Psoriasis is a chronic skin disease of non-infectious origin. According to statistics, 3, 7% of the world's population suffers from psoriasis. People call the disease "scaly lichen".
Psoriasis is not sex-dependent, it is not contagious; most often develops at the age of 14-27 years. The disease is characterized by the appearance of red scales in the form of plaque (spot) covered with white scales. A spot (or several spots) can be found on any part of the body, but most often in places with thin and dry skin: elbows, knees, waist, scalp.
The spots are of different sizes and disturb in different ways: in some patients only skin irritation is observed; in other patients large areas of the skin are affected, which is accompanied by discomfort, itching, pain, insomnia and deterioration of quality of life.
Psoriasis is a chronic disease characterized by periods of exacerbation (rash) and remission (weakening of symptoms).
Psoriasis often complicates pregnancy.
Causes of psoriasis
Psoriasis is a systemic process that affects not only the skin but also the whole body. The causes of psoriasis are not fully understood, but it is assumed that there are several: neurogenic (due to stress), hereditary, infectious, viral, mixed (damage to the skin with the penetration of staphylococci in combination with any of the above causes), etc. n. In this case, cellular and humoral immunity is activated and an autoimmune process of cell damage is activated, mainly skin cells (epidermis).
In addition to activating immunity, metabolism is disrupted. The disease is aggravated by burdened heredity. As a result, the renewal (regeneration) of cells is accelerated 3-5 times - psoriatic plaques form on the skin.
Without timely treatment, the lesion worsens: skin spots grow, crack, fester; nails are destroyed, joints are affected, etc.
The quality of life of a patient with psoriasis depends on up to 80% of timely diagnosis and proper treatment.
Once again, we list the factors that contribute to the onset of the disease:
- bad heredity. Scientists have identified 9 genes that determine the development of the disease, but their interaction is not clear. It has been found that in 15% of cases psoriasis is inherited from relatives of the 1st and 2nd generation;
- stress, nervous tension, depression. Stress has been shown to provoke an exacerbation of psoriasis in 70% of cases;
- hormonal imbalance;
- dysbiosis;
- metabolic disorders, drug addiction;
- colitis and parasitic infections (roundworms, giardia, intestinal infections, etc. );
- viral infections;
- streptoderma; candidiasis of the skin;
- allergies.
Symptoms of psoriasis
In the initial stage, skin rashes in psoriasis are in the form of red plaques (spots) with scaly scales. The appearance of skin plaque is accompanied by severe itching. Under the scales is a thicker (keratinous) layer.
Here are the 6 main forms of psoriasis; everyone has their own symptoms:
Plaque psoriasis occurs in 85% of patients. It is characterized by dry, pink rashes raised above the skin, covered with silvery scales. The skin in the affected areas often exfoliates; in this place remain red spots, bleeding during trauma. In 60% of cases, the plaques merge into large plates.
Guttate psoriasis is characterized by numerous small, dry lesions in the form of pink droplets raised above the surface of the skin. The rash is localized on the thighs, legs, affecting large areas of the body. In 60% of cases, guttate psoriasis worsens after streptococcal infection.
Pustular psoriasis can be recognized by skin blisters filled with clear fluid. The blisters are surrounded by red, swollen, flaky skin. Legs and thighs are more often affected.
Psoriasis of the flexor surfaces manifests itself in the form of smooth, non-peeling red spots that are located in the area of skin folds: the lateral surface of the thighs, armpits and the area of the external genitalia. Due to mechanical irritation (physiological friction) the spots are injured, bleed and fester.
Nail psoriasis is manifested by discoloration, the appearance of spots and transverse lines on the nails. The skin around the lesion is hardened. As the disease progresses, the nail becomes exfoliated, thickened, and then dries or falls off.
Psoriatic arthritis (15% of cases). All kinds of joints are affected, but more often the small ones - the phalanges of the arms and legs. The fingers become like sausages. Psoriasis of the joints leads to bursitis, a person's disability.
Let's talk separately about the lesions of the head and elbows.
Scalp psoriasis (mostly scalp) is the most common form of the disease. It is more common at a young age. Manifested as red scaly patches that itch and itch. Redness is almost always noticeable, therefore it causes emotional discomfort and leads to social isolation of a person.
Elbow psoriasis is a disease of middle-aged people. It manifests itself in the form of rashes on the extensor surfaces of the elbow joints. The rash spreads outwards and merges - a large plaque (plaque) is formed, covered with silvery, easily falling scales. Along with the scales, a thin protective film is released, exposing the bleeding surface. In 80% of cases, the spots go away on their own, without treatment, but sometimes thicken (age) and persist for years, provoking psoriatic lesions of the elbow joint.
Diagnosis of psoriasis
The diagnosis and treatment of psoriasis is performed by a dermatovenerologist.
Due to the characteristic skin lesions, the diagnosis of psoriasis is clear. A general blood test and determination of rheumatoid factor are used as additional laboratory tests. To diagnose psoriatic arthritis, a consultation with a rheumatologist and an X-ray of the affected joints are indicated. In rare cases, a skin biopsy is performed for a differential diagnosis.
Psoriasis should be distinguished from similar skin diseases: seborrhea, lupus and others.
Treatment of psoriasis
Psoriasis is a chronic disease with periods of exacerbation (recurrence of skin rashes) and remission (disappearance of rashes). It is impossible to recover from psoriasis forever. You can prolong remission and reduce the intensity of exacerbations.
In only 40% of cases is it possible to find an effective treatment immediately. Sometimes it takes months and years. Therefore, psoriasis is treated at home, except for severe exacerbations and complications. The effectiveness of treatment is influenced by the type of psoriasis, age, comorbidities and more. In mild psoriasis, topical preparations are prescribed: ointments and creams based on:
- glucocorticosteroids;
- zinc;
- tar;
- salicylic acid;
- vitamin D3.
In severe cases of psoriasis (25% of the skin surface is affected, joint damage) and in case of ineffectiveness of local treatment, complex therapy is prescribed:
- cytostatics that inhibit epidermal cell division;
- immunomodulators that normalize immune responses;
- glucocorticosteroids, which regulate metabolic processes and reduce inflammation;
- non-steroidal anti-inflammatory drugs (to reduce itchy skin);
- multivitamins.
Physiotherapy is prescribed: ultraviolet radiation, cryotherapy, plasmapheresis, hirudotherapy. Folk remedies are also used: ointments based on celandine and lard, meadow and Vaseline, beeswax and lard. To normalize immunity, they drink homemade oat yeast, bay leaf tincture and fennel decoction.
Diet, especially in the exacerbation of psoriasis, plays an important role. Spicy and sweet dishes are excluded from the diet. Fast food and alcohol are prohibited. The diet should be balanced, rich in vitamins and minerals.
To avoid exacerbations of psoriasis, you need to improve your health, avoid stress, hypothermia and seasonal illnesses.
Here are simple rules to prevent exacerbations of psoriasis:
- do not dry the skin;
- avoid prolonged sun exposure;
- avoid skin injuries;
- avoid stress;
- do not smoke or abuse alcohol.
Is psoriasis contagious?
There is no proven case of transmission of psoriasis from a patient through household or other contact. Therefore, psoriasis is not thought to be contagious.
Which doctor to go to
To start timely treatment and avoid the spread of psoriasis, consult a dermatologist. In the presence of psoriatic arthritis, consultation with a rheumatologist is indicated.