Psoriasis is a non-communicable, chronic disease that until recently was considered a simple skin disease. A characteristic of the inflammatory process in certain areas of the skin in patients with psoriasis is that the life cycle of normal skin cells is approximately 30-40 days, when, as in psoriasis, is 4-5 days, ie after 4 days, the skincells gradually die, forming plaques, dryness, peeling of the skin and so on.
The problem of treating this complex and difficult to treat disease today is urgent not only for dermatologists, many doctors from other specialties are often involved in determining the causes of psoriasis in a patient, and are also directly involved in the complex treatment of this disease. Today, medicine considers psoriasis in terms of systemic insufficiency in the body, not just as a skin inflammatory process.
Even his name has changed, it is now a psoriatic disease. Why is psoriasis a systemic pathology? Because patients have several different disorders in the work of the body as a whole - in the nervous, endocrine, immune. In medicine there are several types of psoriasis, there are a large number of causes of this disease, mostly these are theories, as there is no convincing evidence for these alleged causes, we will look at them in more detail.
A few facts:Psoriasis is not contagious because it is thought to be caused by a malfunction in the human immune system, namely overactive T lymphocytes on the skin. Psoriasis is classified as a hereditary disease, in psoriasis in 1 of the parents the risk of developing psoriasis in a child is 25%, if both parents have 65%. In addition to the hereditary factor, the triggering mechanism for psoriasis or relapse is the intake of antibiotics, NSAIDs, B vitamins, as well as stress, alcohol and skin injuries.
Viral theory of the cause of psoriasis
A number of studies conducted in patients with psoriasis have found various changes in the peripheral lymph nodes, which may indicate the viral nature of the development of this disease. It is suspected that retroviruses that are genetically inherited may be one of the causes of psoriasis, but in order to prove the viral nature of the origin of psoriasis, it is necessary to identify the virus, isolate and select the habitat andso far no one can do that.
The fact is that retroviruses have the ability to change the genetic code of the host, they have the ability to synthesize DNA with the help of the enzyme reverse transcriptase, and a "fake program" is formed in the cells that changes the human genome. However, it has been found that even in transfusions from patients with psoriasis to healthy people, no infection or transmission of the disease has ever been reported. Therefore, the version of the viral cause of psoriasis has not yet been proven.
The immune cause of psoriasis
This is one of the generally accepted theories about the causes of psoriasis, as disorders of cellular immunity are considered the leading trigger of the disease. It has long been observed that in people with a genetic predisposition to psoriasis, in the case of chronic foci of infection - tonsillitis, sinusitis, which show impaired immunity - are provoking factors for the appearance of psoriasis.
When the primary focus of psoriasis occurs, medicine also suggests that damage to the epidermis is caused by autoimmune aggression. Numerous studies of patients with psoriasis have found abnormalities in immune complexes, antibodies, immunoglobulins that cause Munro's microabscesses.
In the process of activating the inflammation of psoriasis, the hypersensitivity of the skin increases sharply, due to which rashes characteristic of psoriasis appear in places with physical or chemical irritation. Examination of skin flakes revealed antigenic components and autoantibodies to them in the blood, which are not found in healthy people either on the skin or in the blood.
This fact suggests that the autoimmune process plays an important role in the cause of psoriasis. But all processes, even immune reactions, take place in the body as in an integrated system, therefore a combination of other factors must be taken into account, such as endocrine influence, hereditary factors, metabolic disorders.
Infectious theory for the development of psoriasis
One hundred years ago, many researchers worked hard to find an infectious agent for psoriasis, and streptococci, spirochetes, and epidermophytes were blamed for it. However, none of these fungal pathogens, after research, has been found to be the cause of psoriasis.
However, infectious diseases, tonsillitis, and ARVI flu affect the exacerbation or trigger of the primary onset of psoriasis, especially in the cold season, when the immune system weakens and patients with psoriasis are often admitted to hospital.Some authors believe that the development of psoriasis on the background of acute and chronic infection is explained by the influx of impulses from the focus of infection in the endocrine system and the autonomic region, which leads to restructuring of the body's reactivity. Very often, namely in 90% of cases, chronic tonsillitis accompanies psoriasis, which confirms the influence of infectious processes and impaired immunity on the development of psoriasis.
Also, according to many experts, there is an infectious-allergic cause of psoriasis. His supporters believe that psoriasis is an allergic tissue reaction to viruses, streptococci and their metabolic products. However, neither the viral nor the infectious theory has yet been confirmed.
Genetic cause
This cause is based on a familial manifestation of psoriasis among close and distant relatives. However, psoriasis should not be considered a strictly inherited disease, as well as diabetes, cancer, ischemic heart disease, as psoriasis itself is not inherited, but only a genetic predisposition to it. Yes, 60% of patients with psoriasis have ancestors or close relatives suffering from this disease, and if one of the parents is ill, then according to the theoretical probability the risk of developing psoriasis in the child increases by 25%, and if both parents aresick, up to 75%.
However, not always in psoriasis, the cause is only a genetic factor. This disease has recently become very common in clinical practice and is not always directly dependent on the associated predisposition. In psoriasis, the causes are so multifactorial that it is impossible to unambiguously pinpoint a specific cause. Because pathogens are disorders of protein or carbohydrate metabolism and changes in lipids, enzyme metabolism, combination with foci of streptococcal infection or viral nature.
Metabolic disorders as factors in the development of psoriasis
If we consider the metabolic disorders in psoriasis, then in many patients there is a slight decrease in body temperature and this is one of the symptoms of slow metabolism, there is also an increased cholesterol content, which shows changes in lipid metabolism. Given the high level of cholesterol, many researchers believe that psoriasis is a diathesis of cholesterol and consider its increase as the initial manifestation of dermatosis, as the violation of lipid metabolism stimulates the formation of keratinization of the skin.
Psoriasis also disrupts the metabolism of vitamins, especially vitamin C, A, B12, B6, while the content of vitamin C in the skin is increased. Changes in the content of iron, copper, zinc were also observed, which significantly reduces the adaptive properties of the human body. Almost 25% of patients with psoriasis also suffer from diabetes, but some researchers consider this fact not as a cause of psoriasis, but, on the contrary, as a manifestation of psoriatic disease.
With the progression of the disease, the basic metabolism in patients with psoriasis most often increases, and in those patients who have reduced metabolism, symptoms of hypothyroidism, endocrine glands, gonads often occur, in 60% of patients with psoriasis. disrupts the overall carbohydrate metabolism. Low-calorie food or even moderate starvation reduces the body's self-poisoning, which is why a diet for the treatment of psoriasis improves the patient's condition.Provoking factors for psoriasis
At the present stage of medical research in the field of determining the cause of psoriasis, we can say that it is a persistent recurrent systemic disease that occurs in genetically predisposed people, with concomitant disorders of the various metabolism of the central nervous system.
Stress
Both for the onset of psoriasis and for the exacerbation of existing chronic psoriasis, the main provokers are most often stress, psychological trauma, prolonged fatigue and nervous tension.
Stress causes immunological and biochemical reactions that contribute to the development of psoriasis. Sometimes, however, negative emotions serve, on the contrary, to complement the clinical symptoms of psoriasis. According to a study of patients with psoriasis, this provoking factor causes the onset of the disease in 49% of patients and in 41% recurrence of psoriasis.
Infectious diseases, vaccination, chronic foci of infection
Tonsillitis, sinusitis, STIs, otitis media, etc. , highly virulent streptococcus is particularly common. For exacerbation of the disease, this factor is important in 21% of patients, and for the onset of psoriasis, the infection is a trigger in 15% of patients.
Hormonal changes in women
During pregnancy, lactation, menopause or adolescence - in 6% of respondents this is also a provoking factor for the development of psoriasis.
Injuries, bites, burns
Any trauma to the skin - in 12-14% of patients the appearance of psoriasis is caused by physical trauma.
Prolonged hypothermia
The cause of psoriasis or its exacerbation in 5% of patients.
Medicines
Like any type of antibiotic, NSAIDs. Vitamin therapy - especially vitamins C, B, beta-blockers, cytostatics, vaccination, the use of herbal medicines in treatment - this provokes the appearance of psoriasis in 6% of patients.
Food poisoning, abuse of certain foods
Chocolate, citrus fruits and other products - according to a study of patients, this is the cause of psoriasis in 4% of patients.
Drinking alcohol
Also a provocative factor that causes generalization of the inflammatory process, shortens the remission period and increases the risk of complications, this is shown by 3% of respondents.
Climate change
High humidity, prolonged exposure to intense ultraviolet radiation, sudden changes in temperature and humidity - cause exacerbation in 2% of patients.
The first symptoms of onset of psoriasis can occur regardless of age, it occurs equally often in infants and in people aged 20-40, even in old age, psoriasis can begin to develop. Of course, the earlier it occurs, the more severe the consequences it causes on the patient. If psoriasis begins in a person after the age of 30, it is usually accompanied by gastritis, liver disease, overweight, various neuroses, diabetes, arthritis and other diseases.