Psoriasis or scaly ringwormIt is a chronic disease that affects the skin and its appendages: nails and hair. It is characterized by periods of deterioration (relapses) and temporary well-being, when the manifestations of the disease become less. This disease is not contagious and the patient is not dangerous to others. Because the appearance of psoriasis is not associated with microorganisms.
Psoriasis most often occurs between the ages of 15 and 45. Light-skinned people are more prone to this. In developed countries, the number of patients with psoriasis reaches 2-4% of the population. Every 25th inhabitant of the earth on all continents suffers from it.
A huge number of medical institutions are dealing with this problem. Therefore, psoriasis is recognized as the most studied disease. However, this disease is not fully understood. It is officially considered incurable and raises many questions.
Psoriasis is caused by the body's own immune cells. They rise from the lower layers of the skin to the upper, causing inflammation, proliferation of epidermal cells and the formation of small capillaries.
The manifestations of psoriasis on the skin are quite diverse. Most often the disease causes the appearance of red spots - psoriatic plaques. They are dry to the touch, rise above the surface of the skin and are covered with a white coating.
Types of psoriasis
The disease is divided into two major groups: pustular and non-pustular psoriasis.
Non-pustular psoriasis
- common (vulgar) or simple psoriasis (squamous psoriasis, chronic stable psoriasis)
- psoriatic erythroderma or erythrodermic psoriasis
Pustular psoriasis
- pustular psoriasis of von Zumbusch or generalized pustular psoriasis
- palmoplantar psoriasis (pustular psoriasis of the limbs, chronic persistent palmoplantar pustulosis)
- annular pustular psoriasis
- palmoplantar psoriasis
- herpetiformis psoriatic impetigo
In addition, these types of psoriasis are distinguished.
- seborrheic psoriasis
- psoriasis of the flexor surfaces and skin folds
- Napkin psoriasis
- drug-induced psoriasis
According to the severity, such forms of psoriasis are distinguished.
- Cure - less than 3% of the skin is affected.
- Moderate - 3-10% of the skin is covered with psoriatic plaques.
- Severe - has joint lesions or affects more than 10% of the skin.
Causes of psoriasis
To date, there is no clear answer to the question: "Why does psoriasis occur? " Scientists put forward several theories.
- Psoriasis is an autoimmune disease. It is based on a malfunction of the immune system. The immune cells of T-killers and T-helpers, whose function is to protect the body from viruses, bacteria and tumor cells, for some reason penetrate the upper layers of the skin. Here they produce inflammatory mediators - substances that "trigger" the inflammatory response. This leads to increased division of skin cells and their proliferation (proliferation).
- Psoriasis is a disease caused by impaired growth, division and maturation of epithelial cells - keratinocytes. The result of such changes in the skin is an attack by immune cells of T-lymphocytes and macrophages on diseased skin cells.
Factors that contribute to the development of psoriasis
Doctors note a number of factors that can cause the disease. Of course, psoriasis most often occurs if several of these conditions affect the body at once.
- Hereditary predisposition.There is a version that the genes responsible for the immune system and T-lymphocyte function are carriers of the disease. Therefore, parents who suffer from psoriasis are more likely to have children with the same symptoms.
- Thin dry skin. . . It has been noted that people with such skin characteristics get sick more often than those with oily and well-hydrated skin. This is probably due to the protective functions of sebum and the structural features of the skin.
- External irritants. . . A high percentage of patients are among those people who are constantly in contact with alcoholic solutions, solvents, household chemicals, cosmetics (lotions, hand creams).
- Excessive hygiene- Excessive love of cleanliness also undermines the protective properties of the skin. Soaps, shower gels and towels wash away the natural protective barrier and leave behind microscopic injuries.
- Bad habits- Addiction to alcohol, smoking and drugs is harmful to the skin. Her nutrition and blood supply are deteriorating.
- HIV- AIDS patients are more susceptible to psoriasis. Scientists cannot explain this phenomenon. The fact is that psoriasis is caused by increased activity of lymphocytes, and in AIDS their number decreases.
- Medications- taking certain medicines can provoke illness. Among them: beta-blockers, antidepressants, anticonvulsants and antimalarial drugs, lithium carbonate.
- Infections (fungi and staphylococci). . . Quite often there are cases when psoriasis occurs immediately after fungal infections or diseases caused by streptococcus.
- Moving- Climate change or even the season of the year, environmental degradation may be the cause of this disease.
- Stress- Strong emotional upheavals or physical stress (prolonged periods of hypothermia, overheating, accidents) precede the onset of the first symptoms of psoriasis.
- Trauma- permanent effects on the skin: pressure, friction, scratching. Such regular trauma can lead to the appearance of the first psoriatic plaques at this site.
- Allergic conditions- Allergic skin rashes and the processes that occur in this case, in all layers of the skin, also increase the risk of disease.
What are the symptoms and signs of psoriasis?
Psoriasis is a systemic disease that affects more than just the skin and nails. It affects the joints, tendons and spine, immune, nervous and endocrine systems.
However, the main manifestations of the disease appear on the skin. The name squamous lichen quite accurately conveys the symptoms of psoriasis. The first manifestations are often pink or bright red papules with a regular rounded shape, covered with scales - psoriatic plaques. They are located symmetrically, mainly on the extensor surfaces, waist and scalp. But they can affect any part of the skin and genital mucosa. Their size is from a few millimeters, in the initial stages, to ten centimeters or more.
Depending on the characteristics of the rash, suchforms of psoriasis:
- Pitting psoriasis - the size of the elements is smaller than the head of a pin.
- Guttate psoriasis - the papules are teardrop-shaped and reach the size of a lentil.
- Coin psoriasis - plaques grow up to 3-5 mm and have rounded edges.
They also distinguish the shapes of the rash, when its elements are in the form of rings, arcs and garlands, maps with uneven edges.
The papules are covered with a scaly coating that can be easily removed. It consists of keratinized cells of the epidermis. The psoriatic plaques begin to flake off from the center, after which the plaque spreads to the edges. Its loose and light appearance is due to the fact that keratinized cells are impregnated with spaces filled with air. A pink ring may form around the elements - this is an area of inflammation, an area of plaque growth. The skin around the elements of the rash does not change.
Scalp psoriasisis a psoriatic plaque that rises significantly above the surrounding skin. They are densely covered with dandruff-like scales. In this case, the hair remains intact. Rash can appear not only under the hair, but also on smooth skin, on the neck and behind the ears. Such changes are explained by the active division of keratinocytes in the affected areas.
Psoriasis of the feet and palmscauses severe thickening of the stratum corneum in these areas of the body. The skin becomes thick, rough. Cracks often penetrate it. This is caused by intense cell division, which multiplies 8 times faster than normal, but is not removed in time from the surface of the skin.
Nail psoriasisdiffers in different symptoms. But the most important are two main types of nail plate damage:
- By the type of "thimble". Small holes, similar to needle marks, form on the nail plate.
- By type of onychomycosis. The lesions look like nail fungus. Nails thicken, change color, peel. A psoriatic papule surrounded by a red border can be seen through the nail plate. It looks like an oily stain that shines through the nail.
The symptoms and signs of psoriasis depend on the stage of the disease, which change cyclically throughout the year. So most patients have a "winter" type of disease, when exacerbation occurs during the autumn-winter period. The improvement of the condition in the summer is due to the fact that ultraviolet light in the sun has a therapeutic effect. But some patients suffer from the "summer" type.
There are the following stages in the course of psoriasis:
- progressive - the appearance of new elements, the active growth of existing plaques, the implicitness of the pink zone of growth around them, intense peeling and itching.
- stationary - stopping the growth of papules, lack of new rashes, fine folding of the upper layer of skin around psoriatic plaques.
- regressive - the lack of peeling, the disappearance of plaques and the appearance in their place of areas of pigmentation, indicate a weakening of the process.
What do skin rashes look like in psoriasis?
Each organism is individual and reacts differently to the disease. Therefore, the nature of the rash can be very diverse. This explains the variety of forms and types of psoriasis.
However, for most people, the symptoms of psoriasis are similar. These are red spots - psoriatic plaques, rising 1-3 mm above the level of healthy skin. Their appearance is due to the fact that the cells of the surface layer of the skin - keratinocytes, divide very actively, without having time to mature and become full-fledged epithelial cells. As a result of this enhanced pathological growth, certain areas of the skin thicken. This is due to the fact that immune cells secrete chemicals that cause inflammation in the skin.
The top of the plates can be covered with a gray, silver or yellowish color that resembles paraffin. That's why they got the name - "paraffin lakes". These are keratinized epithelial cells whose rejection is impaired and they accumulate on the surface of the affected area of skin.
The spots are flaky, hotter than the rest of the skin and can grow to a large size. Often the patient feels severe itching in this area. This is due to the fact that against the background of the inflammatory process occurs a cascade of neuro-reflex reactions and allergic reactions.
Another type of element is the papules. These are small elements of a rash that look like a tubercle. The size is about 1 mm. There is no cavity in the middle full of content. They are often found on the knee and elbow joints. They remain even in periods when the disease subsides.
During exacerbations, the elements of the rash gradually increase in width and merge with neighboring plaques. During periods of improvement (remission) the spots begin to lighten from the middle. They gradually acquire the shape of a ring and can completely dissolve. After the plaques on the body remains a trace - pigmentation. It can be significantly lighter or darker than the surrounding skin. Once a person gets a tan, skin tone usually evens out.
What do nail lesions in psoriasis look like?
Nail psoriasis is similar to a fungal infection of the nail plate. For a correct diagnosis it is necessary to conduct a laboratory analysis. The changes can affect only one nail or all at once and are very diverse. They occur in 10-15% of patients. Nail damage is often accompanied by joint pain caused by psoriasis. In this case, there may be no skin rash.
Nail psoriasis has several stages:
- depressed points - thimble nail
- longitudinal concave channels
- transverse compression in the center of the nail, these first signs are associated with damage to the root of the nail - the nail matrix
- "Oily spots" pink spots of irregular shape that appear through the nail - this is the accumulation of serous fluid under the nail
- the nail becomes dull, cloudy, yellow and thickened due to circulatory disorders
- the nail plate acquires the appearance of a bird's claw, which is accompanied by pain. This is due to the fact that the process captures the nerve endings.
The nail lesions start from the edge and gradually move to the root, covering the entire surface. Disorders of microcirculation cause clouding of the nail and change in its color from yellow to bluish.
If you find such symptoms in yourself, do not diagnose yourself. Such changes can be caused by other reasons: fungus, trauma and impaired blood supply.
Is psoriasis contagious?
This question is often asked by those who have just been diagnosed with the disease and by acquaintances of the patient. Scientists give an unequivocal answer to this. Psoriasis is not contagious and a sick person is absolutely safe for others. This is because psoriasis is not caused by a virus or bacteria, but by aggressive white blood cells. These own immune cells, for unknown reasons, attack skin cells, causing inflammation of the skin. The result of this process are rashes and thickening of the skin in places (psoriatic plaques).
How is psoriasis treated?
The treatment of psoriasis depends on the form and stage of the disease and the sensitivity to drugs. Traditional medicine focuses on the use of medicines. Treatment begins with topical preparations that act on the affected skin. In this way, they try to avoid the side effects that occur when taking drugs by mouth. More details on the use of local remedies will be described below. Now let's focus on the pills and capsules.
There is a technique in which the patient is first offered more gentle medications with the least number of side effects. If they are not effective, they are replaced by more powerful ones, etc. Even when the treatment is appropriate for the patient, after a while it is changed. The fact is that the body gradually gets used to the drug and its effect decreases.
Oral systemic drugs are very effective. They are prescribed for moderate and severe stages of the disease. They help even those patients in whom treatment with other means has not given a positive result. However, they have significant disadvantages: they can cause serious side effects and after the removal of these funds the condition worsens again.
| A group of drugs | Dosage form and effect of the drug on the body |
| Retinoids - derivatives of vitamin A. | Affects the maturation of the surface layer of the skin and eliminates disorders in this process caused by psoriasis. Form of release - capsules. Dosage according to the scheme, depending on the stage, 30-75 mg / day. Reduces the rate of keratinocyte division, promotes normal maturation and differentiation of cells. Available in capsules. The daily dose is 25-50 mg. |
| Immunosuppressants - drugs that reduce the activity of the immune system | Reduces the activity of T-lymphocytes, which cause increased division of skin cells. Sterile solution in ampoules. The starting dose when administered intravenously is 3-5 mg / kg per day, for oral administration - 10-15 mg / kg per day. |
| Drugs for the treatment of malignant neoplasms (cytostatics) | Inhibits excess growth and reproduction of atypical epidermal cells. Available in tablets. Prescribe 2, 5-5, 0 mg orally, 2-3 times a day, once a week. |
Physiotherapy procedures for psoriasis are very effective. They bring significant relief to patients, stop the progression of the disease and in some cases serve as a safe substitute for medication.
| Physiotherapeutic method | Effects on the body |
| PUVA therapy or photochemotherapy | Combination of long-wave ultraviolet radiation and internal photosensitizer. The course is 20-30 procedures. The method is based on the fact that UV rays penetrate deep into the skin. The photosensitizer inhibits the DNA synthesis of skin cells and the rate of their division. Special installations or cabins are used for treatment. |
| Selective phototherapy (S. F. T. ) | Irradiation of the skin with ultraviolet rays with a wavelength of 280-320 nm. The course is 15-35 procedures. A special cabin is needed for the therapy. |
| Monochromatic UV treatment | Exposure to each focus individually with a laser or lamp source of UV radiation. It allows you to irradiate outbreaks even in hard-to-reach places, without affecting healthy skin. It is prescribed in cases where less than 10% of the skin is affected. The course of treatment is 15-30 procedures. |
| Laser therapy | Laser radiation with different wavelengths is used to treat rashes. The laser promotes the rapid resorption of psoriatic plaques, prevents the appearance of scars in their place. The doctor determines the number of procedures individually for each patient. |
| Electrosleep | The procedure is performed on a device that is based on a slight effect on the brain with weak electrical impulses. Duration 20-60 minutes. The number of procedures is 10-12. Electrosleep has a calming effect. As a result, the activity of the nervous system is normalized, the plaques begin to dissolve and the period of well-being begins faster. |
| Magnetic therapy | Magnetic field treatment has a beneficial effect on the general condition. Itching and inflammation of the skin, swelling and pain in the joints are reduced, psycho-emotional state improves. The Betatron device is used for treatment. The duration of the procedure is 20 minutes. Number of courses 10-15. |
| Ultrasound therapy | It is used as an analgesic, antipruritic and decongestant. Promotes the resorption of scars. The procedure can be combined with the use of drugs (phonophoresis). The duration of exposure in one area is 15 minutes. 7-14 sessions are needed to achieve a therapeutic effect. |
| Hyperthermia | Heating fabrics to a temperature of 40 degrees with the help of special pillows with thermal mixture. This effect on the body normalizes the functioning of the immune system and reduces the attack on the skin. The duration of the procedure is about 2 hours. Their number is determined by the doctor. |
| Treatment with bee venom | The substance is introduced into the body by electrophoresis or ultrasound. An anti-inflammatory, absorbable, antipruritic effect is achieved. Metabolism is normalized. The minimum number of procedures is 10. |
It is very important for people with scaly lichens to follow a diet. Eating disorders can make the disease worse. The menu should be rich in vitamins and at the same time simple. It should give rest to the intestines and liver, and also not allergy to the body.
| Authorized products | Prohibited foods |
| Vegetables (pumpkin, watermelon, beets, carrots, potatoes, radishes) | Animal fats |
| Fruits (apricots, peaches, apples), juices | alcohol |
| Berries (excluding red fruits: strawberries, raspberries, red currants) | fatty meat (pork, duck) |
| Fresh herbs | Smoked meat |
| Lean meat (beef, veal, rabbit, turkey) not more than 200 g per day | Red fish |
| Cheese, cottage cheese, dairy products | Carbonated drinks and coffee |
| nuts | Eggs |
| Low-fat varieties of fish | Ice cream and milkshakes |
| Seaweed | Minimum amount of confectionery and sugar |
| Whole grain bread | Butter and puff pastry |
To cleanse the body of toxins and metabolic products, it is necessary to spend days on an empty stomach twice a week. They recommend kefir, apple, vegetables.
What ointments are effective in treating psoriasis?
The use of ointments for psoriasis has the greatest effect compared to other external preparations. The components of the ointment do not remain on the surface of the plaque, but soften the scales and get into the skin.
There are a large number of ointments for the treatment of psoriasis. In the early stages, appointnon-hormonal ointments.
If the treatment does not give the expected effect, then prescribehormonal ointments. . . Treatment begins with lighter drugs that have minimal side effects. If no improvement is achieved, then stronger ointments with glucocorticosteroids are prescribed.
| Name of the ointment | Drug action | Side Effects |
| Weak ointments | Suppresses the increased activity of leukocytes, prevents their movement in the skin, eliminates the feeling of tightness and itching. | Swelling of the skin, itching, redness. |
| Moderate ointments | It has anti-inflammatory, anti-allergic, anti-edematous, anti-pruritic action. Suitable for patients with exudative forms of psoriasis, reduces bleeding. Apply a thin layer on limited areas 2-3 times a day. The treatment lasts 10-14 days. | Steroid acne, atrophy and stretching of the skin, burning, itching, hypopigmentation. |
| Strong ointments | Topical anti-inflammatory, antipruritic and anti-allergic agent. Reduces skin hydration. Apply on the affected area 2-3 times a day for two weeks. Used during exacerbations. | Skin atrophy. |
| Very strong ointments | It has a strong antipruritic and anti-allergic effect. It slows down the processes of cell division and keratinization. Apply 1-2 times a day for no more than two weeks per course. | Acne, hair loss, skin atrophy. Do not use in pustular and widespread plaque psoriasis. |
Pharmaceutical companies produce many drugs in the form of ointments. The doctor individually chooses the medicine for the patient and, if necessary, changes it to a stronger one.
Remember that in any case with psoriasis you should not neglect visits to the doctor. Ultimately, this disease can hide the initial stage of skin cancer.
Choosing a psoriasis treatment regimen is a long process that involves many trials and errors. Don't despair if you don't find "your" medicine right away. Remember that many people achieve lasting improvement when the disease doesn't come back for years. You can do it too!