Psoriasis is a chronic skin disease for unknown cause, manifested by the appearance of red peels that peel off on the skin.
The treatment is performed by a dermatologist.Synonym - Lichen flaky.MKB code 10: L40.According to the international classification, it refers to papular skin diseases.
Psoriasis as a disease has been studied for about 200 years.Prior to this period, such patients are considered to be leprosy patients and are therefore treated as lepers.Difference: Lepra (Lepra) - Infectious disease (pathogen - Mycobacterium leprae).Psoriasis is uninfected.
Symptoms
The main symptom of psoriasis: the appearance of pink-red spots on the skin whose surface is covered with silver flakes of the keratinizing layer of the skin (epidermis).
- The symptom of Stearin's Infantry.This is pathognomonic (that is, a characteristic only for a disease) sign.Speaking (grin) of psoriatic spots.It is made with a dull scalpel or object glass (not with the nail !!).With a slightly sling, the surface of the stain turns white, as if covered with wax - this is a symptom of "stearin spot".
- Symptom of "psoriatic film".Another pathognomonic symptom of psoriasis.With a further scrap neatly removes the scales of psoriatic plaque, a shiny surface is visible under the rock - the so -called symptom of psoriatic or terminal.
- The symptom of "blood dew Doltebnov" (symptom of Auspitz).Another pathognomonic symptom of psoriasis.With the more distribution (grave) of plaques, that is, when the terminal film is removed, there is point bleeding that does not merge with each other.This is the symptom of "blood dew".
- Symptom Pilenov.Characteristic of the initial stage and stage of progression.Rounded pink spot without peeling, with clear boundaries.With the progression of the disease along the periphery spots (plaques) marks the rim of the red skin, which is not yet covered with flakes.
- Symptom of Kebner.Psoriatic outbreaks appear on the skin in places of injury - in scratches, bulges, in places to rub around the clothes.
- Symptom of Kartamishev.When the fingers are examined (palpated) plaques on the scalp (HCH), the fingers feel a clear boundary of plaques.Unlike seborrheic dermatitis, when there is no clear boundary between spots and healthy skin on palpation.
- Voronov's symptom is a symptom of regressive (passing) spots.For a while, wrinkled skin remains on the periphery of the psoriatic spot, lighter and shiny than healthy skin.
- The symptom of a "nail thimble" is a sign of nail damage.The nail is everything in the dents, like a thimble.
- The symptom of the "oil spot" on the nails: a yellow-brown spot under the nails is also a sign of psoriasis of the nails.
- Onychgrifosis - deformity of nails with psoriasis nails.The nail takes on ugly shapes, sometimes similar to bird nail.
- Bo-rile line.The longitudinal line passing through the nail is a sign of nail disturbance.
Types of Psoriasis and Clinic
Generalized pustulent psoriasis (L40.1) and Pustulose Palmar and Plantar (L40.3)
These two forms of the disease differ only in the spread of the process.The mechanisms of pathogenesis are the same.The forms of the pustura are found in 1% of patients with psoriasis.The vesicle (bubbles) and pustules (pustules) appear on the skin that can merge with each other, forming "purulent lakes".There may be skin peeling.It can be disturbed by itching of the skin.The skin around the pustules is red, inflamed, hot to the touch.
Improvement of body temperature.In the blood - an increase in leukocytes (leukocytosis).These are rare and most severe types of psoriasis.But they require an immediate examination of the doctor and prescribe complex treatment.And generalized pustular psoriasis requires stationary treatment.In very rare cases, when bacterial infection is joined, even cases of sepsis and death are described in literature.
One of the varieties of pustular psoriasis is an exudative form.At the same time, there are no abscesses and bubbles on the skin, but there is a cry of the affected skin, the formation of crusts and itching of the skin.
Acrodermatitis is a constant allo
MKB code 10: L40.2.
Pustular (pustular) psoriatic changes and peeling appear on the skin of the toes and toes.The process includes nails.The nails are deformed, exfoliated in places of nails, have point dents.
A easier shape is psoriasis of the nails without pustular changes, that is, without abscesses on the skin.
Psoriasis is a rocky
MKB Code 10: L40.4
The survivors, haloid spots with pink size with peeling appear on the skin.It is possible to itch with a slight skin.Localization: The whole body is on the body, the arms and the legs.Rarely - on the face.
Often a drop of form after infectious diseases (tonsillitis, acute respiratory viral infections) occurs.
Psoriasis is an arthropathic
MKB Code 10: L40.5
Other names are psoriasis of the joints, psoriatic arthropathy, psoriatic arthritis.
It develops in 10% of patients with psoriasis.Article surfaces and periarticular fabrics are affected - ligaments, tendons, joints.
Localization - all joints, but small interacting joints of the fingers are mainly affected.However, there are cases, such as psoriatic spondylitis - damage to the intervertebral joints or psoriatic coxarthrosis - damage to the hip joint.
Patient complaints: pain, stiffness in the joints.Swelling and redness of the skin appear in the joints.There are frequent cases where patients do not bother anything at all, but radiographs are indicated by arthrosis -like changes.
Joint pain and restriction of movement in the joints lead to patient damage.Such patients should be referred to the ITU study to determine the disability group.
Another psoriasis
MKB Code 10: L40.8
This type includes psoriasis in the reverse side (reverse, inter -trigonic).
Localization - on the contrary - not on the surfaces of the extensor, but on flexion.The elbow bends, poppy pits, axillary cavities, inguinal folds, under the mammary glands.At the same time, there are no rashes in the rest of the body.
It develops in patients with obesity and diabetes.
Manifestation: Red spots appear on the skin, almost without peeling, slightly raised above the surrounding skin.
Psoriasis is inappropriate
MKB Code 10: L40.9
All other species that cannot be attributed to the above are attributed to this group.
Seasonal forms of psoriasis
- Winter form (photosypative psoriasis).The rashes appear in the cold season.Well treated with ultraviolet radiation.
- Summer form (phototoxic psoriasis).Exacerbation occurs in the summer.UFOs lead to exacerbation of the disease.
Diagnostics
The diagnosis is made on the basis of clinical symptoms and complaints of the patient.
- The presence of certain symptoms of damage to the skin, nails, joints, etc.- Look at it.
- In difficult cases - skin biopsy for checking (installing an accurate diagnosis).At the same time, the infiltration of lymphocytes, neutrophils and macrophages, thickening of skin capillaries, immature keratinocytes are located in the thickness of the skin.
- Joint X -ray - Ideally, all patients should be done.But most often it is done according to indications - in the presence of complaints of joint pain.
- The total blood test is most often normal.Inflammatory changes are detected only with a severe course of the disease.
Recently, it is customary to diagnose a blood test under a microscope.It doesn't matter to the diagnosis of psoriasis!
The differential diagnosis of psoriasis is performed with diseases:
- Flat
- Pink
- Parapsosorize,
- Atopic dermatitis
- Eczema
- Papular syphilide
- Seborrheic dermatitis on the head
- Dermatophyte of the head
- Reuters disease, rheumatoid arthritis, arthrosis
- Drug allergic dermatoses
- Hives
Psoriasis
Remember: it is impossible to completely cure psoriasis.You can only achieve long -term remission.
Local treatment
Caution: If the pustules appear from the ointment, then the ointment should be canceled and consult your doctor to adjust the treatment!
- Ointments and creams with vitamin D. For example, medicines containing substances synthesizing vitamin D.
- Corticosteroid ointments and creams.These drugs reduce the immune response in the skin, reduce the activity of inflammation.
- Combinations in one composition of vitamin D preparations and corticosteroids.
- Naphthalan -Based preparations.Grease the affected area of the skin 2-3 times a day -4 weeks.
- Birch tar and drugs based on it.Berritin, birch tar.Lubricate the affected areas and give an excerpt for 15-30 minutes, then wash with warm water and soap.
- Solidol -based creams and ointments.You can use Solidol itself, but you need to find the old Soviet Solidol, not Solidol, which is now sold in car shops with different additives.Creams and ointments.Solidol and IT creams help in half cases with psoriasis.The itching decreases on day 3, the peeling of the leaves and the spot itself gradually decreases.
- Keratolytic (exfoliating) ointments and creams.Used unstable!Just to remove excessive peeling.Often - in combination with corticosteroid preparations to reduce itching and inflammation.You can't use with exudative psoriasis!Keratolithic Salicylic acid.
- Zinc drugs. Reduces irritation and redness of the skin, dries the skin.Contains no hormones.
Warning: Do not use tar and salicylic acid on "on -call plaques"!Irritation of the low plaques can provoke the spread of pathological rashes further on the skin.
Instrumental methods of treatment
A photo cabinet for bullet therapy
We look at the video how PUVA therapy is performed:
- Eximer Laser.
Skalpa Psoriasis Laser Treatment:
- Plasmapheresis, hemosorption - purification of blood plasma on a special apparatus.At the same time, toxic immune complexes of blood occur, leading to skin infiltration with lymphocytes.The effectiveness of the procedure is high, especially in the severe course of the disease.But the procedure is expensive and is essentially aimed at eliminating the mechanisms of the development of the disease, not its causes.According to patients, plasmapheresis is satisfactorily tolerated, the effect occurs from several procedures.
Psoriasis
Turn off:
Citrus fruits, tomatoes, pineapples and other overseas fruits, honey, sweets, sugar, cookies, spices, alcohol, spicy and salty dishes, coffee, white bread, smoked meats, dyes with dyes and sugar -carpieces, potatoes and depths.
Don't overeat!
Required:
Porridge (buckwheat, oatmeal), vegetable oils (sunflower, olives), fruits and vegetables - apples, carrots, beets, cabbage, cucumbers, boiled meat, fish, one day a week (usually Saturday) - post (or even fasting).On this day, drink only water or eat buckwheat porridge flooded with water.
Folk remedies
At home you can use different folk remedies for psoriasis.But the effect of them is minimal or zero.
Remember: independent home treatment in half of the cases leads to the progression of the disease and the transition in a more severe form.
List of folk remedies from psoriasis used in patient examinations:
- Solidol.
- Therapeutic mud of salt lakes.
- Sea salt baths.
- Birch tar.
- Naftalan oil.
- Decoction of series - compresses (applications) on the affected areas of the skin.
- A decoction of herbs from Sellandin.
- A decoction of nettle.
- Aloe juice.
- Dripidar Baths.
- Hunger.
- ASD fraction 3.
- Flaxseed oil.
- Milk thistle.
- Bades and Anhelmintic medicines.Ineffective or with zero efficiency.At best, it contains extracts of ordinary grasses or even usually starch with vitamins and traces.Very expensive and bring good profits to manufacturers and dashes from nutritional supplements.They are not medicine, so you cannot expect help from them in the treatment of psoriasis.
- Psoriasis ointment.In fact, the current medicine is solid.At the same time, there are many more herbal extracts, bee products that can cause an allergic reaction and exacerbation of the disease.
- Chinese lotion.The drug contains acids that can lead to skin irritation and the progression of the disease.
Exotic treatment
Ihtiotherapy.
Black MRU has a fish station.They press dead areas of human skin and contribute to the "rejuvenation" of the skin.This effect is also used in the treatment of patients with psoriasis.
The effect of ichthiotherapy is only positive in thoroughly observing the technique and the choice of exactly the same fish.There is a similar fish - a kennel fish - they tingle flakes with sharp teeth, thus injuring psoriatic plaques.The effect of exposure to the fish with the chin is exactly the opposite-the distribution of plaques by the type of kebner phenomenon.
Failure to observe hygiene in some spa canals can lead to the appearance of fungal or viral lesions on the skin (mycosis, warts).
Registration prevention
- Turn off risk factors!
- Observe the regime of the day, the labor regime and the rest
- Proper nutrition
- Timely treatment of infectious and endocrine diseases
- UFO and PUVA therapy courses
- Sophisticated vitamins
- Treatment with sanatorium-rack, swimming of the sea
- A healthy lifestyle!
Is psoriasis
No, not contradictory!This is an uninfective disease.