Psoriasis is a chronic skin disease of non-infectious origin. According to statistics, 3. 7% of the world's population suffers from psoriasis. People call the disease "scaly lichen".
Psoriasis is not gender-dependent, it is not contagious; most often develops at the age of 14-27 years. The disease is characterized by the appearance of red scales in the form of a plaque (stain) covered with white scales. A spot (or several spots) can be on any part of the body, but most often in places with thin, dry skin: elbows, knees, lower back, scalp.
The spots are of different sizes and bother in different ways: in some patients only skin irritation is noticed; other patients include large areas of skin, which is associated with discomfort, itching, pain, insomnia, and decreased quality of life.
Psoriasis is a chronic disease, characterized by periods of irritation (redness) and remission (reduction of symptoms).
Psoriasis often complicates pregnancy.
Causes of psoriasis
Psoriasis is a systemic process that involves not only the skin but the whole body. The causes of psoriasis are not fully understood, but it is assumed that there are some of them: neurogenic (due to stress), hereditary, infectious, viral, mixed (skin damage with staphylococcal penetration in combination with any of the above reasons. ), etc. In this case, cellular and humoral immunity is activated and an autoimmune process of cell damage is stimulated, mainly skin cells (epidermis).
In addition to activating immunity, metabolism is disturbed. The disease is exacerbated by an aggravated inheritance. As a result, cell renewal (regeneration) is accelerated 3-5 times - psoriatic plaques form on the skin.
Without timely treatment, the lesion worsens: skin spots grow, crack, irritate; nails are destroyed, joints are involved, etc.
The quality of life of a patient with psoriasis depends 80% on timely diagnosis and proper treatment.
Once again we list the factors that contribute to the occurrence of the disease:
- bad legacy. Scientists have identified 9 genes that determine the development of the disease, but their interaction is not clear. It is well established that in 15% of cases, psoriasis is inherited from generation 1 and 2 relatives;
- stress, nervous tension, depression. It has been proven that stress in 70% of cases provokes a worsening of psoriasis;
- hormonal imbalance;
- dysbiosis;
- metabolic disorders, drug addiction;
- colitis and parasitic infections (roundworm, lamblia, intestinal infections, etc. );
- viral infections;
- streptoderma; skin candidiasis;
- allergies.
Symptoms of psoriasis
In the initial stage, the skin rashes of psoriasis are in the form of red scaly plaques (spots). The appearance of a skin plaque is accompanied by intense itching. A denser layer (keratinous) is found under the scales.
Here are 6 major forms of psoriasis; each has its own symptoms:
Plaque psoriasis occurs in 85% of patients. It is characterized by dry, pink, raised rashes on the skin, covered with silver scales. The skin in the affected areas is often exfoliated; in this place remain red spots, bleeding during trauma. In 60% of cases, the tiles are joined into large tiles.
Guttate psoriasis is characterized by many small, dry lesions in the form of pink spots raised on the surface of the skin. The rash is localized on the thighs, legs, affecting large areas of the body. In 60% of cases, guttate psoriasis worsens after streptococcal infection.
Pustular psoriasis can be recognized by skin blisters filled with clear fluid. The blisters are surrounded by red and edematous skin. The legs and thighs are most often affected.
Psoriasis of the flexor surfaces is manifested in the form of smooth, non-smooth red spots, which are located in the area of skin folds: the lateral surface of the thighs, armpits and the area of the external genitalia. Due to mechanical irritation (physiological friction), the spots are injured, bleed and irritate.
Psoriasis of the nails is manifested by staining, the appearance of spots and transverse lines on the nails. The skin around the lesion is hardened. As the disease progresses, the nail melts, thickens and then dries or falls off.
Psoriatic arthritis (15% of cases). Every joint is affected, but most often the small ones - the phalanges of the hands and feet. Fingers become like sausages. Joint psoriasis leads to bursitis, a person’s disability.
Let's talk separately about head and elbow lesions.
Psoriasis of the scalp (mainly the scalp) is the most common form of the disease. It is most common at a young age. Appears as itchy red spots that itch and itch. The rash is almost always visible, therefore it causes emotional distress and leads to a person's social isolation.
Elbow psoriasis is a disease of middle-aged people. It appears in the form of rashes on the extensor surfaces of the elbow joints. The rash spreads from the outside and joins - a large plaque (plaque) forms, covered with silvery scales that fall off easily. Along with the scales, a thin protective film peels off, exposing the bleeding surface. In 80% of cases, the spots go away on their own, without treatment, but sometimes they thicken (age) and persist for years, provoking psoriatic lesions of the elbow.
Diagnosis of psoriasis
Diagnosis and treatment of psoriasis is performed by a dermatovenerologist.
Due to the characteristic skin lesions, the diagnosis of psoriasis is straightforward. As additional laboratory tests, a general blood test and determination of rheumatoid factor is used. For the diagnosis of psoriatic arthritis, a consultation with a rheumatologist and an x-ray of the affected joints are indicated. In rare cases, a skin biopsy is done for differential diagnosis.
Psoriasis should be distinguished from similar skin diseases: seborrhea, lupus, etc.
Treatment of psoriasis
Psoriasis is a chronic disease with periods of irritation (recurrence of skin rashes) and remission (disappearance of rashes). It is impossible to cure psoriasis forever. You can prolong the remission and reduce the intensity of the irritations.
Only in 40% of cases is it possible to find an effective treatment immediately. Sometimes it takes months and years. Therefore, psoriasis is treated at home, with the exception of severe irritations and complications. The effectiveness of treatment is affected by the type of psoriasis, age, concomitant diseases, etc. With a mild degree of psoriasis, topical preparations are prescribed: ointments and creams based on:
- glucocorticosteroids;
- zinc;
- tar;
- salicylic acid;
- vitamin D3.
In severe cases of psoriasis (25% of the skin surface is affected, joint damage) and ineffectiveness of local treatment, complex therapy is prescribed:
- cytostatics that inhibit epidermal cell division;
- immunomodulators that normalize immune responses;
- glucocorticosteroids, which regulate metabolic processes and reduce inflammation;
- non-steroidal anti-inflammatory drugs (to reduce itching of the skin);
- multivitamin.
Physiotherapy is prescribed: ultraviolet radiation, cryotherapy, plasmapheresis, hirudotherapy. Folk remedies are also used: celandine and lard-based ointments, meadows and Vaseline, beeswax and lard. To normalize immunity, they drank home-made kvass from oats, an infusion of bay leaves and a decoction of fennel.
Diet, especially with the exacerbations of psoriasis, plays an important role. Spicy and sweet dishes are excluded from the diet. Fast food and alcohol are prohibited. The diet should be balanced, rich in vitamins and minerals.
To avoid exacerbations of psoriasis, you need to improve your health, avoid stress, hypothermia and seasonal illnesses.
Here are the simple rules to prevent psoriasis exacerbations:
- do not dry the skin too much;
- avoid prolonged exposure to the sun;
- avoid skin damage;
- avoid stress;
- do not smoke or abuse alcohol.
Is psoriasis contagious?
There is not a single proven case of transmission of psoriasis from a sick person during home or other contacts. Therefore, it is believed that psoriasis is not contagious.
Which doctor to contact
To start treatment on time and to avoid the spread of psoriasis, consult a dermatovenerologist. In the presence of psoriatic arthritis, a consultation with a rheumatologist is indicated.