Psoriasis: possible causes and manifestations

Psoriasis is an unpleasant skin disease in which the body is covered with red rashes that merge into spots.A person may be bothered by itching that prevents him from sleeping, and if complications arise in the form of arthritis, severe joint pain may occur.Psoriasis significantly affects the quality of life.Studies show that patients feel as bad as those who have had a heart attack, heart failure or severe hypertension.

Unfortunately, doctors have not yet found an answer to the question of how to treat psoriasis.Everything offered by the pharmaceutical industry and medicine - ointments, creams, ultraviolet radiation, immunity drugs - brings only temporary relief.Other measures - psychotherapy, vitamin intake, diet for psoriasis - do not cure, but help to improve the condition.

Psoriasis disease

Psoriasis on the head

How does scalp psoriasis occur?

• The first lesions appear in the form of peeling on the back of the head.
• Then the peeling spreads further, the skin itches and itches.In the initial stage of psoriasis, patients tend to believe that they just have dandruff and search hard for a remedy to get rid of it.Contacting doctors is often ineffective - the dermatologist may confuse the lesions with seborrheic dermatitis and prescribe shampoos for it.
• At the next stage, the itching becomes unbearable, the patient injures the skin by scratching until it bleeds.
• Then red plaques and bumps appear, which a person easily injures when scratching.
• The plaques become overgrown with gray particles that gradually cover the entire scalp.The particles are epithelium exfoliated from the surface.
• Psoriasis then spreads to the smooth scalp that is not covered with hair.

Psoriasis of the skin

Cutaneous psoriasis is a non-infectious skin lesion that affects about 4% of the population.Its causes are not fully established, but the main version is a genetic disease.An equally popular belief is that psoriasis is an autoimmune disease.The versions about the infectious origin of the disease deserve attention.

Nail psoriasis

Depending on how the nail plate is damaged, there are:

• Change in the color of the nail bed.
• The appearance of furrows and point damage on the plate.
• Corrosion or, conversely, thickening of the nail.
• Thickening of the skin under the nail plate.

The diagnosis of psoriasis of the nails is possible after an appropriate examination for the presence of fungi.But sometimes even this type of examination does not completely exclude the disease, since a fungal infection can accompany the existing psoriasis.

Psoriasis in adults

Psoriasis in women

Psoriasis in pregnant women

Psoriasis is a chronic disease with periods of flare-ups and improvements.How does it behave during pregnancy?Observations show that pregnant women feel much better - they are less worried about the manifestations of the disease, even if during this period all treatment is almost completely canceled in order not to harm the unborn baby.

Sometimes the disease does not disappear completely even during pregnancy and drug treatment is required.If necessary, it is better to treat psoriasis with products that do not contain hormones.

Psoriasis in nursing mothers

How to treat psoriasis in nursing mothers?Many drugs that have no systemic effect and are not transmitted through milk are permitted:

• Hormonal drugs, provided that they are used under the supervision of a doctor and in an emergency, on small areas of the body.
• Moisturizing creams (including for children's skin).
• Oils and oil-like creams that can moisturize the skin by getting stuck in the stratum corneum.
• Treatment of psoriasis with salicylic ointment is allowed.
• Various sorbents can be used to achieve an anti-allergic effect.
• The use of phototherapy (without oral administration of photosensitizers) is allowed.

Psoriasis in men

Psoriasis is slightly less common in men than in women.The course of the disease in men can be milder - the manifestations are less pronounced and the disease begins on average at a later age than in women.Otherwise, the diagnosis, treatment and prognosis are almost the same in both sexes.

A peculiarity characteristic of men is the localization of psoriasis in the area of the head of the penis.Since the disease occurs without characteristic peeling, the diagnosis can be difficult, especially if the patient turns not to a dermatologist, but to a urologist, whose specific work does not imply a close knowledge of the symptoms of psoriasis.

Psoriasis in children

In childhood, psoriasis can bring a lot of suffering to the child, as it is accompanied by itching, pain, and if the joints are affected, their mobility can be limited.And peers sometimes lack tact and tease children with "ringworm", having no idea about the true non-infectious nature of the disease.

How does childhood psoriasis manifest itself?It is characterized by several forms:

• Localization in typical places - on the extensor surfaces of the limbs, buttocks.
• Nail damage.
• Psoriasis of the scalp, of the scalp.

The exact causes of psoriasis in children are unknown, but the main cause is thought to be a genetic defect.Versions of an unfavorable external environment are also considered - exposure to allergens, rubbing the skin with clothes, chronic and acute stress.Finally, another possible cause of the disease is previous infections.

Psoriasis: symptoms

Symptoms of psoriasis in adults

The symptoms of psoriasis are so characteristic that they allow an accurate and quick diagnosis.The main manifestation of the disease is red, scaly spots (plaques) on the surface of the skin, consisting of papules.Patients are concerned about severe itching and signs of inflammation in the area of the spots.One of the characteristic features of psoriasis is the spread of plaques where there are skin lesions - microtraumas, scratches, cracks.The favorite localization of rashes is on the head under the hair, on the extensor surfaces of the joints, on the lower back and sacrum, in all natural skin folds.

Psoriasis has an undulating course, in which periods of exacerbation are spontaneously replaced by remission.Many patients note that they cannot connect a single event in their life with the beginning of the exacerbation.During this period, the symptoms of psoriasis manifest themselves most clearly - the peeling intensifies, the redness of the spots becomes clearly bright, and as a result of exfoliation of skin scales and infection, suppuration of plaques is possible.

Symptoms of psoriasis in children

Psoriasis in children is almost as common as atopic dermatitis.It manifests itself in several forms characteristic of childhood:

• Tear-shaped - red bumps that appear after injuries and infections.They are often confused with allergies.
• Crying.It presents with the same symptoms as the corresponding form in adults.
• The pustular form is uncommon and is usually caused by infection, anxiety, or taking certain medications.The disease is expressed in the spread of pustules on the skin - vesicles with purulent-liquid contents.As with plaques, the danger comes from scratching the pustule and possible infection.
• The erythrodermic form is characterized by the spread of lesions throughout the body, severe inflammation and itching of the skin, fever and chills.The severe course of the disease requires urgent hospitalization of the child.
• Psoriatic arthritis is one of the forms and at the same time a complication of psoriasis.It appears against the background of an existing disease and is expressed in pain and swelling of the joints, muscle stiffness.
• A special form of the disease is the so-called diaper psoriasis, in which the rashes cover the child's buttocks and, therefore, the pediatrician and the mother mistakenly take it for irritation caused by contact with urine and feces.

Forms of psoriasis

There is still no generally accepted classification of psoriasis.The following forms are distinguished:

• Plaque (regular).
• Exudative.
• Arthropathic.
• Pustulous.
• Psoriatic erythroderma.
• Psoriasis of the scalp.
• Psoriasis of the folds.
• Psoriasis of the palms and soles.

Certain clinical variants of the disease with different severity can be observed in the same patient.

Pustular form

Psoriasis sometimes presents as pustular skin lesions.It is characterized by the formation of pustules-vesicles filled with purulent or sterile contents.The size of the bubbles can reach 2.5-3 cm.A favorite place for rashes is the extensor areas of the arms and legs and the torso.Pustular psoriasis of the scalp is common.The surface of the patient's body is red and hot.Patients complain of fever and chills, general malaise.

Exudative form

The exudative form is characterized by the appearance of large plaques on the surface of the skin, which then, unlike vulgar psoriasis, are covered with yellow-brown crusts.

A characteristic feature of exudative psoriasis is the atypical location of the rashes.Unlike other forms, they occupy surfaces of the bends of the arms and legs and folds of the skin.Due to friction from clothing and irritation, the rash can become injured and then infected.

Stages of psoriasis

initial stage of psoriasis

Different scales are used to assess the severity of psoriasis and its stage, which include:

• Area of rashes.
• The severity of the disease (redness, itching, swelling and exudate, surface bleeding).
• General symptoms (emotional and general physical condition).
• The impact of the disease on a person's lifestyle and social functions.
• Evaluating the effectiveness of previous attempts at therapy.

The initial stage of psoriasis is the stage where the surface of the skin is damaged by no more than 3%, nails and joints are not affected.At this time, a stable remission of the disease can be achieved.

Middle stage of psoriasis

The middle stage of psoriasis corresponds to skin lesions ranging from 3 to 10% of the skin.

Severe stage of psoriasis

Severe stage psoriasis is skin damage of more than 10% or the development of psoriatic arthritis in any area of the rash.The disease at this stage causes significant inconvenience and suffering to patients, as arthritis can be accompanied by pain, and a large area of rash is accompanied by debilitating itching and insomnia.

Psoriasis: causes

Causes of psoriasis in adults

The causes of psoriasis are still not fully understood.Of course, science has advanced in the study of the disease, but the exact answer to the question of why psoriasis appears has not yet been found.It is known for certain that dermatosis is not contagious, which means that the cause is most likely not due to an infection.Researchers tend to believe that the disease has a multifactorial nature - both metabolic disorders and immune problems are to blame.

Causes of psoriasis in children

Psoriasis in children appears against the background of infectious diseases, emotional stress, cold weather, excessive tanning and herbs.The trigger for the development of the disease can be frequent contact with allergens.

Diagnosis of psoriasis

Visual examination and identification of the psoriatic triad

The disease psoriasis has characteristic symptoms that allow the doctor to accurately diagnose the disease with the help of a visual examination of the skin:

• "Stearin stain" - if the plaque is scraped, stearin-like shavings form.
• "Terminal film" - after removing the scales from the surface of the papule, a surface similar to polyethylene film is visible in their place.
• "Bloody dew" - after you continue to scrape the surface that appears from under the plaque, bleeding appears in the form of drops.

Unlike the skin form, nail psoriasis is diagnosed by a dermatologist not by a triad of symptoms, but by other signs:

• Change in the color of the nail bed.
• A corroded nail.
• Grooves located across the nail.
• Small dots on the nail plate, reminiscent of punctures with a sewing needle.
• An increase in the thickness of the skin under the nail.
• Thickening and changing the shape of the nail, ingrowth into the finger.

Laboratory studies

Based on the structure and characteristics of the cells of the fragment, the specialist can determine the origin of the skin rash: in psoriasis, an increase in the number of René bodies, increased proliferation of keratinocytes and accumulation of T-lymphocytes and macrophages in the skin layer is observed.

Psoriasis: treatment

Treatment of psoriasis in adults

How is psoriasis treated?Medicine has not yet given a comprehensive answer to this question, but the principles of therapy have been developed a long time ago.They can be divided into three groups:

• Eliminating the cause of the disease.
• Symptom relief.
• Strengthening immunity.

The goal of all types of treatment is to put the disease in remission for as long as possible.

The effectiveness of the therapy is different in each individual case.

Treatment of psoriasis in children

Treatment of psoriasis in childhood is aimed at quickly achieving long-term remission and does not fundamentally differ from therapy in adults:

• Adherence to a hypoallergenic diet with the usual composition of foods: with the exception of fried, salty, spicy vegetables and fruits containing preservatives that can cause allergies.
• Creating a life without allergens (downy pillows, old dusty things).
• Follow the hygiene advice (properly washing, drying and moisturizing the damaged skin).
• Physiotherapy.Electrosleep, phototherapy, magnetotherapy, ultrasound and laser can be used.The use of photochemotherapy, due to its potential harm, is recommended in children over 15 years of age.
• Sanatorium-resort treatment with mineral baths and healing mud.
• Local treatment with hormonal and non-hormonal ointments and creams prescribed by a doctor in accordance with the severity of the disease, the intensity of the skin manifestations and the individual response.
• If local treatment is not sufficient, children may be prescribed systemic drugs and procedures (UVA photochemotherapy, drugs to affect the immune system, retinoids).

Medicines for the treatment of psoriasis

Psoriasis cream

What creams are most popular in the treatment of psoriasis?

• Containing synthetic hormones.They are good because they quickly and effectively relieve itching and inflammation and help reduce the size of psoriatic plaques.Hormonal creams have many side effects and should be used strictly as directed and under a doctor's supervision.
• Non-hormonal creams have the same effect as hormonal ones, but it takes much longer to appear after long-term use.Therefore, they are not used as an ambulance.But unlike hormones, such creams are not addictive and have almost no side effects.

Ointment for psoriasis

Like creams, ointments are hormonal and non-hormonal:

• Hormonal contain hormones, from the weakest to the most powerful drugs of the 4th generation.Ointments are prescribed by a doctor and can be discontinued by gradually reducing the dose.
• Non-hormonal ointment for psoriasis moisturizes the skin, relieves inflammation and itching, heals wounds.

Physiotherapy as a means of treating psoriasis

The procedures are aimed at achieving different therapeutic effects:

• The main type of physiotherapy is phototherapy (or photochemotherapy).The treatment consists in treating the surface of the skin with ultraviolet radiation of different wavelengths.
• X-ray methods - treatment of the skin surface with soft X-rays.
• Electrosleep is the introduction of the patient into a state of sleep by means of an electrical effect on the brain.The procedure does not cure skin rashes, but it helps to reduce excitability and manifestations of neurosis, due to which the general condition of patients improves.
• Cryotherapy - treating the surface of the skin with nitrogen to accelerate regeneration, relieve inflammation and itching.
• Magnetotherapy is used when psoriasis is complicated by arthritis.
• Laser therapy is primarily used to treat plaque.

How to treat psoriasis at home

What is psoriasis self-treatment at home?

• Organizing a hypoallergenic lifestyle - you need to get rid of carpets, down pillows and blankets, try to replace the furniture with something from which dust can be easily removed.It is better not to have pets for patients with psoriasis, even if an allergy to animals is not confirmed.Prolonged contact with them can cause the body to become allergic.
• Maintaining a healthy lifestyle, giving up smoking and drinking alcohol.
• A psoriasis diet should be healthy and nutritious.
• Eliminate stress and anxiety, because they can serve as a cause of exacerbation.
• Compliance with the rules of hygiene - refusal of a bath in favor of a shower, careful drying, washing and subsequent moisturizing of the skin with special products prescribed by the doctor.
• Taking medications and performing procedures prescribed by a dermatologist depending on the stage of the disease.
• If the doctor has prescribed sunbathing or ultraviolet radiation, you must strictly follow the procedure schedule.

Treatment of psoriasis with folk remedies

What methods are used in folk medicine?

• Birch tar is used in the form of soap or in pure form to apply to the affected skin.
• Treatment with soda is based on the hypothesis that psoriasis occurs due to increased acidity of the skin.To neutralize it, it is suggested to treat the surface with an alkaline preparation, which is soda.
• Treatment of psoriasis with folk remedies in the form of ointment is based on moisturizing the skin due to the fat contained in it.
• Copper sulfate and potassium permanganate are also used to treat psoriasis.For treatment, a solution of vitriol and potassium permanganate is used, which is used to treat the surface of the skin for several hours.

Diet for psoriasis

What does the psoriasis diet allow and even encourage?

• Fibers.It allows you to improve metabolic processes, as well as normalize digestive function.
• Calcium is a generally recognized useful product that has a pronounced anti-inflammatory and anti-allergic effect, which is why its presence in the diet is necessary: cottage cheese, milk and fermented milk products are mandatory for the patient.
• Polyunsaturated fatty acids are necessary to normalize fat metabolism, support the absorption of many vitamins and improve the condition of the skin and vascular walls.
• Zinc should be present in the diet to promote protein synthesis, which boosts immunity.
• At any stage of psoriasis, you should eat foods rich in antioxidants.

Complications of psoriasis

Psoriatic erythroderma

Psoriatic erythroderma is a complication of psoriasis in which the patient's entire skin is covered with bright red spots.A person's temperature rises, his joints hurt, his lymph nodes increase, his general condition worsens.The complication is dangerous because it contributes to the development of heart failure, impaired kidney and liver function.Flaking and inflammation of the skin leads to dehydration, heat and protein loss.

Generalized pustular psoriasis

Cutaneous psoriasis can be complicated by a rash on the surface of the body in the form of small bubbles (pustules) with bright red contours.As the disease progresses, the pustules coalesce into patches, open or remain intact, and then dry up, forming a yellow crust.The places of rashes are the chest, sides and back, extensor areas of the limbs.

Symptoms of pustular psoriasis also include fever, heat, burning, and pain in the area of the rash.

Arthropathic psoriasis

Skin psoriasis with a long course, after 5-6 years from the beginning, can be complicated by the involvement of the joints in the process.The complication is called arthropathic psoriasis and usually manifests as inflammation of the phalanges of the fingers and toes.The fingers swell, the skin in the area of inflammation becomes red.In addition, the disease affects other joints: intervertebral, iliac, heel.

The disease psoriasis in the form of arthropathy has an undulating course with improvements and exacerbations, sometimes accompanied by skin rashes, but it can also occur without skin manifestations.Patients complain of severe pain and limited mobility in the damaged joint.Arthropathic psoriasis is easily recognized by the presence of accompanying rashes, and if there are none, the disease can be confused with other types of arthritis.

Prevention of exacerbation of psoriasis

Balneotherapy

What is the effect of staying at the resorts?

• Mud therapy helps to improve the condition of the skin and relieve inflammation.
• Climate treatment - exposure to mild heat, sea air and swimming has a beneficial effect on the general condition of the skin and strengthens the immune system.
• Sun baths (heliotherapy) are indicated in moderate amounts.They are beneficial for the skin due to the beneficial effects of ultraviolet radiation.However, excessive exposure to the sun can provoke psoriasis complications, so you should not overdo it with the solarium.
• Hydrogen sulphide baths and thermal waters from natural sources improve capillary blood circulation and support better skin regeneration.

Ultraviolet radiation

An excellent means of treating psoriasis is ultraviolet radiation, which can be natural (solar) or artificial.Ultraviolet treatment comes in several forms:

• PUVA photochemotherapy, when long-wave radiation is combined with the absorption of a photosensitizer.
• Narrow-wave 311 nm therapy – phototherapy with narrow-spectrum rays.
• Combined phototherapy is a combination of medium and long waves.

lifestyle

What needs to change in patients' daily lives?

• It is recommended to adhere to a hypoallergenic diet, limit alcohol and drink plenty of clean water (6-8 glasses a day, not counting liquids in meals).
• Personal hygiene should include taking a shower instead of a bath.
• The air in the premises must be sufficiently humidified.
• Sun exposure is beneficial for psoriasis patients if approved by a doctor.
• To avoid the appearance of new foci of the disease, the skin must be protected from injury.
• In order not to provoke an exacerbation of psoriasis, you should strengthen your immune system and protect yourself from colds and respiratory viral infections.
• The exact causes of psoriasis are unknown, but it has been confirmed that stress causes it to flare up.Therefore, patients should try to protect themselves from negative emotions, emotional stress and fatigue.Getting enough sleep is very important.

Vitamin therapy courses

What vitamins are useful for skin diseases?

• Retinol (vitamin A).
• Vitamin D
• Vitamin E.
• vitamin c.
• vitamin B.

Psoriasis is a chronic skin disease that completely changes a person's life.Diagnosing the disease is not difficult, since the "signature" psoriatic rashes are well known to every dermatologist.The causes of skin damage have not yet been precisely established, and no effective remedies have been invented for its removal: neither creams, nor taking hormones, nor ointment for psoriasis guarantee a complete cure.But don't despair!You should always remember that this is not a fatal disease and with the right treatment, diet, preventive measures and sanatorium treatment you can achieve a stable remission.