psoriasis

Psoriasis (lichen scaly) is a chronic, non-infectious autoimmune skin disease of unknown origin.Its most common manifestations are peeling and rash on the skin, including the scalp.Psoriasis can cause pathological changes in other organs: the nails, spine, joints and kidneys are most commonly affected.

The disease causes severe psychological discomfort in patients; due to appearance defects, it makes it difficult for people to adapt to teams and communicate with others.Severe psoriasis can cause disability.It is impossible to completely cure the pathology.However, the right treatment can allow you to achieve stable remission and regain your previous quality of life.

what is psoriasis

The main symptom of the disease is the appearance of psoriatic plaques - flaky pink spots of varying sizes that are accompanied by itching.Most commonly, they are located on the scalp (but may also be along the hairline, behind the ears), elbows, knees, and may also appear on the genitals, buttocks, lower back, and other parts of the body.Sometimes plaques appear on old scars.The pinkish color of the rash is due to dilation of blood vessels in the affected area.

Psoriasis occurs due to immune system dysfunction.Each layer of the epidermis (there are 5 layers - basal layer, spinous layer, granular layer, glossy layer and stratum corneum) has keratinocytes (about 90% of the entire epidermis).Depending on the layer in which they are located, keratinocytes perform different functions (regeneration, synthesis of keratin or other proteins, prevention of skin dehydration, protection of the underlying layers of skin).

Keratinocytes are constantly renewed.Their synthesis occurs in the basal layer.They then move to higher positions, performing new functions each time.After reaching the stratum corneum, they lose their nuclei and become keratinocytes (specialized sacs containing keratin).Now they function as barriers.When keratinocytes end their lifespan, they will fall off the skin surface.Keratinocytes live for about 2-4 weeks and are then replaced by new cells.

With psoriasis, under the influence of a malfunctioning immune system, keratinocytes begin to divide faster and their lifespan is shortened.Peeling occurs, accompanied by inflammation of the epidermis and dermis.

People of any age can develop psoriasis (approximately 4% of the world's population has psoriasis).However, the disease most commonly occurs in people under 20 and over 55.People with fair skin often suffer from psoriasis; among representatives of the black race, this pathology is found much less frequently.

causes of psoriasis

The exact cause of psoriasis has not been determined.However, the most common are two theories about the origin of the disease:

1. Genetic disorders – The tendency to develop psoriasis is thought to be inherited genetically.
2. The result of immune disorders caused by infections, poor lifestyle, climatic conditions and bad habits.

refer to!40% of patients with this disease have relatives who also have psoriasis.In addition, close relatives of patients often have underlying psoriasis, manifested by changes in capillary structure.

Most often, emotional overload (50% of cases), focal infections, metabolic disorders, diabetes, liver disease, and the use of certain medications (most commonly glucocorticoids, beta-blockers, lithium) are "push factors" in the development of psoriasis.

There are other factors that can "trigger" the disease or cause it to worsen:

• Injuries, broken bones.
• frostbite.
• sunburn.
• Smoking.
• alcoholism.
• obesity.
• Chemical damage to skin.
• Food allergies.
• Parasitic infection.
• Pregnancy and childbirth.
• Other skin diseases - eczema, dermatitis.

refer to!As we all know, psoriasis is not contagious.The development of pathology in people with close relatives suffering from the disease can be explained by a genetic predisposition.Psoriasis does not spread from person to person.

Types and stages of psoriasis

Psoriasis comes in many forms, but some of the most common are:

1. Common psoriasisdevelops most frequently.It is characterized by itchy patches on the skin with a scaly surface.In addition, in this form, nail discoloration and the appearance of small white spots on the nails are often observed.In some cases (in advanced stages), the nail moves away from the nail bed.
2. guttate psoriasisIt presents as a small rash, mainly on the chest and back.The rash is accompanied by itching of the affected skin area.Usually the symptoms of the disease disappear and do not reappear after 4-6 months.However, patients may later develop another form of psoriasis.This happens about half of the time.Guttate psoriasis is usually seen in children and teenagers.It is usually caused by an infection, most commonly following a bacterial infection of the throat.
3. reversible psoriasisIt responds well to treatment and can sometimes achieve stable remission without recurrence.Red, oozing patches appear only in certain parts of the body, namely the folds, and do not spread further.Typically, the rash appears in the groin area or under the breasts, but also in the armpits.Reversible psoriasis is most common in older patients.
4. Pustular psoriasisis a serious and dangerous form.In some cases, it develops quickly and suddenly.It is characterized by the appearance of blisters with purulent content on the soles of the feet and palms, after which the affected skin thickens and begins to actively peel off.Later, the rash may spread over a large area.In advanced cases, skin all over the body may be affected.Pustular psoriasis can be life-threatening.Mainly affects adults.

Psoriasis develops in three stages:

1. Enterprising.
2. fixed.
3. Returning.

Advanced stageIt is characterized by the development of multiple nodular rashes that spread to new parts of the body.The plaques gradually increase in size.

stationary phaseThe rash stopped appearing.Existing plaques no longer grow in size, but the entire affected surface begins to actively peel.

is in a retrograde phaseThe plaque becomes denser, its components dissolve, and flaking decreases.Then, unpigmented spots are left on the rash site.

refer to! Psoriasis can also be classified according to seasonality: there are summer and winter forms, depending on how severe the condition is.In most cases, the recurrence rate in autumn and winter is still higher than that in spring and summer.

Symptoms of psoriasis

Symptoms of psoriasis are:

• A pink rash or white patches covered with scales.
• Itching in the affected area.
• Vascular changes.
• Signs of inflammation in the affected tissue.
• Deterioration in the appearance and condition of the nails.

refer to!About 1 in 10 patients develop arthritis as a result of psoriasis.Therefore, it is necessary to start treatment as early as possible to prevent complications.

diagnosis

Psoriasis has very typical clinical manifestations, so diagnosis is usually not difficult.If you scrape off a papule (patch), 3 main phenomena will be observed:

1. Stearin Stains - With slight scratching, the flaking intensifies and the rash becomes similar to crushed stearin droplets.
2. Terminal membrane – If the scales on the surface of plaque are removed, it will have a shiny, moist surface.
3. Blood Dew - If you scratch the end film, needle-like droplets of blood will appear on it.

In some cases, a piece of dead skin is removed and analyzed for differential diagnosis.

psoriasis treatment

The main goal of medical measures is not to cure the patient (because this is impossible), but to achieve stable remission.Comprehensive treatment is performed, with a plan tailored to the specific person's disease course.It includes:

• Topical drug treatments – ointments, creams, shampoos, aerosols, lotions.
• General medical treatment - injectable antihistamines, sedatives, vitamins, immunosuppressants, cytostatics, retinoids, corticosteroid therapy.
• Maintenance treatment - the patient receives UV exposure and takes skin medications.
• Use detoxification methods - the use of immune modulators, procedures to purify the blood.
• In some cases, nonsteroidal anti-inflammatory drugs are given.

If concomitant diseases are diagnosed, they are also treated.

Lifestyle for people with psoriasis

Patients must consider that treatment for the disease will continue throughout their lives.In many ways, the duration of relief depends on it.It is important to quit bad habits (smoking, drinking).Following a diet is also necessary.The diet excludes citrus fruits, whole milk, chocolate, honey, eggs, foods containing red pigments (strawberries, watermelon) and other foods that may cause allergic reactions.It is also recommended to avoid spicy, greasy, fried, smoked foods, greasy meat and fish soups.Condiments not included: ketchup, mayonnaise, mustard, etc.You should limit your sugar and salt intake.You should look for products that contain fiber, omega acids, vitamins A, E, C, B complex, as well as zinc and calcium.

The following simple measures will help alleviate this situation:

• Refuse to stay in the water for long periods of time - swim and bathe less frequently, and short showers are recommended.
• Hard towels should be replaced with soft sponges or cotton cloths, and regular soap with a pH-neutral product.
• After showering, the skin should not be wiped but should be patted gently with a towel to avoid damaging the patches and increasing itching.
• After water treatment, the skin must be moisturized with cream.
• It is necessary to give priority to roomy, lightweight clothes made of soft natural fabrics, since the pressure of clothes on the skin can trigger new rashes.
• Itching often forces patients to scratch, which can cause damage to the skin - to avoid new damage, it's best to keep nails short.
• Dry skin should be avoided, so it is also beneficial to avoid using air conditioners and humidifying indoor air.
• While sunbathing can be beneficial for psoriasis, overexposure to UV rays can worsen the condition—you should talk to your doctor about your sun exposure regimen.
• Any risk of skin irritation should be avoided.
• Cuts and wounds can cause new rashes to appear, so you need to protect yourself from them.
• Stress is a common trigger for disease progression, so it is necessary to avoid traumatic situations whenever possible.
• It is necessary to avoid physical inactivity (inactivity) - moderate physical activity will benefit the condition of the entire organism.

If you feel your condition is worsening, seek medical attention immediately to prevent the condition from progressing to a more severe stage or causing complications.