With the onset, psoriasis in most patients does not go away on its own, but only progresses and becomes more extensive, spreading to the skin.
However, timely diagnosis makes it easier to treat, and recovery comes much faster.
The main thing here is to pay attention to the first signs of psoriasis and make an appointment with a dermatologist immediately.
Signs characteristic of psoriasis
Early psoriasis can appear as small, reddish, scaly patches.
The location of such rashes directly depends on the form in which the disease passes.
In most cases, you can see:
- in elbows and knees;
- on the head (in the hairy area);
- on palms and feet;
- in the area of the folds (buttocks, armpits, areas under the breast in women).
Primary eruptions (papules) are very small in size: their diameter does not exceed 4 millimeters.
However, as the disease progresses, they increase and merge with each other, forming plaques that do not have a clear shape.
Most often the appearance of papules is not accompanied by pain or itching. The feeling of discomfort increases with the development of psoriasis and an increase in the size of the affected areas of the skin.
The affected area begins to ache and itch, and the heat is strong.
These signs of psoriasis are complemented by emotional distress that can significantly increase the rate of spread of the disease.
It is inappropriate, when such rashes are found, to start self-treatment, because psoriasis in the early stages of development has similarities with other skin diseases.
Therefore, the wrong choice of medication will not lead to positive results, but will only worsen the situation.
Cumulative symptoms
Scaly lichen belongs to the category of systemic pathologies.
This means that it manifests not only on the skin and nails, but can also affect the spine, joints and tendons, some body systems (for example, endocrine, immune and nervous).
There have been cases where the disease affects the digestive (liver) and urinary (kidney) systems.
First symptoms of psoriasis
- constant feeling of tiredness;
- weakness;
- state of depression (all the way to depression).
Due to the complex effects of the disease on the body, experts consider it appropriate to call it a psoriatic disease.
But despite this, key aspects of the disease are based on skin damage.
As mentioned above, the first call to start the development of pathology are small papules in the color range between pale pink and red.
They differ in a symmetrical position on the surface of the skin (folds, lower back, area of the head covered with hair), sometimes - on the mucous membrane of the external genitalia.
The size of the papules in the further course of the disease can exceed 10 centimeters.
Psoriatic eruptions, depending on their characteristics, are divided into:
- dotted (their size is not larger than the pinhead);
- teardrop-shaped (teardrop-shaped, the equivalent of a grain size of a lens);
- coin (5 mm diameter tiles, rounded edges);
- Rarely rounded, ring-shaped or map-like.
The top of the papules are covered with plaques with scales, which form from keratinized epidermal cells and are removed without much effort. They initially appear in the center of the plate and gradually spread further.
Keratin cells have air gaps, resulting in visual fragility and light shadow.
Sometimes the elements are surrounded by a pink ring that acts as an area of growth and inflammation of the plaque. In this case, the condition of the surrounding skin does not change.
Plaque removal reveals a shiny, dark red capillary-based surface, which in turn has very thin walls.
The presence of such small vessels in diameter is a consequence of damage to the structure of the upper layers of the skin, whose structure is disturbed due to the incomplete process of maturation of epidermal cells (keratinocytes), which prevents their proper differentiation.
Symptoms of different forms of psoriasis
Frequent psoriasis has quite specific symptoms, so it will not be difficult to diagnose.
Looks like scaly, rounded areas that protrude above normal skin and are pink or red.
Sometimes, in the early stages of the disease, there are no characteristic plaques for it: before they appear on the scalp and in the area of the joints (ankle, elbows and knees), small papules can be noticed.
They are able to exist long enough and not cause discomfort to the patient: nothing itches or hurts or they are not there at all, or they are practically not felt, the papules themselves are almost impossible to notice.
They are not washed, but when lightly scraped, the scales appear immediately. Such pink seals can disappear in the summer or be significantly reduced because the sun’s radiation affects the skin.
The acute form of frequent psoriasis manifests itself in the form of multiple itchy rashes of brightly colored papules and is the result of the influence of factors that activate the disease.
In order not to confuse it with an allergic reaction, it is necessary to scrape the surface of the plaque shortly before the characteristic phenomena appear.
Seborrheic psoriasis starts on the scalp (in the area covered with hair) and then spreads to the face and shoulders.
It is characterized by severe peeling of the skin of the appropriate zone, which patients usually consider dandruff, so do not rush to the dermatologist.
This fact allows the disease to calmly reach the stage of development when the forehead and areas behind the ears are peeled off. And only after that do the plaques form.
A skin fold lesion with psoriatic disease (armpits, genitals and groin, under the breasts in women) is often confused with the usual irritation caused by friction or sweating.
This type of disease is characterized by smooth plaques that look like spots. Peeling is not noticed, but they often get wet. The rashes themselves are bright red, even and shiny.
When the genitals are affected, the characteristic signs of psoriasis can be misinterpreted as balanoposthitis (lesions of the head of the penis as well as the foreskin on its inner part) in men and vulvitis (a rash localized on the labia minora) in women.
The palmar-plantar form of the disease manifests itself in the form of dense, blister-like areas, the surface of which is covered with yellow scales that are difficult to remove.
The affected areas are cracked and painful. In this form of the disease, it is difficult to cause the appearance of the final film and bloody dew by scraping.
Nail psoriasis begins with psoriatic onychodystrophy, which is one of the primary symptoms of this form of the disease and manifests itself much earlier than the rash.
In the early stages the edge of the nail is covered with grooves and small indented areas.
As the disease progresses, it spreads, reaching the root, after which there is a change in its color. The nail became dull and thickened. Due to the malfunction in the blood circulation, the manifestation of the disease increases.
Epidermal cells accumulate under the nail plate, and it is bordered on all sides by redness of the tissue, after which it can peel off after a while.
This type of psoriasis is dangerous because it increases the sensitivity of the tissue, which in turn increases the likelihood of infection. This disease is often mistaken for a fungus.
Movable bone joints (joints) are often affected. They are deformed, the joint capsule undergoes modifications of the dystrophic type.
Psoriatic arthritis begins with an increase in joint volume, which is accompanied by pain.
Fingers and toes are most prone to this type of psoriasis.
In severe forms of the shoulder and elbow, the hip and knee joints, as well as some parts of the spine, are exposed to the disease.
Effect on the manifestation of psoriasis stage symptoms
The symptoms of psoriasis are in direct proportion to the season of the year and the stage of the disease.
Most often in the spring-summer period there is a noticeable decrease in disease activity, which is facilitated by ultraviolet rays.
Accordingly, in the autumn-winter period due to lack of sun the disease is rapidly gaining momentum. There are practically no patients with summer exacerbations.
There are three stages of psoriasis:
- progressive- characterized by the continuous appearance of new rashes, increase in the size of previously appeared plaques and their surroundings with pink borders, the affected area is very itchy and dandruffy;
- stationary- the new rash no longer appears and the old one does not grow; the upper layer of skin in the area of the deposits becomes wrinkled;
- regressive- the skin does not peel, the deposits disappear, leaving behind highly pigmented areas.
Diagnosis of psoriasis
The diagnosis of psoriasis is made on the basis of data obtained by medical examination by interviewing the patient, as well as the symptoms inherent in one or another form of the disease.
The sooner the disease is detected, the faster the healing process begins. Accordingly, more tangible results will be achieved.
Due to the very specific picture of the disease, the diagnosis of psoriasis can be limited to a simple examination by a dermatologist.
But in some cases difficulties can arise due to implicitness or absence of symptoms, which happens if the disease does not manifest in any way or looks uncharacteristic. This situation requires further research procedures.
A specific method is used to make a diagnosis, which consists of gradually scraping the papules along the layer.
As a result of such manipulation, it is possible to identify the characteristic signs (psoriatic triad) to distinguish psoriasis from other diseases and make a definitive diagnosis:
- stearin stain;
- terminal film (pink epidermal cells);
- dew of blood (drops of blood appear on the surface of the plaque due to rupture of capillaries).
If necessary, the patient is tested in the form of samples of affected tissues.
X-rays are taken if psoriasis-related arthritis is suspected.
If psoriasis is at an early stage, its diagnosis is not difficult: the picture of osteoporosis is clearly visible.
In later periods, there is a narrowing of the joint space, erosion of the tissues that make up the bones, osteosclerosis and periostitis.
If the disease is severe, then the ankle joints and metatarsal joints are destroyed, resulting in the joint completely losing mobility.
It should be noted that all tests performed are necessary not only for the final diagnosis, but also to distinguish it from other diseases that are, at first glance, identical.
These diseases include: parapsoriasis, seborrheic eczema, rosacea, atopic dermatitis, lupus erythematosus, rheumatoid arthritis and others.