Psoriasis - what kind of disease is it?

Despite the fact that psoriasis is a common and long-known disease, it is still not fully studied.And patients usually do not even know that psoriasis is not a bacterial infection or a fungus, but a non-standard reaction of the immune system, caused by unknown reasons.Information about the causes and symptoms of psoriasis will be very useful for patients, as it will help them overcome the disease.

What kind of disease is this?

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

Almost everyone has probably heard of a disease like 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 data on the frequency 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 rather significant period of time, researchers have been able to learn not enough about the causes and treatment of psoriasis.

Wide distribution, uncertainty of etiology (reasons for occurrence), insufficiently effective treatment - all this characterizes psoriasis as one of the most difficult problems in dermatology.

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

Therefore, when answering the question of what psoriasis is, a modern dermatologist will answer that it is a disorder of trophism and metabolic processes in the skin caused by malfunctioning 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, since psoriasis often acts as a hereditary or familial dermatosis.A detailed 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 to separate 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 an 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 the case of a virus infection, but also in the presence of certain conditions.

There are other theories that explain the appearance 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 certain 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 influence on the course of this disease.

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

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc.) lead to tissue degeneration of this organ, i.e. 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 accompanied by 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 exclude alcohol.

So, despite numerous studies, it was not possible to get an exact answer to the question of what psoriasis is.However, the 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.In order to make it easier for experts to navigate, 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 Register of Diseases is already in use, which is why the abbreviation ICD 10 is used. Work on the 10th revision of the International Classification of Diseases began in 1983 and was completed in 1987.

Essentially, ICD 10 is a standard assessment tool used in medicine and health care management.The 10th revision of the manual serves to monitor the spread 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 makes it possible to obtain statistical data and systematize diagnostic information.As agreed by WHO members, ICD 10 is used to assign codes to various diseases.In version 10 of the classifier, alphanumeric codes were 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 separate code.In dermatology, the following forms and types of psoriasis are distinguished:

• Common psoriasis(synonyms: vulgar, simple, like a placard).The disease received 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 plaques raised above the surface of the unaffected skin, covered with white-gray skin flakes.This form is characterized by a slight flaking of the scales.After their removal, inflamed red skin is revealed, which is easily injured and begins to bleed.As the inflammatory process progresses, plaques can significantly increase in size.
• Inverse psoriasis.This is a disease that affects skin folds (flex surfaces).For this form of the disease, the ICD 10 code is L83-4.Dermatosis occurs with the formation of folds of smooth or minimally scaly spots on the skin.The condition worsens when the skin is injured by friction.The disease is often complicated by an associated streptococcal infection or fungus.
• Guttate psoriasis.This form of psoriasis is characterized by the formation of a large number of small red or purple spots in the form of water droplets on the skin.According to the 10th version of the international classification, this disease was coded L4.Guttate psoriasis most often affects the skin of the legs, but the rash 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– it is a severe skin form, according to ICD 10 it is assigned the designation L1-3 and L 40.82.It is characterized by the formation of blisters or pustules.The skin in 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 over the entire body.
• Arthritis psoriatic or arthropathic psoriasis.According to the 10th version of the ICD, the pathology is coded L5.It is manifested by inflammation of the joints.Arthropathic psoriasis can affect all types of joints, but in most cases inflammation of the joints occurs on the phalanges of the fingers and hands.The knee, hip or shoulder joints can be affected.Lesions can be so severe that they disable the patient.Therefore, you should not think of psoriasis as an exclusively 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 was coded L85.Erythrodermic psoriasis often manifests generalized;the affected area can cover the entire or almost the entire surface of the skin.The disease is accompanied by severe itching, swelling and pain.
• Psoriatic onychodystrophy or nail psoriasis.According to version 10 of the ICD, the disease is coded L86.The pathology manifests itself as changes in the appearance of the nails on the toes and fingers.Nails may change color, become thicker, and begin to fall apart.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 speak of universal psoriasis.

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

Flow stages

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

The progressive stage of psoriasis is characterized by the following:

• appearance of new rashes;
• growth of existing plaques;
• the appearance of new elements of the rash at the site of skin injuries (scratches, scratches);
• excessive peeling of existing plaques.

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

• lack of emergence of new elements;

• moderate peeling of elements;
• no signs of elemental growth.

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

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

• reduction of peeling intensity;
• element resolution.

After removing psoriatic plaques, hypo- or hyperpigmented spots remain in their place.

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

• winter (with worsening in autumn and winter);
• summer (with exacerbations in the warm period);
• Non-seasonal psoriasis is the most difficult type, since there is no clear connection between relapses and seasons, periods of remission 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 mistaken for nail fungus, because 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.Because skin mycoses (skin fungi) manifest themselves with similar symptoms - the formation of scaly 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 with pharmaceutical or folk remedies.

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

When contacting a dermatologist, a fungal test will be done and a nail or skin scraping will be taken.Then the obtained material is placed in nutrient media.If the fungus is present in the material, then in a few days a large colony will grow in the test sample.By the appearance of the material, it will be possible to understand which type of fungus caused the infection.

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

In the diagnostic process, a certain role is attributed to a set of phenomena called the psoriatic triad.The phenomena appear sequentially when the rash element is scraped.

The psoriatic triad manifests itself in the following way:

• when the rash element is scraped, 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, precise bleeding occurs.

A dermatologist makes a diagnosis of psoriasis, but if necessary, he can refer the patient to consultations with other specialists - 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" denoted all skin diseases that manifested as peeling 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 unambiguously assessed, because it was called either the "emperor's" or the "devil's" 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 that are manifested by itching and flaking.

Psoriasis was known first-hand not only by ordinary people, but also by prominent political figures.For example, Winston Churchill, who suffered from this disease, promised to erect a monument of pure gold to the person who could learn all about psoriasis and offer an effective treatment for this disease.

Modern ideas about illness

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 have managed to learn about the nature of psoriasis.This disease is autoimmune, that is, it is caused by a malfunction of the immune system;
• Another established 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 rash are formed in places of skin damage - scratches, burns, frostbite.Sometimes psoriasis appears after some time, in the place of scars;
• 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 with the change of season;
• Patients have probably noticed the connection between exacerbations and stress in practice.All patients should know for sure that the disease repeats or worsens its course against the background of nervous tension and anxiety;
• a new fact about psoriasis is that the disease can appear at any age, although pityriasis versicolor was previously believed to appear after the age of 30;
• It is important for all people to know that psoriasis is not a contagious disease.Even with close contact with the patient, there is no risk of infection;
• Almost everyone has heard about the incurability of psoriasis, and it is true, because no medicine has been found that would guarantee to defeat the disease.But patients should know that psoriasis can be controlled.Adequate and timely treatment enables achieving long-term remission.

Modern methods of treatment

Speaking about the common disease of psoriasis, we cannot but talk about the treatment of this common disease.It must be said that it is impossible to cure psoriasis only with pills or ointments.

In order to forget about the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will have to make efforts.It will be necessary to properly organize the food.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 create a preliminary regimen according to which the treatment will be carried out.As a rule, methods of external (ointments, creams) and systemic (tablets, injections) therapy are used.In addition, physiotherapeutic methods will be used, and treatment in resorts will be recommended.Treatment of psoriasis with medicinal mud, mineral and thermal water is recommended.

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, medicinal baths and applications, sun treatments, etc.

You must be prepared for the fact that the treatment regimen will change from time to time.Because not all methods are suitable for a particular patient.If the selected treatment methods do not work, they should be replaced.

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

You must understand that it is possible to forget about 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 to defeat this mysterious and insidious disease.