Psoriasis is a common non-communicable skin disease associated with inflammatory lesions. It is chronic - an acute period followed by periods of relief or disappearance of symptoms - and is caused by a combination of different factors.
The disease is widespread and occurs somewhat more often in women than in men. It is not completely cured, but it is possible to alleviate the symptoms and improve the quality of life of the patient.
Psoriasis can lead to arthritis, inflammation of the joints.
Synonyms Russian
Scaly lichens.
English synonyms
Psoriasis.
Symptoms
The symptoms and signs of psoriasis depend on the type of psoriasis.
- Plaque psoriasis. It is accompanied by specific inflammatory skin formations - raised, oval, sharply outlined reddish lesions, scaly and covered with silvery scales. The most common formations appear on the outer surface of the elbows, knees, scalp, and torso. The elements of a skin rash can be painful and itchy. In severe cases, the skin near the joints of the affected areas cracks and bleeds.
- Guttate psoriasis. This type is associated with the appearance on the body of numerous papules (nodules) of orange-pink color, size 1-10 mm. The rash usually appears on the torso, shoulders and thighs, but can be found all over the body. It usually affects people under the age of 30, as well as 2-3 weeks after suffering from infectious diseases of the upper respiratory tract, after superficial bacterial infections in the anus.
- Nail psoriasis. It is characterized by compaction, peeling, discoloration of nail plates, discoloration, yellowing of nails, the presence of stains on them, the creation of holes, cracks, damage to the nails. The nail plates are destroyed, the growth of the nails is disturbed, they can be separated from the nails. It occurs in 30-50% of patients with psoriasis.
- Psoriasis of large folds. In this case, skin lesions in the form of red inflammatory spots appear in the armpit fold area, below the mammary glands, in the cervical folds, in the genital area, on the foreskin. Cracks may appear along the edges and in the center of the lesion. Large wrinkle psoriasis most commonly occurs in overweight and obese people. Sweating and friction make the disease worse.
- Head psoriasis. It is accompanied by redness of the scalp, itching, peeling of the scalp with the appearance of white scales on the hair and shoulders - particles of dead skin.
- Psoriatic arthritis. Skin damage is accompanied by joint pain, swelling, curvature and deformity of the joints. The joints of the fingers, ankles, feet, and knee joints may be affected.
- Pustular psoriasis. This type is characterized by redness of the skin and the formation of a large number of pustules - small blisters filled with pus. Formations can appear on the palms and soles of the feet or all over the body. When more pustules appear on the body, fever and weakness join.
- Psoriatic erythroderma. Areas of skin are red, plaques may appear. Lesions are usually accompanied by severe itching. Most commonly, psoriatic erythroderma is associated with sunburn or drug abuse.
Usually with different types of psoriasis the disease manifests itself gradually, skin lesions spread and are observed for several weeks. Then the symptoms disappear. After exposure to a factor that contributes to the development of psoriasis (or spontaneously), the symptoms reappear after some time.
General information about the disease
Psoriasis is a common non-communicable skin disease associated with inflammatory lesions.
It is chronic and often recurrent - the acute period is followed by periods of weakening or disappearance of symptoms, and then after some time the symptoms reappear.
Psoriasis is widespread, especially among people aged 16-22, 57-60. Women are more susceptible to this than men. People with fair skin have an increased risk of developing the disease.
Despite the fact that psoriasis is synonymous with shell lichen, it is absolutely not contagious to others.
The causes of psoriasis have not yet been fully determined. Its occurrence is associated with a genetic predisposition, with malfunctions in the immune system and with environmental factors affecting the body.
The development of psoriasis is associated with one of the cells of the immune system (with T-lymphocytes), while T-cell hyperactivity is observed. They usually travel through the blood throughout the body, discovering foreign causes - viruses and bacteria. In psoriasis, for unknown reasons, T cells begin to accumulate in the skin. Their hyperactivity causes blood vessels to dilate in the affected area, disrupting the cycle of creating new skin cells - they are formed much faster than usual. Meanwhile, dead skin cells do not have time to peel and accumulate on the surface of the skin, creating plaques.
Psoriasis can be caused by one of the following factors:
- infections (tonsillitis, thrush, HIV);
- skin damage - cuts, scratches, bites or burns;
- hypothermia;
- sunburn;
- emotional stress;
- smoking, alcohol abuse;
- use of drugs (antimalarial, etc. ).
At the same time, some patients with psoriasis develop rashes without the obvious influence of environmental factors.
There are the following main types of psoriasis.
- Plaque psoriasis. It is the most common.
- Guttate psoriasis. It usually affects people under the age of 30. It occurs 2-3 weeks after transmitted infectious diseases of the upper respiratory tract, as well as after superficial bacterial infections in the area around the anus.
- Nail psoriasis.
- Psoriatic arthritis. In this type of psoriasis, skin lesions are accompanied by arthritis - inflammation of the joints.
- Psoriatic erythroderma. They are most often associated with sunburn and drug abuse.
- Pustular psoriasis. Rarely, in severe cases, it endangers the patient's life.
- Head psoriasis. In this case, hair loss caused by the disease usually does not occur, because the hair roots are located much deeper than the scaly formations.
Classification of psoriasis according to the severity of the course:
- soft (less than 2% of the whole skin is affected);
- moderate (skin lesions occupy a maximum of 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:
- thickening of the skin, adding secondary infection by scratching and scratches caused by itching with psoriasis;
- psychological problems (stress, low self-esteem, depression, social self-isolation);
- joint damage (deformity with stiffness and reduced joint mobility);
- 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 adjustment becomes a major problem, especially in the presence of skin lesions on visible parts of the skin - hostility of others to the type of skin lesions, their fear of infection (many do not know that the disease is not contagious).
Who is in danger?
- People with a hereditary predisposition (more than 40% of psoriasis patients have a relative with psoriasis).
- People with viral, bacterial, fungal infections (streptococcus, thrush, HIV, etc. ).
- Emotionally stressed.
- Obese and overweight people.
- Smokers.
- Alcohol abusers.
- Taking certain medications (anti-malarial drugs, etc. ).
- Burned in the sun.
Diagnosis
The diagnosis of psoriasis is usually based on the typical type of lesion, taking into account their location. In severe cases, additional testing may be needed to rule out other skin conditions.
Laboratory research
- General blood test. In psoriasis, leukocytosis and anemia can be detected.
- Rheumatoid factor (RF) is a protein whose level in the blood can increase in systemic inflammatory diseases accompanied by joint damage, especially in rheumatoid arthritis. The results of the psoriasis test are negative. This allows you to distinguish psoriasis from rheumatoid arthritis, in which RF is increased.
- Erythrocyte sedimentation rate (ESR) is generally normal, with the exception of pustular psoriasis and psoriatic erythroderma.
- Uric acid. Uric acid levels in psoriasis can be elevated (especially in pustular psoriasis), leading to confusion of psoriatic arthritis with gout, in which the concentration of uric acid increases significantly.
- Antibodies to HIV (human immunodeficiency virus). The sudden onset of psoriasis can be the result of HIV infection.
Other research methods
- X-ray of the joints. It allows you to assess the severity of joint damage in psoriatic arthritis.
- Skin biopsy. Examination involves taking a small sample of skin for later examination under a microscope. It is performed in severe cases to differentiate psoriasis from other skin diseases.
Treatment
Treatment of psoriasis includes topical treatment of skin lesions, medication, phototherapy, prevention of exposure to factors that cause rashes. It depends on the type and severity of psoriasis.
Softeners (creams, Vaseline, paraffin, vegetable oils) can be used to remove skin lesions. They are most effective when used twice a day after showering. Salicylic acid, anthralin, tar preparations, ointments, solutions, shampoos containing coal tar are also used. These agents are anti-inflammatory and slow down the formation of new skin cells.
The use of corticosteroid ointments makes treatment more effective. They are indicated for mild to moderate psoriasis. However, their long-term use is not recommended (skin atrophy, drug dependence is possible).
Light therapy - exposing the skin to ultraviolet radiation - can be helpful. In this case, burns should be avoided.
Local treatment of lesions in severe cases is combined with the intake of drugs - retinoids, vitamin D preparations, methotrexate, etc.
Treating psoriasis can be difficult because the disease is chronic and recurs after the symptoms disappear. The effectiveness of a particular method of treatment depends on the patient's sensitivity to it.
Daily bathing (bath oil, oatmeal or sea salt is recommended; warm water and exfoliation should be avoided) and hydration after bathing can help soften the skin and reduce psoriasis inflammation.
Prevention
- Avoid hypothermia, sunburn.
- Avoid emotional stress whenever possible.
- Quit smoking and alcohol abuse.
- Take certain medications (antimalarial, etc. ) with caution.
Recommended analyzes
- General blood test
- Erythrocyte sedimentation rate (ESR)
- Rheumatoid factor
- Serum uric acid
- HIV 1, 2 Ag / Ab Combo (determination of antibodies to HIV types 1 and 2 and p24 antigen)