Psoriasis is a non-communicable, chronic disease that until recently was considered simply a skin disease. The peculiarity 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, when, as in psoriasis, lasts 4-5 days, or after 4 days, skin cells gradually die forming plaques. dryness, flaking of the skin and so on.
The problem of treating this complex and today difficult to treat disease is urgent not only for dermatologists, many doctors of other specializations are often involved in determining the cause of psoriasis in a patient, but are also directly involved in the complex treatment of this disease. Today, medicine considers psoriasis to be a systemic failure of the body, not just a cutaneous inflammatory process.
Even his name has changed, he is now a psoriatic disease. Why is psoriasis a systemic pathology? Because patients have several different disorders in the work of the organism as a whole - nervous, endocrine, immune. There are several types of psoriasis in medicine, and there are a number of reasons for the appearance of this disease, mostly theories, since there is no convincing evidence of these alleged causes, we will consider them in more detail.
A few facts:Psoriasis is not contagious because it is believed to be caused by a malfunction in the human immune system, or overactive T-lymphocytes on the skin. Psoriasis is classified as an inherited disease, with psoriasis in 1 parent, the risk of developing psoriasis in a child is 25%, if both parents have 65%. In addition to the hereditary factor, the driving mechanism for the occurrence of psoriasis or relapse is the intake of antibiotics, NSAIDs, vitamin B, as well as stress, alcohol and skin injuries.
Viral theory of the cause of psoriasis
Numerous studies conducted among patients with psoriasis have revealed various changes in peripheral lymph nodes, which may indicate the viral nature of the development of this disease. It is suspected that inherited retroviruses may be one of the causes of psoriasis, but in order to prove the viral nature of the origin of psoriasis, it is necessary to identify, isolate and select a habitat, and so far no one can do that.
The fact is that retroviruses have the ability to change the genetic code of the host, they, with the help of the enzyme reverse transcriptase, have the ability to synthesize DNA, and a "fake program" is created in the cells that changes the human genome. However, it has been found that even in the transfusion of blood from patients with psoriasis to healthy individuals, no infection or transmission of the disease has ever been reported. Therefore, a version of the viral cause of psoriasis has not yet been proven.Immune cause of psoriasis
This is one of the generally accepted theories about the causes of psoriasis, because cellular immunity disorders are considered the leading trigger of the disease. It has long been noticed that in people with a genetic predisposition to psoriatic disease, in the case of chronic foci of infection - tonsillitis, sinusitis, which indicate impaired immunity - provoke factors for the development of psoriasis.
When the primary focus of psoriasis occurs, medicine also suggests that epidermal damage is caused by autoimmune aggression. Numerous studies of patients with psoriasis have identified abnormalities in immune complexes, antibodies, and immunoglobulins that cause Munr's microabscesses.
In the process of activating psoriasis inflammation, skin hypersensitivity increases sharply, so rashes characteristic of psoriasis appear at the sites of physical or chemical irritation. During the examination of the scales on the skin, antigenic components and autoantibodies to them were found in the blood, which in healthy people are not found on the skin or in the blood.
This fact provides the basis for the claim that the autoimmune process plays an important role in the cause of psoriasis. But any processes, even immune reactions, take place in the body as a whole system, so a combination of other factors should be considered, such as endocrine influence, hereditary factors, metabolic disorders.
Infectious theory of psoriasis development
One hundred years ago, many researchers stubbornly searched for the infectious agent of psoriatic disease, and streptococci, spirochetes, and epidermophytes were blamed for its appearance. However, none of these pathogenic microorganisms, the fungus, after research has determined that it is the cause of psoriasis.
However, infectious diseases, tonsillitis, ARVI flu affect the worsening or trigger the primary onset of psoriasis, especially in the cold season, when the immune system is weak and patients with psoriasis are often admitted to the hospital.
Some authors believe that the development of psoriasis in 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 the restructuring of the body's reactivity. Very often, namely in 90% of cases, chronic tonsillitis accompanies psoriasis, which confirms the influence of infectious processes and weakened immunity on the development of psoriasis.
Also, according to many experts, there is an infectious-allergic cause of psoriasis. Her supporters believe that psoriasis is an allergic tissue reaction to viruses, streptococci and their metabolic products. However, neither the viral nor the infectious theory has yet been confirmed.
Genetic cause
This cause is based on the familial manifestation of psoriasis in close and distant relatives. However, psoriasis should not be considered a strictly inherited disease, as well as diabetes, cancer, ischemic heart disease, because psoriasis itself is not inherited, but only a genetic predisposition to it. Yes, 60% of patients with psoriasis have ancestors or close relatives who suffer 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 if both parents are ill, and up to 75%.
However, psoriasis is not always caused by a genetic factor. This disease has been very common in clinical practice lately and is not always directly dependent on the associated predisposition. The causes of psoriasis are so multifactorial that it is impossible to unambiguously indicate one specific cause. Because pathogenic factors are also a violation of protein or carbohydrate metabolism, and changes in lipids, enzymatic metabolism, combination with foci of streptococcal infection or viral nature.
Metabolic disorders as factors in the development of psoriasis
If we take into account metabolic disorders in psoriasis, then in many patients there is a slight decrease in body temperature, which is one of the symptoms of slow metabolism, there is also an elevated cholesterol content, which indicates changes in lipid metabolism. Due to the high level of cholesterol, many researchers consider psoriasis to be a diathesis of cholesterol, and consider its increase to be the initial manifestation of dermatosis, because the violation of lipid metabolism stimulates the creation of skin keratinization.
Also, in psoriasis, the metabolism of vitamins is disturbed, especially vitamins C, A, B12, B6, while the content of vitamin C in the skin is increased. Also, shifts in the content of iron, copper, zinc have been noticed, which significantly reduces the adaptive properties of the human body. Almost 25% of patients with psoriasis also suffer from diabetes mellitus, however, some researchers do not consider this fact to be the cause of psoriasis, but on the contrary a manifestation of psoriatic disease.
Progression of the disease most often increases basal metabolism in patients with psoriasis, and in those patients who have reduced metabolism often show symptoms of hypothyroidism, endocrine glands, gonads, in 60% of patients with psoriasis the general metabolism of carbohydrates is disturbed. A low-calorie diet or even moderate fasting reduces the body’s self-poisoning, so diet in the treatment of psoriasis improves the patient’s condition.
Provoking factors for psoriasis
In the current phase of medical research in the field of determining the cause of psoriasis, we can say that it is a systemic disease that is constantly recurring and that occurs in genetically predisposed people, with a simultaneous disorder of various metabolics of the central nervous system.
Stress
Both for the onset of psoriasis and for the worsening of existing chronic psoriasis, the main triggers are most often stress, psychological trauma, long-term fatigue and nervous tension.
Stress triggers immune and biochemical reactions that contribute to the development of psoriasis. However, sometimes negative emotions, on the contrary, serve to complete the clinical symptoms of psoriasis. According to the research of patients with psoriasis, this provoking factor causes the beginning of the disease in 49% of patients, and in 41% it gives a relapse of psoriasis.
Infectious diseases, vaccination, chronic foci of infection
Tonsillitis, sinusitis, sexually transmitted diseases, otitis media, etc. , very virulent streptococcus is particularly common. For the worsening of the disease, this factor is relevant in 21% of patients, and for the beginning of the development of psoriasis, the infection is the driving mechanism in 15% of patients.
Hormonal changes in women
During pregnancy, breastfeeding, menopause or adolescence - in 6% of patients examined, this was also a provocative factor in the development of psoriasis.
Injuries, bites, burns
Any skin trauma - in 12-14% of patients the appearance of psoriasis is caused by physical trauma.
Prolonged hypothermia
It is the cause of psoriasis or its worsening in 5% of patients.
Medications
Like any type of antibiotic, NSAIDs. Vitamin therapy - especially vitamins C, B, beta-blockers, cytostatics, vaccination, the use of herbal medicines in treatment - this provokes psoriasis in 6% of patients.
Food poisoning, food abuse
Chocolate, citrus fruits and other products - according to a patient survey, this is the cause of psoriasis in 4% of patients.
Drinking alcohol
Also, the 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 - cause deterioration in 2% of patients.
The first symptoms of initial psoriasis can occur regardless of age, they occur equally often in newborns and people aged 20-40, even in old age, psoriasis can begin to develop. Naturally, the earlier it occurs, the more severe the consequences it causes on the patient. If psoriasis starts in a person after the age of 30, it is usually accompanied by gastritis, liver disease, overweight, various neuroses, diabetes, arthritis and other diseases.