Psoriasis - causes and symptoms, types, treatments, and who to contact

For centuries, humans have been trying to uncover all the secrets of this mysterious skin disease, but much remains unknown. According to statistics, psoriasis affects 4% to 7% of the population, and men and women are equally susceptible to psoriasis. Typically, the first signs of psoriasis appear during adolescence and may persist throughout a person's life, sometimes weakening and disappearing and sometimes intensifying.

Psoriasis Causes and Risk Factors

psoriasisis a long-term inflammatory process of the skin, considered an autoimmune disease (associated with an allergic reaction of its tissues). This is a chronic skin disease that affects cells in the outer layer of the epidermis. This condition usually manifests itself as red, silvery scaly skin on the feet, knees, back, chest, etc. In most cases, psoriasis starts in a small patch of skin and then spreads to large areas of the body. There are many causes and risk factors for this disorder, and there are several theories to explain its occurrence.

autoimmune causes

Some research suggests that psoriasis may develop due to a combination of genetics and environmental factors such as infection, trauma, stress, and certain medications. These factors trigger a response from the immune system, which begins fighting body tissues, including the skin.However, the pathogenesis of psoriasis remains incompletely understood. It's important to note that psoriasis is a diverse disease that presents differently in every patient. Studying the underlying mechanisms of psoriasis may help develop more effective treatments, reduce the risk of complications and improve patients' quality of life.

metabolic effects

Metabolic disorders significantly affect the skin condition and immunity of patients with psoriasis. Increased metabolism leads to the formation of toxins and free radicals, leading to an inflammatory response. Various metabolic imbalances occur.

• Patients with psoriasis have disordered protein metabolism, reduced albumin content in the blood, increased globulin content, and increased sensitization.
• In fat metabolism, an increase in lipid and cholesterol content in the blood is observed.
• Cutting calories and eating plant-based foods can reduce the activity of psoriasis inflammation.
• Disturbance of carbohydrate metabolism almost always occurs.
• The metabolism of vitamins and minerals is also impaired, as shown by the decrease in the levels of vitamins C, A, B6, B12, iron, copper, and zinc in the blood, while the content of vitamin C increases.

Infectious causes

This theory was popular in the last century. It is thought that psoriasis may be caused by certain bacteria (strep), fungi, and viruses, but these hypotheses have not been scientifically proven. However, dermatologists note that any acute infectious process or chronic infection may lead to a recurrence of psoriasis. Special attention is paid to virus theory. Recent research suggests that RNA viruses, such as HIV and other retroviruses, can affect the genetic apparatus and lead to the emergence of genes that predispose to psoriasis.

genetic susceptibility

A genetic predisposition to autoimmune reactions is a risk factor for psoriasis. A person's likelihood of developing the disease increases if a close relative has the disease. Several genes may be involved in psoriasis, including the PSORS1-PSORS9 complex, of which PSORS1 is thought to be particularly active. It contains HLA-C, HLA-Cw6, CCHCR1 and CDSN genes, which may be involved in the development of the disease. Genes influence the development of metabolic, immune, and autoimmune processes. However, the presence of these genes does not mean a person will develop psoriasis. The development of the disease may be caused by other factors.

neurogenic causes

Excessive stress on the nervous system, chronic stress, and imbalances in the autonomic nervous system that provides innervation to blood vessels and internal organs may be risk factors for the development of psoriasis. These factors can lead to psoriasis by causing imbalances in the endocrine system, altered metabolic processes and immune responses, increased irritability or depression, persistent fatigue, lethargy, and apathy.

endocrine

Endocrine disruption in psoriasis is fairly common and can have a significant impact on the progression of the disease. However, their link to psoriasis is not fully understood and has not been proven. Experts believe that psoriasis patients often suffer from thyroid, pituitary and adrenal gland dysfunction. Women may experience menstrual cycle problems and men may experience sexual function problems.

Symptoms and Characteristics of Psoriasis

Psoriasis presents not only as a rash but also other symptoms. It usually begins in childhood or adolescence and is associated with hormonal imbalances, vegetative vascular dystonia, and stress.The first sign isfatigueandmood changes. The main symptom is the appearance of small pink bumps on the skin, called papules, that are covered with white scales. There is a brighter edge around the papule.Over time, the components of the rash combine into large, abnormally shaped patches. The base of each papule isinflammatory infiltrate. Rashes can be divided into the following types:

• Needle tip (no more than 1 mm in diameter);
• Teardrop shape - (water droplet papules up to 2 mm in size);
• Coin-shaped - (round papules - coin size up to 5 mm).

The rash also has its own characteristics:

• Stearic acid stain - if the surface of the papule is scratched;
• Terminal membrane - after clearing the scaly papules, a transparent membrane is visible;
• Blood Dew (Ospitz Phenomenon) – If the integrity of the membrane is compromised, small droplets of blood may appear.

Psoriasis contagious?

Many people believe that psoriasis is contagious, which is why they try to avoid contact with people who have it. This can cause patients to want to withdraw from others and lead to serious psychological problems. However, research shows that psoriasis is not spread through contact with someone who has it. If all family members suffer from the disease, this only indicates the presence of a genetic factor in the development of the pathology.

Classification and stages of development of psoriasis

At present, the development of psoriasis is mainly divided into three stages:

1. The progressive stage is characterized by the constant formation of new rashes accompanied by severe itching.
2. In the quiescent phase, new forms cease to appear and existing forms begin to heal.
3. In the degenerative phase, a border appears around the rash and the skin affected by the rash becomes darker due to increased pigmentation.

In addition, the pathology has several degrees of severity:

• Mild, which means no more than 3% of the skin surface is affected.
• Moderate, characterized by 3-10% damage to the skin.
• Severely, the disease affects more than 10%.

Types of psoriasis

psoriasisis a chronic skin condition that can manifest itself in a variety of ways. The rash, its location, and damage to other systems and organs can vary. Based on these characteristics, various forms of psoriasis can be distinguished.

Simple (vulgar, plaque)

Plaque psoriasis is the most common form of this disease. Symptoms include bright pink papules covered with white scales.

Elbow psoriasis

This is typical of mild plaque psoriasis. A characteristic feature of elbow psoriasis is the presence of one or more permanent "culpable" plaques on the extensor side of the elbow joint. If these factors are traumatized, the condition will worsen.

guttate psoriasis

This type of psoriasis is associated with bacterial (most commonly Streptococcus) and viral infections that cause inflammation. This condition often occurs in children and begins with small, red, tear-shaped papules on the skin of the limbs, body, or face. Papules have a scaly surface and can develop into erosions and ulcers, increasing the risk of infection.The condition can develop rapidly or gradually become chronic, followed by a period of worsening and diminishing symptoms. In rare cases, psoriasis may become more severe.

Palmoplantar psoriasis

This type of psoriasis usually occurs in people who do manual labor, is often accompanied by severe itching, and can lead to nail complications. Several subtypes of this psoriasis include:

• Fan-shaped patches: Large elements on the palmar and sole surfaces with white scales that merge into fan-shaped patches. This subtype is most common on the hands.
• Round: Ring-shaped scale elements on the palm and sole surfaces.
• Corpus callosum: The growth of rough epithelium that forms a callus.
• Pustular: This is a unique subtype of Barber’s psoriasis on the palms and soles of the feet. The area under the big toe can develop blisters and pustules containing pus, causing severe itching. The ulcers coalesce, then dry and form scabs. Characteristic elements of psoriasis also appear in other parts of the body.

Leg psoriasis may be related to varicose veins, which mainly appear on the lower legs.

Nail psoriasis

It can occur as a separate disease or as a complication of another type of psoriasis. The main symptom is small indentations of varying depths on the nail plate. These dimples are often more noticeable and painful when pressed than with other types of dermatitis. Additionally, symptoms include spontaneous nail separation, subungual bleeding (especially when wearing tight shoes), nail color and surface changes, such as rough onychomycosis and onychomycosis.

scalp psoriasis

It can manifest as an independent disease or as part of a general pathological process. One of the characteristics is tearing and the formation of scabs on part or all of the head. In this case, hair growth is not compromised because the function of the hair roots is not compromised. However, getting wet creates the threat of infection, which can lead to damage to the hair follicles.

seborrheic psoriasis

It occurs due to the destruction of skin glands, which produce sticky sebum, causing skin irritation and promoting inflammation - dermatitis. The condition quickly spreads to the entire head, covering it in the form of a hood and accompanied by severe itching. In the area behind the ear, tearing sometimes occurs and infection may occur. A scalp covered with dandruff and crusts may look like a crown of psoriasis.

psoriasis on face

It usually occurs in the nasolabial triangle, eyelids, above the eyebrows, and behind the ears. The rashes may coalesce to form large areas of redness and swelling. If sebaceous gland function is compromised, the process may be accompanied by tearing, crusting, and an increased risk of infection.

Genital psoriasis

Psoriasis affecting the genitals is an accompanying process, often accompanied by the characteristic psoriasis rash all over the body, which makes diagnosis easier.Psoriasis rashes on the male penis, female labia majora, and surrounding skin areas are oval-shaped and slightly above the surface of the skin. They are pink and flaky. There is almost no itching. Occasionally, the pathological process spreads to the mucous membranes and may present with vulvovaginitis in women and balanoposthitis in men.In obese people, an atypical psoriasis rash may appear in the folds near the genitals (groin, intergluteal area). In these areas, intense red areas appear, which have a mirror-like surface and do not peel off due to continued wetting.

Why is psoriasis dangerous?

Psoriasis can become very severe when the rash covers more than 10% of the skin. The condition is difficult and prone to recurrence, and the rash may become moist, moist and prone to infection. Only timely and effective treatment of psoriasis can prevent the spread of the disease.In some cases, psoriasis may be complicated by the development of joint inflammation and psoriatic polyarthritis, which may lead to joint dysfunction. In addition, the systemic autoimmune processes caused by psoriasis can lead to the development of other autoimmune diseases, severe cardiovascular and gastrointestinal pathologies, and neurological reactions.Neglecting to treat psoriasis promptly can lead to complications such as psoriatic erythroderma, which can occur due to improper treatment of psoriasis or exposure of the skin to various irritants. With psoriatic erythroderma, the skin turns dark pink, with clear distinction between affected and healthy areas, and with large and small peelings. This condition requires emergency medical attention.

Complications of psoriasis

If psoriasis is not treated promptly and adequately, it can seriously damage the body's vital organs and systems, such as the joints, heart, kidneys, and nervous system. These consequences can lead to disability or even death.

diagnosis

Usually, the diagnosis of psoriasis is based on the typical symptoms of the skin lesions and their location. In some complex cases, additional testing may be needed to rule out other skin conditions.Laboratory tests may include:

• Complete blood count, which can detect leukocytosis and anemia in psoriasis.
• Rheumatoid factor (RF) is a protein whose levels may be elevated in systemic inflammatory diseases involving joint damage, but in psoriasis, levels are usually normal.
• The erythrocyte sedimentation rate (ESR) is also usually normal except in pustular psoriasis and psoriatic erythroderma.
• People with psoriasis may have elevated uric acid levels, which may lead to confusion with gout.
• Human immunodeficiency virus (HIV) antibodies may be detected during a psoriasis flare-up.

Other tests, such as joint X-rays and skin biopsies, may be used in more complex cases to assess the severity of joint damage and distinguish psoriasis from other skin conditions.

treat

Treatment of psoriasis requires a comprehensive approach that includes topical treatment of lesions, medications, phototherapy, and prevention of exposure to factors that worsen the condition. The choice of treatment depends on the type and severity of psoriasis. Treatment may include:

• Topical preparations (topical ointments, petroleum jelly, paraffin, vegetable oils and creams with anti-inflammatory effect, the dosage depends on the nature of the lesion, used daily);
• Lotions and shampoos based on salicylic acid and photosensitizers;
• Oral drugs (retinoids, vitamin D preparations, etc. );
• physical therapy procedures;
• Daily bathing with bath oil, oatmeal infusion, or sea salt can help soften the skin and reduce inflammation caused by psoriasis. It is important to avoid hot water and scrubs and use a moisturizer after bathing;
• Phototherapy, which involves exposing the skin to ultraviolet light, may also be helpful (to avoid burns);
• Photochemotherapy using medium wave radiation;
• Observe special diets and general regimens.

The patient's sex and age, the presence of concomitant diseases, overall health, and the influence of external factors are taken into consideration when formulating a treatment plan. Sometimes, to cure it, lifestyle changes are enough, while in other cases, several courses of treatment are needed.In addition to traditional methods, treatment of psoriasis may include the use of modern laser technology. Laser treatment can reduce pathological symptoms, achieve long-term remission, and relieve patients from unpleasant rashes and related problems. A special feature of laser treatment is that the special excimer laser acts only on the affected areas of skin, leaving healthy areas unaffected, ensuring a quick recovery and no side effects. Laser treatments are safe and painless, require no preparation and can be used regularly, allowing patients to live without restrictions.The effectiveness of treatment depends on many factors, including genetic predisposition, predisposing factors, disease stage and specific nature of the lesion, so it is recommended to first consult a specialist and develop treatment based on clinical recommendations.

prevention

Psoriasis is a disease that can be successfully treated as long as you consult your doctor promptly and receive qualified help. With simple psoriasis, patients can work without any restrictions, except in chemical plants, which can be dangerous.However, psoriasis can cause complications, such as psoriatic arthritis, which can limit work performance and lead to disability.Psoriasis prevention is an important part of treatment. After recovery, patients need to reconsider their lifestyle, get rid of bad habits, pay attention to the treatment of other chronic diseases, control their diet and increase physical activity, and engage in more outdoor activities and sports.

Psoriasis Nutrition

The diet for psoriasis is not strict, but proper nutrition plays an important role in complex treatment. When making nutritional recommendations, advise patients to:

1. Avoid these foods that your body is allergic to and exclude them from your diet.
2. Like fresh fruits, vegetables, berries, lean meats, grilled or boiled meats, and drink plenty of water.
3. Avoid the following foods: onions, garlic, radishes, strong tea, coffee, alcohol, sweets, salty and sour foods, and foods that may cause allergic reactions such as oranges, honey, nuts, cocoa and eggs.
4. Avoid fatty foods from animal sources.