Psoriasis - what it is, symptoms and treatment

Psoriasis is a systemic inflammatory chronic disease that mainly involves skin lesions, forming well-defined red spots and plaques with silvery scales on the surface.The course of this disease is characterized by exacerbations and remissions (decreased symptom expression). Unfortunately, medicine has not yet identified the exact, reliable cause of psoriasis, but genetic factors have been clearly pointed to, which, combined with triggering factors, lead to the triggering moments for the appearance of this disease. A link between the development of psoriasis and HLA system antigens has been revealed.Between 1 and 5 percent of the world's population suffers from this highly unpleasant disease, with fair-skinned people at greater risk than black people.The disease can appear at any age, but the 20-30 and 50-60 years are considered critical periods.

important!Psoriasis is not contagious to others, but it can cause inconvenience to the patient himself, since the rash that occurs during the disease is not only unsightly but also accompanied by unpleasant itching. In addition, psoriatic arthritis may develop, which can significantly worsen the patient's quality of life.

Most rashes are concentrated on the scalp, elbow and knee surfaces, skin folds, and genital area. The areas around the nails, buttocks and eyebrows are usually affected. The nature and appearance of the rash depends on the type of psoriasis.

causes of psoriasis

Medicine has not yet revealed the nature of why psoriasis occurs; some doctors talk about autoimmune causes. A second theory to explain the development of the disease is an interference with the normal maturation and division process of skin cells. Genetics and stress are also thought to be causes.A genetic predisposition to psoriasis, allergies and frequent disruption of the skin's barrier function (intense friction, chemical exposure, influence of alcohol-containing products) may lead to an exacerbation of the condition.For known triggerspsoriasis, association:

• Kobner's phenomenon refers to the appearance of a fresh rash at the site of skin irritation in the acute phase of some skin diseases;
• sunburn or other types of burns;
• HIV infection;
• Beta-hemolytic streptococcal infection, leading to punctate psoriasis;
• use of medications (especially beta-blockers, lithium, angiotensin-converting enzyme inhibitors);
• severe emotional stress;
• alcohol consumption;
• smoking;
• obesity;
• Hormonal imbalances, especially in women during menopause and pregnancy;
• Digestive system disorders.

The main reasons for the development of the disease are excessive, accelerated growth and division of skin cells and inflammatory processes in the dermis. In other words, skin cells located in the lower layer of the epidermis begin to grow rapidly and put pressure on the cells above. This process is accompanied by significant peeling of the skin, called parakeratosis. Overstimulation of the immune system is thought to be a major contributor to this mechanism.

Signs and symptoms of psoriasis

Rashes associated with psoriasis are asymptomatic or accompanied by itching. Most commonly, they are located on the scalp, extensor surfaces of the knees and elbows, the sacrum and buttocks (especially the gluteal cleft), and the genital area. The skin of the finger and toenails, eyebrows, armpits, and belly button may be affected. The rash can merge with the lesions and cover large anatomical areas and the areas of skin between them. Depending on the type of psoriasis, the rash may have different external manifestations.Typically, the rash is scattered and appears as erythematous papules or plaques covered with dense, silvery, shiny scales. The rash appears gradually. Remissions and exacerbations occur spontaneously or after exposure to predisposing factors.Appears in 5-30% of patientspsoriatic arthritis, which may result in patient disability. This process can lead to joint destruction.

important!Psoriasis does not threaten a patient's life, but it does destroy a patient's self-image. In addition to changes in the patient's appearance, significant time is required to treat the rash and keep clothing and bedding clean, which significantly reduces the patient's quality of life.

Types of psoriasis

• vulgar(common or chronic plaque) psoriasis, a rash that has the appearance of individual plaques covered with silvery flakes of skin. As the disease progresses, plaques may coalesce. Of all subtypes, this type of psoriasis is the most common, accounting for approximately 90% of cases.
• anti psoriasisA rash that occurs in areas of natural folds and may form cracks.
• guttate psoriasisIt is characterized by multiple rashes, 0. 5-1. 5 cm in diameter, often formed after strep pharyngitis.
• palmoplantar psoriasisAppears as plaques on the palms and soles of the feet, which may coalesce.
• Nail psoriasisAffects the nail plate in the form of pinpoint indentations and grooves, causing nail discoloration and thickening. Nail changes caused by psoriasis often resemble changes caused by fungal infections.
• Pustular psoriasisIt is accompanied by the formation of pustules on the palms and soles of the feet, or possibly damage to a finger. There may also be a generalized form.
• Erythrodermic psoriasisPeople with psoriasis plaques develop sudden or gradual redness, while the plaques themselves are mild or non-existent. It usually occurs due to improper treatment of psoriasis vulgaris.

How to diagnose psoriasis

When symptoms of psoriasis occur, patients should consult a dermatologist. He will perform an external examination of the affected skin area and take a complete medical history.Psoriasis has general similarities with other skin diseases, especially in the first stages of manifestation. It is important to rule out fungal infections in the hands and nails. Seborrheic psoriasis requires a specific differential diagnosis to exclude seborrheic eczema, pityriasis rosea, and papular syphilis.If the disease is active and there are extensive lesions in the epidermal area, a visual analysis of the scrapings may be performed. During the scraping process, the peeling phenomenon intensifies. Where the scales were removed, a smooth film was visible, which peeled off under mechanical action, revealing a wet surface with blood droplets.Diagnosing psoriasis is not difficult in most cases; simply examining the patient's skin is enough. Doctors must rule out diagnostic errors and determine the presence of other diseases and other pathologies occurring in the context of psoriasis.In rare cases, diagnosis requires a biopsy. If atypical clinical symptoms occur, the need should be considered. The severity of the disease is classified as mild, moderate, or severe based on the area of affected skin. Less than 10% skin damage equates to mild severity. There are more sophisticated ways to assess disease severity, but these methods are used in clinical trials.

psoriasis treatment

The development of the disease and its various manifestations depend on a variety of factors. Therefore, many treatments for psoriasis have been developed. These approaches are often combined and include pharmacological and non-pharmacological interventions.A treatment plan is developed based on the severity of the disease, the area of skin affected, and the severity of symptoms such as redness, itching, and peeling. Age and sex, disease stage and general condition of the patient, and the presence of concomitant diseases are also taken into account, as they may limit the choice of treatment.Treatment of psoriasis should reduce the clinical manifestations (rash and other symptoms), improve the patient's general condition and restore his or her ability to work.When treating psoriasis, it is important to follow a diet and take proper care of your skin, as there is a risk of liver damage. In this case, it is recommended to reduce the amount of fatty foods in the patient's diet and to eliminate alcohol, sweets (simple sugars) and starchy foods. The focus of the diet should be protein: lean meats, fish, dairy products, vegetables and fruits. Be sure to be aware of allergic reactions or intolerances to certain products.To improve the patient's quality of life and get rid of the disease, a comprehensive approach is needed:

• topical treatment–Ointments and creams work well for treating small areas of localized skin peeling and itching. Hormone ointments, salicylic acid, retinoids, and moisturizers are particularly effective in treating psoriasis on the face and hands.
• medical treatementUse as an additional method to effectively treat psoriasis when ointments do not help. Medications can reduce the inflammatory process, eliminate swelling and itching, and prevent increased activity of skin cells. But it's worth considering that these pills have many side effects (increased fatigue, loss of appetite, high blood pressure). Therefore, it is very important to follow all your doctor's recommendations regarding drug dosage.
• Use when psoriasis is limited to the head and neckMedicated Treatment Shampoo: Antifungal, tar, contains corticosteroids. This shampoo eliminates the pathogens of pathological inflammation, removes scales, relieves itching and burning sensations.
• Therapeutic antihistamine injectionsBlocking severe itching, biologic drugs have beneficial effects on the immune system.

Unfortunately, it is not possible to completely cure psoriasis today. The goal of any psoriasis treatment is to eliminate disease symptoms and prolong remission over the long term. However, despite the slow chronic course of psoriasis, treatment is still necessary because long-term untreatment can lead to disability.