Psoriasis - what kind of disease is it?

Despite the fact that psoriasis is a common and long-known disease, it has not yet been fully studied.And patients most often do not know at all that psoriasis is not a bacterial infection or a fungus, but a non-standard reaction of the immune system, provoked by unknown reasons.Information about the causes and symptoms of psoriasis will be very useful for patients, as it will help to overcome the disease.

What kind of disease is this?

Lichen squamosus is another name for psoriasis, and this name perfectly characterizes this disease.Psoriasis manifests itself in the formation of inflamed plaques of various sizes on the skin, which are densely covered with thick skin scales.

Surely, almost everyone has heard of such a disease as psoriasis.And this is not surprising, since scaly lichen is quite widespread.This disease is diagnosed in 4-10% of the world's population.Moreover, statisticians who collect information on the prevalence of psoriasis claim that the number of patients is constantly increasing.

Scaly lichen has been known to people since ancient times;even healers in Ancient Greece tried to treat this disease.The modern history of the study of psoriasis goes back about 150 years.But during this significant period of time, researchers were able to learn not enough about the causes and treatment of psoriasis.

Widespread prevalence, uncertainty of etiology (reasons for appearance), insufficiently effective treatment - all this characterizes psoriasis as one of the most difficult problems of dermatology.

Today, dermatologists consider psoriasis as a complex systemic disease associated with disorders in the functioning of the immune system, failure of metabolic processes and the appearance of trophic disorders.The result of these failures are specific skin changes.

Therefore, answering the question of what psoriasis is, a modern dermatologist will answer that these are disorders of trophism and metabolic processes in the skin caused by a malfunction in the functioning of the body's systems.Today, two theories about the etiology of psoriasis are considered the most likely: genetic and viral.

• The genetic theory has many supporters, as psoriasis often acts as a hereditary or familial dermatosis.A complete examination of the patient's family history confirms in 60-80% the presence of psoriasis in one form or another in the patient's relatives.However, in some patients it is not possible to confirm the fact of the hereditary origin of psoriasis.This circumstance is the reason for dividing these cases into a special group, in which the main cause is not genetic, but phenotypic failures.
• The viral theory, according to which psoriasis develops as a result of infection, has its supporters.Confirmation of information about the viral origin of psoriasis is the detection of antibodies in the blood of patients, as well as "elementary bodies" in the cells of the epidermis.According to this theory, psoriasis develops not only in case of virus infection, but also in the presence of certain conditions.

There are other theories that explain the occurrence of psoriasis.For example, endocrine, neurogenic, metabolic, etc.Of course, all these theories are not without basis and their study allows us to get more important information about the psoriasis disease.However, today it is already known for sure that the state of the endocrine and nervous system, as well as the functioning of the gastrointestinal tract, do not cause psoriasis, but have a significant impact on the course of this disease.

For example, pathologies affecting the liver lead to the fact that the quality of blood purification performed by this organ is greatly reduced.And this, in turn, can provoke the appearance of various skin lesions, including psoriasis.

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc.) lead to the degeneration of the tissues of this organ, that is, the liver is gradually replaced by connective tissue.As a result, the liver ceases to cope with its cleaning functions.Externally, this is manifested by yellowing of the mucous membranes and skin, and the development of skin diseases, including psoriasis, is also possible.

There is also an inverse relationship: psoriasis is often associated with fatty degeneration affecting the liver.Therefore, in the treatment of this skin disease, it is important to follow a diet so as not to burden the liver unnecessarily.Patients are advised to limit fatty foods and completely eliminate alcohol.

Thus, despite numerous studies, it was not possible to get an exact answer to the question of what psoriasis is.However, work continues, so there is a chance that the mystery of this mysterious disease will be solved and we will learn a lot about the skin disease psoriasis.

Classification according to the international system

Psoriasis manifests itself in different forms.To make navigation easier for specialists, a generally accepted classification of psoriasis is used.

Psoriasis is also included in the International Classification of Diseases (ICD) system.Today, the 10th revision of the international registry of diseases is already in use, therefore the abbreviation ICD 10 is used. Work on the 10th revision of the international classification of diseases began in 1983 and ended in 1987.

Basically, ICD 10 is the standard assessment tool used in medicine and health care management.The 10th revision of the reference book is used to monitor the prevalence of various diseases and other problems related to public health.

Using version 10 of the ICD, it is possible to compare data on morbidity and mortality in different countries, which allows obtaining statistical data and systematizing diagnostic information.As agreed upon by WHO members, ICD 10 is used to assign codes to various diseases.In version 10 of the classifier, alphanumeric codes are adopted, with the help of which it is convenient to store information in electronic form.

All types of psoriasis are included in ICD 10, and each of them is assigned a specific code.In dermatology, the following forms and types of psoriasis are distinguished:

• Common psoriasis(synonyms: vulgar, plain, like a slab).The disease was assigned a code according to ICD 10 – L-40.0.This is the most common form, observed in 80-90% of patients.The main symptoms are the formation of raised plaques on the surface of the unchanged skin, covered with white-gray skin flakes.This form is characterized by easy peeling of the scales.After removing them, red inflamed skin is revealed, which hurts very easily and starts to bleed.As the inflammatory process progresses, plaques can increase significantly in size.
• Inverse psoriasis.This is a disease that affects the skin folds (flexible surfaces).For this form of the disease, the ICD 10 code is L83-4.Dermatosis appears with the formation of wrinkles of smooth or minimally cracked spots on the skin.The condition worsens when the skin is injured by friction.The disease is often complicated by a streptococcal or fungal infection.
• Pharyngeal psoriasis.This form of psoriasis is characterized by the formation on the skin of a large number of small red or purple spots, shaped like water drops.According to the 10th version of the international classification, this disease received the L4 code.Most often, guttate psoriasis affects the skin of the feet, but rashes can also appear on other parts of the body.At the same time, guttate psoriasis is known to develop as a complication after streptococcal infections - pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasis- this is a severe form of skin, according to ICD 10 code L1-3 and L 40.82 are assigned to it.It is characterized by the formation of bubbles or pustules.The skin on the lesions is swollen, red, inflamed and peels easily.If fungi or bacteria penetrate the pustules, the contents of the pustules become purulent.Pustular psoriasis most often affects the distal parts of the extremities, but in the most severe cases a generalized process can develop with the rash spreading throughout the body.
• Psoriatic arthritis or arthropathic psoriasis.According to the 10th version of the ICD, the pathology is coded L5.Manifested by joint inflammation.Arthropathic psoriasis can affect all types of joints, but in most cases the joints in the phalanges of the fingers and hands become inflamed.Knee, hip or shoulder joints may be affected.The lesions can be so severe that they lead to the patient's disability.Therefore, you should not think of psoriasis as exclusively a skin disease.Severe types of psoriasis can lead to systemic lesions, disability or even death of the patient.

• Erythrodermic psoriasis.A rare but severe type of psoriasis, according to ICD 10, this disease received the code L85.Erythrodermic psoriasis often manifests in a generalized manner;the affected area may involve all or almost all of the skin surface.The disease is accompanied by severe itching, swelling and pain.
• Psoriatic onychodystrophy or nail psoriasis.According to ICD version 10, the disease is coded L86.The pathology is manifested as changes in the appearance of the nails on the toes and fingers.Nails can change color, become thicker and begin to break.Possible complete loss of nails.

In psoriasis, the classification of the disease takes into account not only the types of the disease, but also the severity of the symptoms:

• limited psoriasis is a disease in which less than 20% of the skin is affected;
• widespread psoriasis affects more than 20% of the body surface;
• When almost the entire surface of the skin is affected, we talk about universal psoriasis.

If we consider all types of the disease, then widespread psoriasis is more common than other forms.

Flow stages

Limited or widespread psoriasis goes through three stages in its course: progressive, stable and regressive.

The progressive stage of psoriasis is characterized by the following:

• the appearance of new rashes;
• increasing existing tiles;
• the appearance of new elements of redness at the site of skin injuries (scratches, scratches);
• excessive peeling of existing tiles.

The following symptoms are characteristic of the stationary phase of psoriasis:

• lack of emergence of new elements;

• moderate peeling of the elements;
• there are no signs of growth of the elements.

The appearance of folds in the stratum corneum around the elements is a sign of the transition from the stationary phase to the regressive one.

The regression phase is characterized by the following types of symptoms:

• reduction of peeling intensity;
• element resolution.

After the resolution of psoriatic plaques, hypo- or hyperpigmented spots remain in their place.

Lichen squamosus is characterized by a long course with periodic flare-ups.The following types of psoriasis are distinguished:

• winter (with aggravation in autumn and winter);
• summer (with exacerbations in the warm period);
• Non-seasonal psoriasis is the most severe type, since there is no clear connection between relapses and the seasons of the year, remission periods can be practically absent.

Diagnostic features

If psoriasis has a typical clinical picture, then the diagnosis will not be so difficult.However, this disease is often disguised as other pathologies.

For example, nail psoriasis is often confused with nail fungus, as the external manifestations in the early stages of these diseases are very similar.However, nail fungus and psoriasis have completely different natures, so the treatment should be different.

A non-specialist may confuse it with fungus and psoriasis of the skin.Since mycoses of the skin (skin fungi) manifest themselves with similar symptoms - the formation of smooth plaques.Therefore, if you notice suspicious symptoms on your body or nails, you do not need to make a diagnosis yourself and start treating the fungus using pharmaceutical or folk remedies.

If the diagnosis is wrong, and in fact, the cause of the symptoms is not a fungus, but psoriasis, then the treatment will not be useful, but, on the contrary, will worsen the symptoms.

When you contact a dermatologist, a fungal test will be done and an itch from the nail or skin will be taken.Then the resulting material is placed in nutrient media.If fungi are present in the material, then within a few days a large colony will grow in the test sample.From the appearance of the material, it will be possible to understand what kind of fungus caused the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, this can be a bacterial infection or a fungus.Therefore, patients who change the clinical picture (appearance of purulent secretions, change in the color of plaques, etc.)You will need to be tested periodically for fungi and other infectious agents.

In the diagnostic process, a certain role is assigned to a group of phenomena called the psoriatic triad.The phenomena appear sequentially when an element of the rash is scratched.

The psoriatic triad is manifested as follows:

• when an element of the rash is scratched, the scales are removed in the form of "chips";
• after removing the chips, a thin transparent film similar to polyethylene is revealed;
• When the film is damaged, accurate bleeding occurs.

A dermatologist diagnoses psoriasis, but if necessary, the doctor can refer the patient for consultations with other specialists - a rheumatologist, gastroenterologist, surgeon, etc.

Interesting facts about psoriasis

People have known about psoriasis since ancient times.Even the name of the disease came to our language from ancient Greek.During the heyday of Ancient Hellas, the word "psora" meant all skin diseases that manifested as skin and itching.

The first person to write a detailed treatise on psoriasis was a Roman named Cornelius Celsus.In the fifth volume of his work "De medicina" there is an extensive chapter dedicated to this disease.

They knew about psoriasis, but this disease was not evaluated unambiguously, as it was called either the "imperial" or "devil" disease.

Of course, ancient healers knew very little about psoriasis.Until the 19th century, this disease was often confused with other skin diseases.Psoriasis was first identified as an independent nosological form in 1799. This was done by the English dermatologist Robert Willan, who identified psoriasis from a large group of skin diseases manifested by itching and inflammation.

Not only ordinary people, but also prominent political figures knew about psoriasis firsthand.For example, Winston Churchill, who suffered from this disease, promised to erect a monument of pure gold to a person who could learn everything about psoriasis and provide effective treatment for this disease.

Modern ideas about disease

It must be said that modern science does not know much about this mysterious disease.There are different theories about the origin, course and treatment of psoriasis.

Here are some facts about psoriasis that are beyond doubt among experts:

• Despite the fact that the causes of the disease are unclear, we managed to discover the nature of psoriasis.This disease is autoimmune, that is, it is caused by a malfunction of the immune system;
• Another proven fact about psoriasis: the disease can be inherited.However, this is not always the case;even if both parents are sick, the risk of developing the disease in their child is 65%.At the same time, some patients develop psoriasis, although none of their relatives is sick;
• An interesting fact about psoriasis is that this disease is characterized by the Koebner phenomenon.This phenomenon is manifested in the fact that elements of redness are formed in places of damage to the skin - scratches, burns, frostbite.Sometimes psoriasis appears after some time, in the place of wounds;
• An important observation that allows us to get more information about psoriasis is the connection of this disease with climatic factors.Exacerbations and relapses are often timed to coincide with the change of season;
• Patients have probably noticed in practice the connection between irritations and stress.All patients should know for sure that the disease recurs or worsens against a background of nervous tension and anxiety;
• a new fact about psoriasis is that the disease can debut at any age, although previously it was believed that pityriasis versicolor appears after 30;
• It is important for all people to know that psoriasis is not a contagious disease.Even with close contact with a patient, there is no risk of infection;
• Almost everyone has heard about the incurability of psoriasis, and this is true, since no treatment has been found that could be guaranteed to defeat the disease.But patients should know that psoriasis can be controlled.Adequate and timely treatment allows you to achieve long-term remission.

Modern methods of treatment

Talking about the common disease psoriasis, we cannot avoid talking about the treatment of this common disease.It must be said that psoriasis cannot be cured with tablets or ointments alone.

To forget the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will have to make an effort.It will be necessary to organize the food properly.Some experts say that you can forget psoriasis forever only with the help of a properly formulated diet and regular cleansing of the body.

The doctor will draw up a preliminary regimen according to which the treatment will be carried out.As a rule, methods of external therapy (ointments, creams) and systemic (tablets, injections) are used.Also, physiotherapeutic methods will be used and treatment in resorts will be recommended.It is recommended to treat psoriasis using healing mud, mineral and thermal water.

Resorts can also offer non-traditional treatment methods.For example, with the help of fish that live in thermal springs.These little healers effectively remove dead skin flakes and disinfect the skin, promoting faster healing.

Resorts may offer other methods of treating lichen planus.For example, leech therapy, healing baths and applications, sun treatment, etc.

You will have to prepare for the fact that the treatment regimen will change periodically.Since not all methods are suitable for a specific patient.If the chosen treatment methods have no effect, they will have to be replaced.

Traditional methods of treating psoriasis are also widely advertised.Indeed, some of them can help achieve forgiveness.However, when choosing a method, you should remember common sense so as not to harm your health.If any recipe or recommendation is in doubt, then it is better not to use it.Consult your doctor before using any treatment method.

You should understand that it will be possible to forget psoriasis forever only if the patient himself and his immediate environment are in a positive mood.Only faith in success and an optimistic attitude will help defeat this mysterious and insidious disease.