Psoriasis is a common non-infectious skin disease that is associated with inflammatory lesions. This is the chronic phase – the acute phase followed by periods of remission or disappearance of symptoms – and is caused by a combination of many different factors.
This disease is common and occurs more often in women than in men. It is not a complete cure, but can relieve symptoms and improve a patient's quality of life.
Psoriasis can lead to arthritis, arthritis.
Synonyms of Russian
Lichens have scales.
English synonyms
Psoriasis.
Symptom
The symptoms and signs of psoriasis depend on the type of psoriasis.
- Plaque psoriasis. It is accompanied by specific inflammatory skin formations - raised red lesions, oval, with clear borders, peeling and covered with silvery scales. Usually, the formations appear on the outer surfaces of the elbows, knees, scalp, and trunk. The factors that cause skin rashes can cause pain and itching. In severe cases, the skin near the joints of the affected areas cracks and bleeds.
- Intestinal psoriasis. This type is associated with the appearance on the body of many pink-orange papules (nodules) ranging in size from 1 to 10 mm. The rash usually appears on the torso, shoulders, and thighs, but can be found all over the body. As a rule, it affects people under 30 years of age, as well as 2-3 weeks after contracting infectious diseases of the upper respiratory tract, after superficial bacterial infection of the anus.
- Psoriasis of the nails. It is characterized by compaction, peeling, discoloration of the nail plates, discoloration, yellowing of the nails, the presence of spots on them, the formation of pits, cracks, lesions on the nails. The nail plates are destroyed, the nail growth is disturbed, they can be separated from the nail bed. It occurs in 30-50% of patients with psoriasis.
- Psoriasis of the large folds. In this case, skin lesions in the form of red inflammatory nodules appear in the folds of the armpits, under the mammary glands, in the folds of the cervix, in the genitals, on the foreskin. Cracks may appear along the edge and in the center of the lesion. Usually, fold psoriasis occurs in people who are overweight and obese. Sweating and friction make the disease worse.
- Psoriasis of the head. Accompanied by a red, itchy, flaky scalp with the appearance of white flakes on the hair and shoulders - particles of dead skin.
- Psoriatic arthritis. Skin lesions accompanied by joint pain, swelling, curvature and joint deformity. The joints of the fingers, wrists, feet, and knees can be affected.
- Pustular psoriasis. This type is characterized by reddening of the skin and the formation of a large number of pustules - small blisters filled with pus. The formations may appear on the palms and soles or all over the body. When many pustules appear on the body, accompanied by fever and weakness.
- Erythema psoriatic. Reddened areas of skin, patches may appear. Lesions are often accompanied by intense itching. Usually, psoriatic erythema is associated with sunburn or medication misuse.
Usually, with different types of psoriasis, the disease manifests gradually, the skin lesions spread and are observed for several weeks. Then the symptoms disappeared. After exposure to a factor that contributes to the development of psoriasis (or spontaneously), symptoms reappear after a while.
General information about the disease
Psoriasis is a common non-infectious skin disease that is associated with inflammatory lesions.
It is a chronic and often relapsing disease - the acute phase is followed by a period of weakening or disappearance of symptoms, followed by a period of reappearance of symptoms.
Psoriasis is widespread, especially in people aged 16-22 years, 57-60 years old. Women are more susceptible to this disease than men. People with fair skin have a higher risk of developing the disease.
Despite the fact that psoriasis is synonymous with scaly lichen, it is absolutely not contagious to others.
The cause of psoriasis is still not fully established. Its occurrence is associated with a genetic predisposition, with malfunctions of the immune system and with environmental factors affecting the body.
The development of psoriasis is associated with one of the cell types of the immune system (with T lymphocytes), while the hyperactivity of T cells. Normally, they travel with the blood throughout the body. body, detect foreign agents - viruses and bacteria. In psoriasis, for unknown reasons, T cells begin to accumulate on the skin. Their hyperactivity causes the dilation of blood vessels in the affected area, breaking the cycle of formation of new skin cells - they are formed much faster than normal. Meanwhile, dead skin cells that do not have time to exfoliate will accumulate on the surface of the skin, forming patches.
Psoriasis can be triggered by one of the following factors:
- infections (tonsillitis, thrush, HIV);
- skin damage - cut, scratch, bite, or burn;
- Hypothermia;
- sunburn;
- emotional stress;
- smoking, abuse of alcohol;
- the use of drugs (malarial, etc. ).
Also, in some patients with psoriasis, rashes appear without obvious environmental factors.
There are the following main types of psoriasis.
- Plaque psoriasis. It is the most popular.
- Intestinal psoriasis. It usually affects people under the age of 30. It occurs 2-3 weeks after the transfer of infectious diseases of the upper respiratory tract, as well as after a superficial bacterial infection in the area around the anus.
- Psoriasis of the nails.
- Psoriatic arthritis. In this type of psoriasis, skin lesions are accompanied by arthritis - inflammation of the joints.
- Erythema psoriatic. Most often associated with sunburn and drug abuse.
- Pustular psoriasis. It is quite rare, in severe cases it is life-threatening to the patient.
- Psoriasis of the head. In this case, hair loss due to the disease usually does not occur, as the hair roots lie much deeper than the scab formation.
Classification of psoriasis by severity of course:
- tender (less than 2% of the entire skin is affected);
- moderate (skin lesions occupy no more than 3-10% of the skin surface);
- severe psoriasis (more than 10% of the skin is affected).
Depending on the type, location, and extent, psoriasis can cause complications:
- thickened skin, additional infections secondary to scratching, and scratches that appear as a result of itching with psoriasis;
- psychological problems (stress, low self-esteem, depression, social isolation);
- joint damage (deformation with stiffness and reduced mobility of the joint);
- increased risk of developing various diseases and conditions: high blood pressure, inflammatory bowel disease, cardiovascular disease, skin cancer.
Psoriasis is usually relatively mild. However, for most patients, social adaptation becomes the main issue, especially when there is skin damage in visible skin areas - the hostility of others towards this type of person. skin lesions, their fear of infection (many people do not know that the disease is not contagious).
Who is at risk?
- People with genetic predisposition (more than 40% of patients with psoriasis have a relative with psoriasis).
- People infected with viruses, bacteria, fungi (streptococcal, thrush, HIV, . . . ).
- Emotional stress.
- Obese and overweight people.
- Smoker.
- Alcohol abusers.
- Are taking certain medications (malarials, etc. ).
- Sunburnt.
Diagnose
The diagnosis of psoriasis is usually based on the type of typical lesions, taking into account their location. In difficult cases, further testing may be required to rule out other skin conditions.
Research in the laboratory
- General blood analysis. With psoriasis, leukocytosis and anemia can be detected.
- Rheumatoid factor (RF) is a protein, the level of which in the blood can be elevated in systemic inflammatory diseases accompanied by joint damage, especially in rheumatoid arthritis. Psoriasis test results were negative. This allows you to distinguish psoriasis from rheumatoid arthritis, in which RF is increased.
- The erythrocyte sedimentation rate (ESR) is generally normal, except for pustular psoriasis and erythrocytosis.
- Uric acid. Uric acid levels in psoriasis can be elevated (especially in pustular psoriasis), leading to psoriatic arthritis that is mistaken for gout, in which uric acid levels rise dramatically.
- Antibodies to HIV (Human Immunodeficiency Virus). Sudden-onset psoriasis can be caused by HIV infection.
Other research methods
- Joint X-ray. Allows you to assess the severity of joint damage in psoriatic arthritis.
- Skin biopsy. The examination involves taking a small sample of skin for later examination under a microscope. It is performed in cases where it is difficult to distinguish psoriasis from other skin diseases.
Treatment
Psoriasis therapy includes topical treatment of skin lesions, medication, phototherapy, and prevention of exposure to rash triggers. It depends on the type and severity of psoriasis.
To remove skin lesions, emollients (creams, mineral oils, paraffins, vegetable oils) can be used. They are most effective when used twice daily after bathing. Also used are salicylic acid, anthralin, tar preparations, ointments, solutions, shampoos containing coal tar. These agents have anti-inflammatory properties and slow down the formation of new skin cells.
The use of corticosteroid ointments makes the treatment more effective. They are indicated for mild to moderate psoriasis. However, their long-term use is not recommended (possibly skin atrophy, drug addiction).
Light therapy - exposing the skin to UV radiation - may be beneficial. In this case, burns should be avoided.
Local treatment of lesions in more severe cases is combined with the use of drugs - retinoids, vitamin D preparations, methotrexate, etc. v.
Treating psoriasis can be difficult, as the disease is chronic and recurs after symptoms disappear. The effectiveness of a particular treatment depends on the patient's susceptibility to it.
Showering daily (preferably with bath oil, oatmeal, or sea salt; avoid hot water and scrubs) and moisturizing after bathing can help soften skin and reduce inflammation caused by psoriasis.
Prevent
- Avoid hypothermia and sunburn.
- Avoid emotional stress whenever possible.
- Quit smoking and alcohol abuse.
- Use caution when taking certain medications (antimalarials, etc. ).
Proposal analysis
- General blood analysis
- Erythrocyte sedimentation rate (ESR)
- Low form factor
- Serum uric acid
- HIV 1, 2 Ag/Ab Combo (determination of antibodies to HIV types 1 and 2 and p24 antigen)