Psoriasis is a chronic skin disease of non-infectious origin. According to statistics, 3. 7% of the world's population suffers from psoriasis. The disease is popularly called "scaly lichen".
Psoriasis does not depend on gender, it is not contagious; it most often develops at the age of 14-27 years. The disease is characterized by the appearance of red scales in the form of plaques (spots) covered with white scales. Freckles (or more spots) can be on any part of the body, but most often on places with thin and dry skin: elbows, knees, lower back, scalp.
The spots are of different sizes and are disturbing in different ways: in some patients only skin irritation is noticed; in other patients, large areas of skin are affected, which is accompanied by discomfort, itching, pain, insomnia and reduced quality of life.
Psoriasis is a chronic disease characterized by periods of exacerbation (rash) and remission (calming of symptoms).
Psoriasis often complicates pregnancy.
Causes of psoriasis
Psoriasis is a systemic process that involves not only the skin but also the whole body. The causes of psoriasis are not fully understood, but it is assumed that there are several: neurogenic (due to stress), hereditary, infectious, viral, mixed (skin damage by staphylococcal penetration in combination with any of the above reasons), etc. In that case, cellular and humoral immunity is activated and the autoimmune process of cell damage is initiated, primarily skin cells (epidermis).
In addition to activating the immune system, there are metabolic disorders. The disease is exacerbated by burdened heredity. As a result, cell regeneration is accelerated 3-5 times - psoriatic plaques form on the skin.
Without timely treatment, the lesion worsens: spots on the skin grow, crack, pus; nails are destroyed, joints are affected, etc.
The quality of life of patients with psoriasis 80% depends on timely diagnosis and proper treatment.
Once again, we list the factors that contribute to the development of the disease:
- poor heredity. Scientists have identified 9 genes that determine the development of the disease, but their interaction is not clear. It has been found that in 15% of cases psoriasis is inherited by 1st and 2nd generation relatives;
- stress, nervous tension, depression. Stress has been shown to worsen psoriasis in 70% of cases;
- hormonal imbalance;
- dysbiosis;
- metabolic disorders, drug addiction;
- colitis and parasitic infections (roundworms, lamblia, intestinal infections, etc. );
- viral infections;
- streptoderma; skin candidiasis;
- allergies.
Symptoms of psoriasis
In the initial phase, skin rashes of psoriasis are in the form of red plaques (spots) with scaly scales. The appearance of plaque on the skin is accompanied by intense itching. Under the shell there is a thicker (keratinous) layer.
Here are 6 major forms of psoriasis; each has its own symptoms:
Plaque psoriasis occurs in 85% of patients. It is characterized by a dry, pink rash, raised above the skin, covered with silvery scales. The skin in the affected areas often peels off; in this place remain red spots that bleed during trauma. In 60% of cases, the plaques merge into large plates.
Guttate psoriasis is characterized by many small, dry lesions in the form of pink droplets raised above the surface of the skin. The rash is localized on the thighs, legs, affecting large parts 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 redness, edematous peeling skin. Legs and thighs are more often affected.
Psoriasis of the flexor surfaces is manifested in the form of smooth, red, non-scaly patches located in the area of the skin folds: the lateral surfaces of the thighs, armpits and areas of the external genitalia. Due to mechanical irritation (physiological friction), the spots are injured, bleeding and purulent.
Nail psoriasis is manifested by discoloration, the appearance of spots and transverse lines on the nails. The skin around the lesion is hardened. As the disease progresses, the nail peels, thickens, and then dries or falls off.
Psoriatic arthritis (15% of cases). All joints are affected, but more often small - the phalanges of the hands and feet. Fingers become like sausages. Psoriasis of the joints leads to bursitis, disability of the person.
Let's talk about head and elbow lesions separately.
Scalp psoriasis (primarily scalp) is the most common form of the disease. It is more common at a young age. It manifests as red spots that itch and itch. Redness is almost always noticeable, so it causes emotional discomfort and leads to a person’s social isolation.
Elbow psoriasis is a disease of middle-aged people. It manifests itself in the form of a rash on the extensor surfaces of the elbow joints. The rash spreads outwards and merges - a large plaque (plaque) is formed, covered with silvery scales that fall off easily. Together with the shell, a thin protective film separates, revealing a bleeding surface. In 80% of cases, the spots disappear on their own, without treatment, but sometimes they thicken (age) and last for years, causing psoriatic lesions of the elbow joint.
Diagnosis of psoriasis
Diagnosis and treatment of psoriasis is performed by a dermatovenerologist.
Due to the characteristic skin lesions, the diagnosis of psoriasis is simple. General blood tests and determination of rheumatoid factor are used as additional laboratory tests. For the diagnosis of psoriatic arthritis, consultation with a rheumatologist and X-ray of the affected joints are indicated. In rare cases, a skin biopsy is performed for a differential diagnosis.
Psoriasis should be distinguished from similar skin diseases: seborrhea, lupus, etc.
Treatment of psoriasis
Psoriasis is a chronic disease with periods of exacerbation (recurrence of skin rashes) and remission (disappearance of rashes). It is impossible to recover from psoriasis forever. You can prolong remission and reduce the intensity of exacerbations.
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 exacerbations and complications. The effectiveness of treatment is influenced by the type of psoriasis, age, concomitant diseases, etc. For mild psoriasis, local 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 the immune response;
- glucocorticosteroids, which regulate metabolic processes and reduce inflammation;
- nonsteroidal anti-inflammatory drugs (to reduce itchy skin);
- multivitamins.
Physiotherapy is prescribed: ultraviolet radiation, cryotherapy, plasmapheresis, chiropractic. Folk remedies are also used: fats based on celandine and lard, meadow and vaseline, beeswax and lard. To normalize immunity, they drink homemade oat yeast, bay leaf infusion and dill decoction.
Diet, especially in 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 worsening psoriasis, you need to improve your health, avoid stress, hypothermia and seasonal illnesses.
Here are simple rules to prevent worsening psoriasis:
- do not dry the skin;
- avoid prolonged sun exposure;
- avoid skin injuries;
- avoid stress;
- do not smoke or abuse alcohol.
Is psoriasis contagious?
There is no proven case of psoriasis transmission from a sick person during home or other contact. Therefore, psoriasis is believed to be not contagious.
Which doctor to go to
Consult a dermatovenerologist to begin timely treatment and avoid the spread of psoriasis. In the presence of psoriatic arthritis, a consultation with a rheumatologist is indicated.