Once it occurs, psoriasis in most patients does not go away on its own, but only progresses and becomes more extensive, spreading to the skin.
However, with timely diagnosis it becomes easier to treat and recovery comes much faster.
The main thing here is to pay attention to the first signs of psoriasis in time and immediately make an appointment with a dermatologist.
Signs of psoriasis
Early psoriasis can manifest as small, reddish, scaly patches.
The location of such rashes is directly dependent on the form in which the disease occurs.
In most cases, they can be seen:
- in the elbows and knees;
- on the head (in the hairy area);
- on palms and feet;
- in the folds (buttocks, armpits, areas under the breasts in women).
Primary eruptions (papules) are very small: their diameter does not exceed 4 millimeters.
However, as the disease progresses, they expand and merge with each other, forming vague plaques.
Most often the appearance of papules is not accompanied by pain or itching. The feeling of discomfort increases with the development of psoriasis and an increase in the size of the affected skin areas.
The affected area begins to ache and itch and there is a strong burning sensation.
These signs of psoriasis are complemented by emotional discomfort, which can significantly increase the rate of spread of the disease.
It is inappropriate to initiate self-medication when such rashes are detected, as psoriasis in its early stages has similarities with other skin conditions.
Accordingly, the wrong choice of drugs will not lead to positive results, but will only worsen the situation.
Cumulative symptoms
Scaly lichen belongs to the category of systemic pathologies.
This means that it affects not only the skin and nails, but can also affect the spine, joints and tendons, some body systems (eg endocrine, immune and nervous).
There are cases when the disease affects the digestive (liver) and urinary system (kidneys).
The first symptoms of psoriasis
- constant feeling of tiredness;
- weakness;
- state of depression (up to depression).
Due to the complex effect of the disease on the body, experts consider it appropriate to call it psoriatic disease.
However, key aspects of the disease are based on skin damage.
As mentioned above, the first call for the onset of the pathology are small papules in the color range between pale pink and red.
They differ in a symmetrical position on the surface of the skin (folds, lower back, head area covered with hair), sometimes - on the mucous membrane of the external genitalia.The size of the papules in the further course of the disease can exceed 10 centimeters.
Psoriatic eruptions, depending on their characteristics, are divided into:
- dotted (their size is not larger than the head of a pin);
- drop shape (similar in teardrop shape, grain equivalent to a lentil); coin-shaped
- (plates 5 mm in diameter, with rounded edges);
- Rarely arcuate, annular or card-like.
Above the papules are covered with plaques with scales, which are formed by keratinized cells of the epidermis and are removed without much effort. Initially, they appear in the center of the poster and gradually spread more and more.
Keratin cells have air gaps, which leads to visual crumbliness and light hue.
Sometimes the elements are surrounded by a pink ring, which acts as a zone of growth and inflammation of the plaque. In this case, the condition of the surrounding skin does not change.
Removing the plaque reveals a glossy, deep red surface based on capillaries, which in turn have very thin walls.
The presence of such vessels with a small diameter is due to damage to the structure of the upper layers of the skin, whose structure is disrupted due to the incomplete maturation of epidermal cells (keratinocytes), which makes their proper differentiation impossible.
Symptoms of various forms of psoriasis
Frequent psoriasis has very specific symptoms, so it will not be difficult to diagnose.
Looks like scaly, rounded areas that protrude above normal skin and are pink or red.
Sometimes in the early stages of the disease there are no plaques characteristic of it: before they appear on the scalp and in the joints (ankle, elbows and knees), small papules can be observed.
They are able to persist for a long enough period of time and do not cause any inconvenience to the patient: nothing itches and hurts or there is no pain at all or they are practically not felt, the papules themselves are almost impossible to notice.
They do not flake, but with a slight scrape the scales appear immediately. Such pink seals can disappear or significantly reduce in size during the summer, as sun exposure affects the skin.
The acute form of common psoriasis manifests itself in the form of numerous persistently itchy rashes on brightly colored papules and is the result of the influence of factors that activate the disease.
In order not to confuse it with an allergic reaction, you should scrape the surface of the plaque shortly before the characteristic phenomena appear.
Seborrheic psoriasis starts in the scalp (in the area covered with hair) and then spreads to the face and shoulders.
It is characterized by severe peeling of the skin in the area, which is most often treated by patients as dandruff, so they do not rush to a dermatologist.
This fact allows the disease to easily reach the stage of development when the forehead and areas behind the ears are peeled. And only then plaques form.
Skin lesions with psoriatic disease (armpits, genitals and groin, under the breasts in women) are often confused with simple irritation caused by friction or sweat.
This type of disease is characterized by smooth plaques that look like spots. No peeling is observed, but they often get wet. The rashes themselves are bright red, they are even and shiny.
When the genitals are affected, the characteristic signs of psoriasis can be misinterpreted as balanoposthitis (a lesion with rashes on the glans penis and foreskin on the inside) in men and vulvitis (rashes located on the labia minora) inwomen.
The palmar-plantar form of the disease manifests itself in the form of compacted areas, similar to corns, whose surface is covered with yellow scales, which are difficult to remove.
The affected area is cracked and inflamed. In this form of the disease it is difficult to cause the appearance of a terminal film and bloody dew by scraping.
Nail psoriasis begins with psoriatic onychodystrophy, which is one of the main symptoms of this form of the disease and manifests itself much earlier than the rash.
In the early stages, the edge of the nail is covered with grooves and small depressed areas.
As the disease progresses, they spread to the root, after which there are changes in its color. The nail dulls and thickens. Due to circulatory failures, the manifestation of the disease increases.
Epidermal cells accumulate under the nail plate and it is surrounded by red tissue on all sides, after which it may peel off after a while.
This type of psoriasis is dangerous because it increases the sensitivity of the tissues, which in turn increases the likelihood of infection. Quite often this disease is confused with fungi.
Moving joints of the bones (joints) are often affected. They are deformed, the joint capsule undergoes dystrophic modifications.
Psoriatic arthritis begins with an increase in joint volume, which is accompanied by pain.
The fingers of both hands and feet are most susceptible to this type of psoriasis.
In severe forms, the shoulder and elbow, hip and knee joints, as well as some parts of the spine, are exposed to the disease.
Effect on the manifestation of symptoms in stages of psoriasis
The symptoms of psoriasis are directly proportional to the season of the year and the stage of the disease.
Most often during the spring-summer period a significant decrease in the activity of the disease is observed, which is facilitated by ultraviolet rays.
Accordingly, during the autumn-winter period due to the lack of sun the disease is rapidly gaining momentum. There are virtually no patients with summer exacerbations.
There are three stages of psoriasis:
- progressive- characterized by the constant appearance of new rashes, an increase in the size of previously appearing plaques and their surrounding environment with pink edging, the affected area is very itchy and scaly;
- stationary- new rashes no longer appear and old ones do not grow; the upper layer of skin in the area of the plaques wrinkles;
- regressive- the skin does not peel off, the plaques disappear, leaving behind heavily pigmented areas.
Diagnosis of psoriasis
The diagnosis of psoriasis is made on the basis of information obtained from a medical examination by interviewing a patient, as well as symptoms inherent in one or another form of the disease.
The sooner a disease is detected, the faster the healing process begins. Accordingly, more tangible results will be obtained.
Due to the very specific picture of the disease, the diagnosis of psoriasis can be limited to a simple examination by a dermatologist.
However, in some cases, difficulties may arise due to the implicitness or lack of symptoms, which occurs if the disease does not manifest itself in any way or appears uncharacteristic. This situation requires additional research procedures.
A specific method is used to make the diagnosis, which consists of gradually scraping the papules along the layer.
As a result of such manipulation, it is possible to identify characteristic signs (psoriatic triad) for differentiating psoriasis from other diseases and making a definitive diagnosis:
- stearin stain;
- terminal film (pink epidermal cells);
- blood dew (drops of blood appear on the surface of the plaque due to rupture of capillaries).
If necessary, the patient is tested in the form of samples of affected tissues.
X-rays are taken if psoriasis-related arthritis is suspected.
If psoriasis is at an early stage, its diagnosis is not difficult: the picture of osteoporosis is clearly visible.
In later periods, there is a narrowing of the joint space, erosion of the tissues that form bones, osteosclerosis and periostitis.
If the disease is severe, the wrist and metatarsal joints are destroyed, as a result the joint completely loses its mobility.
It should be noted that all tests performed are necessary not only for the final diagnosis, but also for differentiation with other diseases, which at first glance are identical.
These diseases include: parapsoriasis, seborrheic eczema, rosacea lichen, atopic dermatitis, lupus erythematosus, rheumatoid arthritis and others.