According to the World Health Organization, 2-4% of the world’s population currently suffers from psoriasis. This disease affects patients of all ages, but it is most common among young people (15-25 years old). Unfortunately, today's medicine cannot completely cure psoriasis, but timely professional treatment can significantly improve the quality of life. Therefore, if the first symptoms are found, it is best to consult a doctor immediately.
psoriasis-This is a skin disease characterized by scaly papules on the skin. Its distinguishing feature is that in addition to the skin, it can also affect the joints and nail plates. In the pathogenesis of psoriasis, genetic factors are clearly traced, and other stimulating factors are only secondary causes of its occurrence.
During the worsening of the disease, the natural process of formation is disrupted-keratinocytes (cells from which human skin is mainly composed). The skin also has obvious biochemical changes. In addition, recently, doctors have been able to determine that in the acute phase of the disease, the function of the nervous system is also different from normal. Generally speaking, the main cause of psoriasis is a malfunction of the immune system.
Prevalence of psoriasis
Psoriasis is very common. At present, the incidence statistics are roughly as follows:
- China-0. 3%;
- United States-1%;
- Denmark-1-2. 3%;
- Northern Europe-3%;
- Germany-1-1. 3%.
Strangely, the indigenous peoples of South America were not affected by this disease. At least one such case has not been reported so far. If you look at it as a whole, the proportion of psoriasis is about 6-8% of all skin diseases.
As mentioned earlier, psoriasis manifests at any age, but the most common is that young people (up to 25 years old) still suffer from the disease, and it occurs at the same frequency in men and women.
Epidemiological situation
According to the cause of disease, psoriasis is a non-communicable disease with obvious genetic predisposition. Those at greatest risk of illness are those whose relatives also suffer from the disease (in this case, only the closest relatives). European researchers have determined that if one of the parents is sick, there is a 14-25% chance that he will transmit the disease to his children. If both parents are sick, the probability is already 41-60%.
According to the type of disease, psoriasis is divided into two groups:
- Early;
- late.
This proves that there are two main types of psoriasis (such as diabetes). The first occurs in early humans (16-22 years on average) and is strictly inherited in nature, directly related to the HLA phenotype (HLA-Cw6). The course of the disease is usually severe, and the disease will only progress over time.
The cause of type II psoriasis is relatively random, so this disease is sporadic. It most often occurs in the elderly (approximately 60 years of age). Generally speaking, it is easy to perform, but, in some cases, it can be exacerbated by damage to the joints and nails.
Factors that induce psoriasis
Although psoriasis tends to be inherited, it is usually multifactorial. Anything can cause a fatal failure of the immune system. So predisposing factors are divided into external and internal causes (or, in scientific terms, external and internal causes).
External cause
In turn, they are divided into physics and chemistry. The former includes common mechanical damage to the skin, such as household injuries, thermal burns, abrasions, scars, tattoos, scratches, insect and pet bites. Cases of psoriasis at the injection site are also recorded. X-ray and ultraviolet radiation also play an important role. Of all cases, about 5% of cases occurred in the summer, and 40% of them were caused by sunburn.
The chemical factor is the toxic effect of harmful chemicals or other irritants on the skin. In addition, psoriasis is also caused by other skin diseases, such as:
- skin disease;
- Fungal infections;
- Contagious impetigo;
- acne;
- Hyperhidrosis;
- Lichen;
- Shingles;
- Pyoderma gangrenosum;
- Allergic dermatitis of various natures.
After basic diagnostic skin tests to find out how the body reacts to cosmetics, hygiene products, formalin, chromium, nickel, and other chemicals, cases of this disease are known.
Endogenous factors
The internal cause of psoriasis may be an infectious disease. The latest research in this field shows that streptococcal infection and HIV are the most likely to be blamed. In addition, symptoms usually do not appear during the disease itself, but after the usual vaccination. In these cases, psoriasis is often difficult to treat.
To induce remission, lithium preparations, β-blockers, non-steroidal anti-inflammatory drugs, and ACE inhibitors are used. In this case, corticosteroids are contraindicated.
Pregnancy and childbirth
Significant changes in hormone levels caused by pregnancy can also be a trigger. A similar pattern was observed during adolescence. It is also curious that women who already have psoriasis may experience improvement during pregnancy (40%). Deterioration is less common (only in 14% of cases). Indeed, most of the patients' condition deteriorated again after delivery (54% of cases)
Diet and nutrition
These factors usually do not have a significant impact on the course of the disease. It is well known that the abuse of alcohol and cigarettes can significantly increase the chance of psoriasis and worsen its course.
Hypocalcemia and hypokalemia
These factors can cause the appearance of systemic pustular psoriasis. In this case, the chance of obtaining favorable results is very small.
Pustular psoriasis.
Psychological factors
Their role today is considered quite controversial. Some researchers claim that in 60% of cases, the presence of traumatic psychogenic factors can cause psoriasis. However, one can only be sure that they will only worsen the course of the disease and reduce the effectiveness of treatment.
classification
Currently, several different types of psoriasis have been identified. They have significant differences in clinical manifestations and the degree of impact on the body. Therefore, in order to understand what is at stake, it is best to check the World Wide Web and carefully study the various causes of psoriasis, as well as familiar descriptions.
Vulgar Psoriasis
Crude or common psoriasis occurs in most cases. The disease manifests itself as a large number of small, bright red papules (from match heads to peas). It grows rapidly after emergence, and silver-white scales appear on the surface. In the future, the papules will transform into plaques, and the plaques will merge into one large lesion. Many times, they have clear boundaries to distinguish them from healthy skin.
When you try to comb or remove pimples, the flaking will increase first. This phenomenon is called "scleroderma symptom". Once all the scales are removed, a shiny, smooth surface is found, which is the "terminal membrane symptom". If you continue to scrape, the capillaries will be injured and release bleeding drops. This symptom is called "blood dew".
The development of psoriasis is divided into three main periods:
- Progressive (acute);
- stationary;
- Settlement period.
The success of the treatment here mainly depends on whether the choice of the treatment method is correct, because their effectiveness will vary greatly depending on the time period.
Progression. A characteristic of this stage is the appearance of specific rashes in large numbers. In the exacerbation stage, some parts of the patient's body are covered with small papules, which are actively peeling off. In this case, peeling is strictly local and will not affect healthy skin. Acute psoriasis is easily identified by limiting the characteristic red or pink border of the papules.
The most typical symptoms at this stage are the presence of itching and the so-called Koebner symptoms. The latter is manifested as psoriasis papules appearing on any skin injury site (minor burns, scratches, injections, scratches, etc. ). This phenomenon occurs on average two weeks after injury and occurs in 38-76% of all patients.
It is also very strange that (rarely) the opposite effect has been observed. Scientists believe that this is due to the presence of special factors that inhibit Koebner syndrome in the serum of some patients.
Quiescent period. On average, 2-3 months after the first rash appears, new papules stop forming. The growth of plaque will also stop. At this stage, their entire surface has been covered by scales. This period can last for months or even years. However, the latter is relatively rare.
Resolution period. This period is also called the regression period, as the plaques are observed to decrease gradually during this period. At first, they will stop peeling, and then gradually become smoother until they disappear completely. If the condition is mild, this phenomenon will happen spontaneously. Treatment will only accelerate its onset. Usually, the location of the plaque will stand out against the background of healthy skin areas due to depigmentation or hyperpigmentation, which happens less frequently. With psoriasis vulgaris, rashes can occur almost anywhere, and they are usually localized symmetrically (extension of the elbows and knees). It may also appear on the head, sacrum, hands, palms, soles of the feet, groin, and armpits. In addition, in many cases, the nail plate will also be affected (point-like pits, looseness, thickening). These symptoms are very similar to those that occur when infected with a fungus, so the final diagnosis can only be made after a negative reaction to fungal spores in a special laboratory study. Psoriasis vulgaris has no general negative effects on the patient's body as a whole, and its course is chronic. The acute exacerbation period occurs in autumn or winter, and on the contrary, the acute exacerbation period in summer is much less. The main motivation for active treatment is that without proper treatment, psoriasis plaques can cover the body for many years, and proper treatment will improve after a few months.
Psoriasis erythroderma
Psoriasis erythroderma is one of the most unpleasant forms of this disease. On average, a similar reaction is observed in approximately 2% of patients, and it occurs spontaneously, or it may be due to an improper choice of treatment. Of course, if the medication used irritates the skin or is exposed to ultraviolet light, the risk of psoriatic erythroderma is much higher. In most cases, psoriatic erythroderma appears suddenly in the first stage of psoriasis. It can be combined with arthritis and systemic pustular psoriasis, and exposure to factors such as streptococcal infection or hypocalcemia can significantly increase the likelihood of this complication. Stopping corticosteroids abruptly can also make the condition worse. The appearance of erythroderma completely eliminated the clinical symptoms of psoriasis, and replaced it with diffuse redness, severe itching and lamellar peeling of the skin.
Pustular psoriasis
It is also a severe form of psoriasis. It is characterized by an abscess, which is usually the only symptom. They are much less combined with the typical symptoms of psoriasis vulgaris. Pustular psoriasis is systemic and local. The second difference is that the abscess in this case is only concentrated in the palm or sole area.
Psoriatic arthritis
Currently, psoriatic arthritis itself is classified as an autoimmune disease. It manifests as bone and muscle damage in high-risk patients who already have psoriasis or have a family history of the disease. Psoriatic arthritis is often combined with typical psoriasis and psoriatic nail lesions. This disease is diagnosed by the appearance of back pain and is accompanied by the following conditions:
- Lack of clearly stated reasons;
- The patient is over 40 years old;
- Deep unexplained pain in the lower back or buttocks;
- Vague location of pain;
- Reduce pain after exercise;
- Pain or stiffness in the morning or at night;
- The presence of pain is good with the general condition of the musculoskeletal system.
Nail plate psoriasis
Many times, psoriasis vulgaris is accompanied by nail damage. In this case, their obvious malnutrition was observed, as well as the characteristic symptoms of fungal infections. It is a common companion of psoriatic arthritis. Considering that about 4% of the global population suffers from common psoriasis, 30-50% of them also suffer from nail psoriasis.
Psoriasis treatment
Unfortunately, at present, medicine still cannot cure psoriasis, because this requires a deeper understanding of the working characteristics of the basic mechanisms of the human immune system. Due to the slow progress of such research and the disease itself does not pose a special threat to life, symptomatic treatment is currently given priority. Before starting treatment, patients need to undergo a thorough examination, because every organism contains a set of factors that affect the course of the disease. Gender, age, occupation, general health, type of psoriasis-all these factors must be considered when prescribing treatment. Determining the nature of the disease course, the individual's susceptibility to drugs, and the current stage of the disease also play an important role.
General activity
First, the doctor needs to determine the patient's mental and physical condition, assess his general physical condition, and understand his tolerance to the disease. The best prerequisites for effective treatment are good rest, maintaining a calm environment, switching to a less intense work mode or short-term hospitalization. Various psychological treatment methods (using cognitive behavioral therapy for rehabilitation at sea resorts, etc. ) have also proven their effectiveness. It is also very important for patients to know that the treatment process is proceeding as expected, because if rapid results are not received, about 40% of patients lose confidence in the effectiveness of the treatment and begin to ignore it. It is important not to forget that psoriasis is a chronic disease, so the safety of treatment must be considered. Many drugs are toxic and will accumulate in the body and become a time bomb. Addictive effects are also possible, so it is best to keep the most effective drugs until the truly dangerous symptoms appear.
Course of disease and long-term prognosis
The course of psoriasis is usually unpredictable. Modern doctors have had little success in this area, so, as before, psoriasis is still an unpleasant and uncontrollable disease. In each case, it is carried out completely independently, so any attempt to predict the course of the disease and the duration of the worsening and remission phases is doomed to fail prematurely. Only one thing is pleasing-although treatment is difficult, it rarely poses a real threat to the patient's life. As for psoriatic arthritis, this disease is much easier than rheumatoid arthritis, and the decline in the quality of life of patients is very insignificant compared with the latter. Statistics show that with proper treatment, most patients with psoriatic arthritis can maintain their function and lead a fulfilling life. If there is no necessary treatment, or the disease will have complications, with the further development of serious pathology, joint deformities may develop. However, such complications are only seen in a very small number of patients with psoriasis. Most patients can count on the gradual stabilization and long-term remission (more than two years). In rare cases, the disease mainly occurs in the active phase, but, in this case, it can be effectively located. Today, effective psoriasis treatments are available in any major city. And, although as you know, the ultimate recovery will not be achieved, but diet, special medications and procedures will quickly take effect. In addition, you do not need to receive long-term treatment in the hospital. The task of the doctor is to quickly bypass the first two stages of psoriasis and relieve the patient. After that, patients can only take care of themselves, follow instructions, and forget about the disease for a long time.