feet and knees can be affected.
- Pustular psoriasis. This type is characterized by redness of the skin and the formation of a large number of pustules - small blisters filled with pus. The formations can appear on the palms of the hands and feet or all over the body. When multiple pustules appear on the body, fever and weakness join.
- Psoriatic erythroderma. Skin areas become red, plaques may appear. The lesions are often accompanied by intense itching. Most often, psoriatic erythroderma is associated with sunburn or drug misuse.
Usually with different types of psoriasis, the disease manifests itself gradually, skin lesions spread and are observed for several weeks. Then the symptoms disappear. After exposure to a factor that contributes to the development of psoriasis (or spontaneously), symptoms reappear after a while.
General information about the disease.
Psoriasis is a common non-contagious skin disease that is associated with inflammatory lesions.
It is chronic and often recurs: the acute period is followed by periods of weakening or disappearance of symptoms, then after a while the symptoms reappear.
Psoriasis is widespread, especially among people 16-22 years old, 57-60 years old. Women are more susceptible than men. Fair-skinned people are at higher risk of developing the disease.
Even though psoriasis is synonymous with squamous lichen, it is not contagious to others.
The causes of psoriasis have not yet been fully established. Its appearance is associated with a genetic predisposition, dysfunctions of the immune system and environmental factors that affect the body.
The development of psoriasis is associated with one of the types of cells of the immune system (with T lymphocytes), while hyperactivity of T cells is observed. Normally, they travel with the blood throughout the body, detecting foreign agents: viruses and bacteria. In psoriasis, for unknown reasons, T cells begin to accumulate in the skin. Its hyperactivity causes the expansion of blood vessels in the affected area, interrupts the cycle of formation of new skin cells; they form much faster than usual. Dead skin cells, meanwhile, do not have time to exfoliate and accumulate on the skin's surface, forming plaques.
Psoriasis can be triggered by one of the following factors:
- infections (tonsillitis, thrush, HIV);
- skin damage: cut, scratch, bite, or burn;
- hypothermia;
- Sun tanning;
- emotional stress;
- smoking, alcohol abuse;
- the use of medications (antimalarials, etc. ).
At the same time, in some patients with psoriasis, rashes appear without an obvious influence of environmental factors.
There are the following main types of psoriasis.
- Plaque psoriasis. It is the most common.
- Guttate psoriasis. It usually affects people under 30 years of age. It occurs 2-3 weeks after infectious diseases transferred from the upper respiratory tract, as well as after superficial bacterial infections in the area around the anus.
- Nail psoriasis.
- Psoriasic arthritis. In this type of psoriasis, the skin lesions are accompanied by arthritis, that is, inflammation of the joints.
- Psoriatic erythroderma. Most of the time it is associated with sunburn and drug misuse.
- Pustular psoriasis. It is quite rare, in severe cases, it threatens the life of the patient.
- Head psoriasis. In this case, hair loss caused by the disease does not usually occur, since the roots of the hair are much deeper than the scaly formations.
Classification of psoriasis according to the severity of the course:
- smooth (less than 2% of all skin is affected);
- moderate (skin lesions occupy no more than 3-10% of the skin surface);
- severe psoriasis (more than 10% of the skin is affected).
Depending on the type, location, and extent, psoriasis can cause complications:
- thickening of the skin, the addition of a secondary infection from scratching and scratches that appeared due to itching with psoriasis;
- psychological problems (stress, low self-esteem, depression, social self-isolation);
- joint damage (deformity with stiffness and decreased joint mobility);
- increased risk of developing various diseases and conditions: high blood pressure, inflammatory bowel disease, cardiovascular disease, skin cancer.
Psoriasis is usually relatively mild. However, for most patients, social adaptation becomes the main problem, especially in the presence of skin lesions in visible areas of the skin: the hostility of others towards the type of skin lesions, their fear of becoming infected ( many do not know that the disease is not contagious).
Who is at risk?
- People with a hereditary predisposition (more than 40% of psoriasis patients have a relative with psoriasis).
- People with viral, bacterial, fungal infections (streptococci, thrush, HIV, etc. ).
- Emotionally stressed.
- Obese and overweight people.
- Smokers
- Alcohol abusers.
- Taking certain medications (antimalarial drugs, etc. ).
- Burned by the Sun.
Diagnostics
The diagnosis of psoriasis is usually based on the typical type of lesion, taking into account its location. In difficult cases, additional tests may be required to rule out other skin conditions.
Laboratory research
- General blood test. With psoriasis, leukocytosis and anemia can be detected.
- Rheumatoid factor (RF) is a protein, the level of which in the blood may increase in systemic inflammatory diseases accompanied by joint damage, especially rheumatoid arthritis. The psoriasis test result is negative. This allows you to distinguish psoriasis from rheumatoid arthritis, in which the RF is increased.
- The erythrocyte sedimentation rate (ESR) is generally normal, with the exception of pustular psoriasis and psoriatic erythroderma.
- Uric acid. Uric acid levels in psoriasis can be elevated (especially in pustular psoriasis), causing psoriatic arthritis to be confused with gout, in which the uric acid concentration increases significantly.
- Antibodies to HIV (human immunodeficiency virus). The sudden onset of psoriasis may be due to an HIV infection.
Other research methods
- X-ray of the joints. It allows you to assess the severity of joint damage in psoriatic arthritis.
- Skin biopsy. The test involves taking a small sample of skin for later examination under a microscope. It is carried out in difficult cases to distinguish psoriasis from other skin diseases.
Treatment
Therapy for psoriasis includes local treatment of skin lesions, medication, phototherapy, prevention of exposure to factors that provoke the appearance of rashes. It depends on the type and severity of psoriasis.
To get rid of skin lesions, emollients (creams, petroleum jelly, paraffin, vegetable oils) can be used. They are most effective when used twice a day after showering. Also used are salicylic acid, anthralin, tar preparations, ointments, solutions, shampoos containing coal tar. These agents are anti-inflammatory and slow the formation of new skin cells.
Using corticosteroid ointments makes treatment more effective. They are indicated for mild to moderate psoriasis. However, its long-term use is not recommended (skin atrophy, drug addiction is possible).
Phototherapy (exposure of the skin to ultraviolet radiation) can be beneficial. In this case, burns should be avoided.
Local treatment of lesions in more severe cases is combined with the intake of drugs: retinoids, vitamin D preparations, methotrexate, etc.
Treating psoriasis can be difficult, as the disease is chronic and returns after symptoms disappear. The effectiveness of a particular treatment method depends on the susceptibility of the patient.
Daily baths (bath oil, oatmeal, or sea salt recommended; hot water and scrubs should be avoided) and post-bath hydration can help soften the skin and reduce psoriasis inflammation.
Prevention
- Avoid hypothermia, sunburn.
- Avoid emotional stress whenever possible.
- Stop smoking and abusing alcohol.
- Take certain medications (antimalarials, etc. ) with caution.
Recommended analysis
- General blood test
- Erythrocyte sedimentation rate (ESR)
- Rheumatoid factor
- Serum uric acid
- HIV 1, 2 Ag / Ab Combo (determination of antibodies against HIV types 1 and 2 and p24 antigen)