The stages of psoriasis are defined time intervals during which the disease takes on its characteristic features. Many psoriatics mistakenly call the stage a severe or mild form of the disease, but in medical records the term is used in a completely different sense.
What are the stages of psoriasis?
Psoriasis is recognized as a recurrent skin pathology, the appearance of which is caused by genetics. According to dermatologists, at least 2% of the world's population suffers from this disease, which means that the problem is very urgent. During psoriasis, 2 conditions are clearly distinguished:
- Return.This term refers to skin deterioration. In relapse, the patient suffers from itching, pain, burning, profuse skin rashes, irritation and discomfort. The victim's situation is aggravated by insomnia, neurosis and anxiety.
- Remission.This word is used to improve the appearance of the skin. During remission, the skin returns to its normal color, the redness goes away, and the area of psoriatic plaques shrinks.
The stages of psoriasis partly duplicate the description of remissions and relapses, so many dermatologists use these words alternately. In clinical practice, 3 stages of psoriasis have been described:
- progress phase;
- stationary;
- regression phase.
Since we are talking about a cyclic process, the phases merge into each other and form a continuous course of the disease.
Fact!The progress phase is considered to be the most difficult to feel.
What is the progression of psoriasis?
The progress phase is driven by a number of drivers, such as the cold season or stress. In some cases, even an experienced dermatologist cannot unambiguously determine the trigger. During the progressive phase, the following occurs:
- Psoriatic nodules develop rapidly, affect the skin, interconnect into so-called plaques that flake and itch. The plaque is a place of arbitrary shape, usually round or oval, sometimes with an uneven edge.
- Papules, or individual nodules of psoriatic rash, are nodules on the skin. The edges of the papules do not peel, and the central part peels off. As a large number of dead scales accumulate, deposits begin to grow above the surface of the skin. Puffiness gives them an even more convex and uneven appearance.
- This phase of pathology is characterized by an isomorphic reaction consisting in exacerbation of the rash in the case of skin lesions, scratches, injections, cuts, microtrauma. This phenomenon is called Köbner.
Delayed reaction is characteristic of the progressive stage of psoriasis. In some cases, the skin rash appears about 9 days after exposure to the trigger (such as a food allergen). Typically, a psoriatic rash appears within 24 hours after exposure to adverse factors.
Interesting!95% of psoriatics have some kind of food intolerance that can cause relapse. To avoid deterioration, you need to keep a food diary and observe the reaction to different types of food.
Stationary and recessive phases
The stationary stage is the period during psoriasis during which the victim's condition is relatively stabilized. In stationary phase:
- Psoriatic tiles have smooth outlines. The entire surface of the plaque is covered with a thick layer of flakes that peel easily. Itching and discomfort are moderate. There is no bright red inflamed edge around the papules.
- In microtrauma of the skin, the Koebner phenomenon is not noticed, ie scratching or cutting of healthy skin no longer turns into psoriatic plaque.
The regressive or recessive stage is characterized by massive lesions in psoriasis. A pseudo-atrophic edge around the papules may be observed first, and then patients notice a rapid cessation of skin peeling, with the formation of hyperpigmentation plaques in place.
Severity of pathology
An additional diagnostic criterion is the assessment of the area of psoriatic lesions. The term "seriousness" is used for the description. Dermatologists distinguish 3 degrees of severity of skin disease:
- Easy.Psoriatic plaques occupy 1 to 3% of the total body surface area. The small size of the affected areas does not mean that the patient is doing well. With psoriasis of the head or face, even a few pads will be enough to cause a person discomfort and nausea.
- Medium.The extent of psoriatic eruptions occupies 3 to 10% of the total body surface area. In this case, the back, chest and outer surfaces of the joints, scalp, palms and feet are affected. This prevalence leads to serious intoxication and severe pain. The patient may completely or partially lose their ability to work, the mental state and the condition of the nervous system worsen.
- Heavy.The disease covers more than 10-15% of the skin surface. According to rough estimates, if psoriasis occupies more than a quarter of the total body surface area, the likelihood of liver or kidney failure increases many times over. Decompensated damage to internal organs can cause the death of psoriatic patients.
To comprehensively assess the severity of psoriasis, a special scale called PASI is used. The scale takes into account:
- percentage of healthy and diseased skin;
- stage of pathology;
- patient response to drug therapy;
- individual tolerance of psoriasis (mental state, complications of the nervous system and psyche);
- objective data from laboratory tests in dynamics (for example, the volume of uric acid in a blood test).
The diagnosis takes into account all the symptoms that affect the condition of a person with psoriasis. The intensity is reflected in the medical record:
- itchy skin processes;
- redness;
- swelling;
- hyperemia;
- thickening of the skin;
- peeling;
- blood flow;
- swelling;
- infections;
- pain syndrome.
On the PASI scale, the volume of skin lesions is described by numbers, from 0 to 72, where 0 represents the absence of skin symptoms and 72 is the largest possible spread of the disease.
Attention!It is important that the patient first and foremost knows and monitors for signs of deterioration. If unfavorable symptoms appear, you should visit a dermatologist immediately, because psoriasis does not always enter the stationary stage. Relapse can last for decades.
The treatment of psoriasis depends on the stage
For each stage of the disease, a set of therapeutic measures has been developed, so the first thing a dermatologist determines is whether psoriasis has progressed, stabilized or regressed.
How to treat the progressive phase
Every psoriasis sufferer assumes that his remission ends because of his own feelings. If the itching gets worse, the skin looks worse, and the psoriasis is clearly spreading over the surface of the body, treatment should be started. Advanced therapy has the following features:
- The patient is engaged in the prevention of further deterioration, strictly adheres to the diet, refrains from triggers the pathological process (stress, smoking, alcohol).
- Antihistamines can be used for severe itching, an additional benefit of this class of drugs is the removal of swelling in the area of psoriatic plaques.
- Dermatologist prescribes a wide range of topical treatments to heal, soften and thin the skin. Creams, ointments or sprays are chosen by the doctor's decision. Compresses of tar soap and solid oil give positive dynamics. You can also apply compresses or apply cosmetics with Dead Sea mud.
The main task at this stage is to stop the deterioration before the disease enters a prolonged relapse. According to the indications, the doctor chooses corticosteroids in injections or in the form of ointments.
Attention!Corticosteroids should be used in a short and intensive course under the supervision of a dermatologist. You can give yourself injections or apply antihistamine ointments.
Inpatient and regressive therapy in phase
Further actions of the dermatologist depend on the body's reaction to the selected treatment. The following scenarios are possible:
- Medications have a positive effect. Within 1-2 weeks, psoriasis passes the stationary phase, regresses and remission occurs.
- Medications have no effect. If after 2-4 weeks from the moment of prescribing the drug the results are still not visible, this is the reason for changing the list of drugs or the doctor who comes.
- The drug is getting worse. Such dynamics are also possible, especially if the dose or frequency of administration is not sufficient. Recurrence is delayed, psoriatic deposits cover a large area of the body, the person needs hospitalization.
A more powerful therapy is used in a medical institution, for example, hardware blood purification. With a favorable reaction, psoriasis progresses to a stationary stage, which can last from a few days to several months.
Interesting!More than 80% of patients notice the seasonal nature of the deterioration. This makes the disease predictable and allows you to prepare for the onset of relapse.
The list of drugs for the stationary and regressive stages is exactly the same, but the doses and frequency of administration are less than those for the progressive stage.
10-15 years of remission
The competent dermatologist sets himself the following task - to choose such drugs and physiotherapeutic agents that will provide psoriatic patients with the longest possible improvement. At the same time, the patient himself should do everything to promote treatment, avoid triggers and take medication responsibly. If the alliance between patient and physician has developed successfully, then the duration of remission is unlimited. Stable wellness can last for 15 years or more.