Psoriasis is a chronic non-communicable disease that until recently was considered simply a skin disease. A feature 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, whereas, as in psoriasis, it is 4-5 days, i. e. , after 4 days, skin cells gradually die, forming plaques, dryness, skin rash, etc.
The problem of treating this complex and difficult disease to treat today is urgent not only for dermatologists, many doctors of other specialties are often involved in determining the causes of psoriasis in a patient, and are also directly involved in the treatmentcomplex of this disease. Today, medicine considers psoriasis in terms of a systemic failure in the body, and not just as an inflammatory process of the skin.
Even his name has changed, he is now a psoriatic disease. Why is psoriasis a systemic pathology? Because in patients, several different disorders in the work of the body as a whole are found immediately - in the nervous, endocrine, immune. In medicine, there are several types of psoriasis, there are also a large number of reasons for the occurrence of this disease, mainly these are theories, as there is no convincing evidence of these alleged causes, we will examine them in more detail.
Some facts:Psoriasis is not contagious as it is believed to be caused by a malfunction in the human immune system, namely overactive T lymphocytes in the skin. Psoriasis is classified as an inherited disease, with 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 the appearance of psoriasis or relapse is taking antibiotics, NSAIDs, B vitamins, as well as stress, alcohol and skin damage.
Viral theory of the cause of psoriasis
A number of studies conducted among 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 it is retroviruses, which are genetically transmitted from heredity, that may be one of the causes of psoriasis, but to prove the viral nature of the origin of psoriasis, it is necessary to identify the virus, isolate it and select the habitat and so on. now no one can do that.
The fact is that retroviruses have the ability to modify the genetic code of the host, they, with the help of the reverse transcriptase enzyme, have the ability to synthesize DNA and a "fake program" is formed in the cells that changes the genome ofhuman. However, it has been proven that even with blood transfusions from psoriasis patients to healthy individuals, infection or transmission of the disease has never been observed. Therefore, the version regarding the viral cause of psoriasis has not yet been proven.
Immune cause of psoriasis
This is one of the generally accepted theories of the causes of psoriasis, since cellular immune disorders are considered to be the leading cause of the disease. It has long been observed that in people with a genetic predisposition to psoriatic disease, in the case of chronic foci of infection - tonsils, sinuses, which show impaired immunity - are provocative factors for the appearance of psoriasis.
When a major focus of psoriasis occurs, medicine also suggests that epidermal damage is caused by autoimmune aggression. In numerous studies of psoriasis patients, abnormalities in immune complexes, antibodies, immunoglobulins, which cause Munro microabscesses have been identified.
In the process of activating the inflammation of psoriasis, skin hypersensitivity increases significantly, therefore, in places of physical or chemical irritation, typical psoriatic rashes appear. During the examination of the skin scales, antigenic ingredients were found, and antibodies to them in the blood, which are not found in healthy people neither in the skin nor in the blood.
This fact provides grounds to claim that the autoimmune process plays an important role in the cause of psoriasis. But every process, even immune reactions, are played out in the body as in an integral system, therefore, a combination of other factors must be considered, such as endocrine influence, hereditary factors, metabolic disorders.
Infectious theory of psoriasis development
One hundred years ago, many researchers stubbornly searched for an infectious agent of psoriatic disease and streptococci, spirochetes and epidermophytos were found guilty of its occurrence. However, none of these pathogenic microorganisms, fungi, after research, were found to be the cause of psoriasis. However, infectious diseases, tonsillitis, ARVI flu worsen or cause the initial onset of psoriasis, especially in the cold season, when the immune system is weakened and patients with psoriasis are often admitted to hospital.Some authors believe that the development of psoriasis against the background of acute and chronic infection is explained by the influx of impulses from the focus of infection into the endocrine system and the vegetative part, which leads to a restructuring of the body's reactivity. Very often, respectively in 90% of cases, chronic tonsillitis accompanies psoriasis, which confirms the impact of infectious processes and impaired immunity on the development of psoriasis.
Also, according to many experts, there is an infectious-allergic cause of psoriasis. Its proponents believe that psoriasis is an allergic reaction of tissues to viruses, streptococci and their metabolic products. However, neither viral nor infectious theory has yet been confirmed.
Genetic cause
This cause is based on a familial manifestation of psoriasis between close and distant relatives. However, psoriasis should not be considered a strictly inherited disease, as well as diabetes, cancer, ischemic heart disease, as not psoriasis itself is inherited, but only a genetic predisposition to it. Yes, 60% of psoriasis patients have ancestors or close relatives suffering from this disease and if one of the parents is ill, then, according to the theoretical probability, the child's risk of developing psoriasis increases by 25%, and ifboth parents are ill, up to 75%.
However, not always with psoriasis, the cause is only a genetic factor. This disease has recently become very common in clinical practice and does not always have a direct dependence on the predisposition associated with it. In psoriasis, the causes of onset are so many factors that it is impossible to tell without a doubt a specific cause. Since pathogenic factors are also violations of protein or carbohydrate metabolism, and changes in lipids, enzymatic metabolism, a combination with foci of streptococcal infection or a 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 drop in body temperature, and this is one of the symptoms of a slowed metabolism, also marked an increased cholesterol content, which shows changesin lipid metabolism. Given the high level of cholesterol, many researchers consider psoriasis as a cholesterol diathesis and consider its increase as the initial manifestation of dermatosis, as a violation of lipid metabolism stimulates the formation of keratinization of the skin.
Also, in psoriasis, the metabolism of vitamins is disturbed, especially of vitamins C, A, B12, B6, while the content of vitamin C in the skin increases. Also, changes in the content of iron, copper, zinc were observed, which significantly reduces the adaptive properties of the human body. Almost 25% of patients with psoriasis also suffer from diabetes, however, some researchers consider this fact not as the cause of psoriasis, but, on the contrary, as a manifestation of psoriatic disease.
As the disease progresses, basal metabolism in patients with psoriasis increases more frequently, and in those patients who have a reduced metabolism often show symptoms of hypothyroidism, endocrine glands, gonads, in 60% of patients with psoriasis, general metabolismof carbohydrates is concerned. Low calorie diet, or even moderate fasting, reduces the body's self-poisoning, therefore, a diet for psoriasis therapy improves the patient's condition.
Provocative factors for psoriasis
At the current stage of medical research in the field of determining the cause of psoriasis, it can be said that this is a recurrent systemic disease that occurs in genetically predisposed people, with concomitant disorders of various metabolism of the central nervous system. .
Stress
For both the onset of psoriasis and the worsening of existing chronic psoriasis, the main causes are most often stress, psychological trauma, prolonged fatigue, and nervous tension.
Stress causes immunological and biochemical reactions that contribute to the development of psoriasis. However, sometimes negative emotions serve, on the contrary, to complete the clinical symptoms of psoriasis. According to a study of patients with psoriasis, this provocative factor causes the onset of the disease in 49% of patients and in 41% gives recurrence of psoriasis.Infectious diseases, vaccinations, chronic foci of infection
Tonsillitis, sinusitis, STIs, otitis media, and so on, very virulent streptococcus is often detected. For an exacerbation of the disease, this factor is important in 21% of patients and for the onset of psoriasis development, infection is a triggering mechanism in 15% of patients.
Hormonal changes in women
During pregnancy, breastfeeding, during menopause or during adolescence - in 6% of patients surveyed, this was also a provocative factor in the development of psoriasis.
Injuries, bites, burns
Any trauma to the skin - in 12-14% of patients, the onset of psoriasis is caused by physical trauma.
Prolonged hypothermia
Is it the cause of psoriasis or its worsening in 5% of patients.
Medications
Such as any type of antibiotic, NSAID. Vitamin therapy - especially vitamins C, B, beta-blockers, cytostatics, vaccination, 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 patient survey, this is the cause of psoriasis in 4% of patients.
Drinking alcohol
Also, a provocative factor that causes the generalization of the inflammatory process shortens the remission period and increases the risk of complications, this is indicated by 3% of respondents.
Climate Change
High humidity, prolonged exposure to intense ultraviolet radiation, sudden changes in temperature and humidity - causes a deterioration in 2% of patients.
The first symptoms of initial psoriasis can occur regardless of age, they appear equally often in infants and people 20-40 years old, even in old age, the onset of psoriasis is possible. Of course, the earlier it appears, the more severe the consequences it causes to the patient. If psoriasis starts in a person after 30 years, it is usually associated with gastritis, liver disease, overweight, various neuroses, diabetes, arthritis and other diseases.