Psoriasis - Symptoms and Treatment

PsoriasisIt is a chronic disease that affects the skin, sometimes nails, joints and internal organs. It manifests as itchiness and the appearance of reddish-pink skin rashes - papules, which can fuse into larger plaques. These papules rise above the surface of the skin. They are covered with silvery scales that easily peel off when peeling.

psoriasis on the skin

The disease is often combined with impotence, accelerated ejaculation and Reiter's syndrome. With extensive psoriasis, psoriatic arthritis can occur.

Risk factors

Causes of psoriasishave not yet been fully identified. Risk factors for developing the disease include:

  • microbial factor - various types of fungus, mycoplasma;
  • neuropsychic trauma, stress;
  • endocrine diseases - diabetes mellitus, thyroid disease;
  • foci of chronic infection, especially streptococcal;
  • immunodeficiency states;
  • disorders of lipid and protein metabolism;
  • skin and joint injuries.

Is psoriasis transmitted?

Psoriasis is not contagious. Many researchers pay attention to the familial nature of psoriasis and recognize its genetic nature. Furthermore, it is not the disease itself that is inherited, but a predisposition to it.

If you experience similar symptoms, see your doctor. Don't self-medicate - it's dangerous for your health!

psoriasis symptoms

The first symptoms of psoriasis:skin rashes in the form of bright pink plaques with a scaly surface. The plaques are unique, rise above the level of healthy skin, are located on the elbows and in the popliteal cavities.

More often, psoriatic plaques appear on the skin of the knees, elbows, chest, abdomen, back, and scalp, but as the disease progresses, they can appear in any other, more unexpected places in the integument.

where is psoriasis located

Initially, the papules are small - 3-5 mm, the color is bright pink. Gradually increasing in size, they become covered with silvery scales and fuse into larger formations called plates.

psoriatic papule overgrowth

The fresh elements of the papules, as a rule, are bright in color, even red, and the "old" ones are more faded. In the early stage of psoriasis, the edges of the papules do not detach. They represent a hyperemic frontier -growth corolla. . .

the early stage of psoriasis

The hallmark of psoriasis is the Auspitz triad. This triad can be seen by scraping the surface of the papule with a sharp object. It includes three phenomena:

  • stearin stain phenomenon- stratification of a large number of silvery-white scales, which are easily separated when scraped off;
  • psoriatic film symptom- exuded surface, made with a prickly layer, which opens after the removal of the lower layers of the stratum corneum;
  • blood dew phenomenon- exposure of superficial capillaries in the form of small blood spots after detachment of the psoriatic film.
psoriatic film detachment

Signs of different types of psoriasis

Clinical types of psoriasis:

  • Spotted psoriasis- represented by faintly infiltrated pale pink spots. It resembles toxiderma.
  • spotted psoriasis
  • irritated psoriasis- occurs due to skin exposure to aggressive environmental factors (sunlight, cold, heat) and irritating drugs. The color of the plaque becomes more intense, increases in size, rises higher above the surface of the skin, and a reddish band forms at the edges.
  • irritated psoriasis in the body
  • seborrheic psoriasis- often develops in patients with seborrhea. The clinical picture is very similar to seborrheic eczema.
  • seborrheic psoriasis in the head
  • Exudative psoriasis- occurs quite often. It occurs due to excessive secretion of an inflammatory fluid - exudate. It impregnates the scale accumulations, turning them into scale crusts.
  • exudative psoriasis in the body
  • Psoriasis of the palms and soles- is represented by common plaques and papules or hyperkeratotic formations, similar to calluses and calluses.
  • psoriasis of the palms and below
  • follicular psoriasis- a rare form of the disease. The eruption consists of white miliary nodules with a funnel-shaped depression in the center.
  • follicular psoriasis
  • Mucous membrane psoriasis- a rare form of the disease. It occurs in the mucous membrane of the mouth and bladder. It manifests as whitish-gray areas with a red border.
mucous membrane psoriasis

Frequency of psoriatic manifestations

Cyclic exacerbations are characteristic of psoriasis. Most often, they occur in autumn and spring.

Pathogenesis of psoriasis

skin cross section in psoriasis

Dermatosis is an inflammatory process associated with the work of immune T cells. As a result of this inflammation, the proliferation of keratinocytes, the main cells in the epidermis, is accelerated.

psoriasis development mechanism

Psoriasis, a type of dermatosis, is a chronic inflammatory disease. It continues with the participation of microbial pathogens that can bind to the skin surface.

Everything that happens to the skin under the influence of the pathogen is a classic inflammatory reaction according to the RTCDF principle:

  • Redness - redness;
  • Tumor - tubercle, edema;
  • Heat - fever, fever;
  • Pain - pain;
  • Functia laesa - dysfunction.

Redness and thickening of the skin at the sites of lesions, itching, increased keratinization followed by the formation of scales - all these are manifestations of the inflammatory process, a protective reaction of the organism that aims to combat the microbial pathogen. Without timely outside help, the body is often defeated.

keratinization of cells in psoriasis

Some scientists subscribe to the theory of a genetic predisposition to violation of the cell division process. With such a violation, there is an increase in cell death and keratinization, followed by their growth and the appearance of a large number of incompletely keratinized epithelial cells. But this theory in no way contradicts the above microbial.

Classification and stages of development of psoriasis

There is no generally accepted classification of psoriasis.

Traditionallythere are four types of the disease:

  • psoriasis vulgaris - seborrheic, follicular, verrucous, exudative, bullous, psoriasis of the palms and soles, psoriasis of the mucous membranes;
  • pustular psoriasis;
  • psoriatic erythroderma;
  • psoriatic arthritis.

According to ICD-10, there are:

  • L40. 0 Psoriasis vulgaris (coin and plaque psoriasis);
  • L40. 1 Generalized pustular psoriasis (impetigo herpetiformis, Tsumbusch's disease);
  • L40. 2 Persistent Acrodermatitis;
  • L40. 3 Palmar and plantar pustulosis;
  • L40. 4 Psoriasis tear;
  • L40. 5 Arthropathic psoriasis;
  • L40. 8 Other psoriasis;
  • L40. 9 Psoriasis, unspecified

Complications of psoriasis

Without proper and timely treatment, psoriasis begins to negatively affect vital organs and systems: joints, heart, kidneys and nervous system. These conditions can lead to disability and even death.

What is Psoriatic Arthritis

Psoriatic arthritis is the most serious form of psoriasis, as it often causes deficiency.

Doctors face this complication more often. It occurs as a result of inflammatory changes in the joints.

psoriatic arthritistypes of psoriatic arthritis

The joints of the hands, wrists, feet and knees are the most affected. Over time, the disease can spread to the hip, shoulder, and spinal joints. With further progression, muscles begin to ache near the affected joints. Patients complain of rigidity of movement, especially in the morning. Body temperature usually rises throughout the day.

The clinical picture of psoriatic arthritis develops in the manner of common arthritis: first there is pain, then swelling, stiffness, and limited mobility. A characteristic symptom of this complication is a sausage toe. It seems due to the defeat of all interphalangeal surfaces.

pathogenic syndrome in psoriasis

Other complications of psoriasis

slightly less commonpsoriatic erythroderma. . .This condition occurs when the skin is completely affected. Patients are concerned about itching and burning, copious scaling of dead tissue, a strong skin reaction to a change in temperature.

psoriatic erythroderma

The next most frequent occurrence ispustular psoriasis. . .This complication is associated with the addition of a secondary infection - staphylococci and streptococci. Clinically, pustular psoriasis is accompanied by the appearance of pustules - pustules the size of a buckwheat grain. The pustules appear in different places. They rise above the surface of the skin, are characterized by rapid growth and a tendency to fuse. Existing symptoms are added to high fever and signs of severe intoxication.

pustular psoriasis

Internal organ injurieswith psoriasis are now extremely rare. As a rule, people who lead a non-social lifestyle are susceptible to them. The genitourinary system is most often affected: the kidneys, the mucous membrane of the bladder and the urethra. This leads to the development of pyelonephritis, glomerulonephritis, cystitis and urethritis.

In the heart part, psoriasis can cause damage to the mitral valves, inflammation of the heart muscle and the outer lining of the heart - myocarditis and pericarditis. With nervous system damage, patients complain of a crawling sensation, increased irritability or depression, constant fatigue, drowsiness, and apathy.

Diagnosis of psoriasis

when to see a doctor

It is necessary to consult the doctor at the first symptoms of psoriasis: the appearance of shiny pink patches on the skin with a scaly surface.

Preparing to visit a doctor

Three days before visiting a doctor, you should stop applying medicinal ointments to your skin. No other special training is required.

Psoriasis is such a recognizable disease that it will not be difficult to diagnose it based on external signs. Often a diagnosis can be made to patients, as they say, "ready to use". If necessary, the doctor scrapes the surface of the skin to detect the Auspitz triad.

OV Terletskiy, Candidate in Medical Sciences, together with the co-authors, proposed a diagnostic scheme developed based on data from the American Rheumatological Association. Includes the following exams:

  • complete blood count (with platelets);
  • general urine analysis;
  • blood chemistry;
  • acute body phase reactions - C-reactive protein and rheumatoid factor;
  • immunoglobulins - IgA, IgG, IgM, IgE)
  • complement binding reaction with gonococcal antigen and chlamydia;
  • Wright and Heddelson's reactions;
  • coagulogram - assessment of blood clotting;
  • blood test for borreliosis and toxoplasmosis (as indicated);
  • blood test for HLA.

However, there are many diseases disguised as psoriasis. In this sense, it is necessary to conductdifferential diagnosis, in particular among papular syphilis, Reiter's syndrome, neurodermatitis, lichen rosacea, systemic lupus erythematosus and seborrheic eczema. To do this, use:

  • biopsy - clamping of a piece of skin with subsequent histological examination;
  • laboratory diagnosis - often used to distinguish psoriasis from papular syphilis;
  • blood tests for other occult infections for better antibiotic selection.
psoriasis diagnosis

Instrumental diagnostic methodsmainly used for complicated forms of psoriasis associated with damage to joints and internal organs. This includes: X-rays of the joints, ultrasounds of the heart, kidneys and bladder.

psoriasis treatment

There is an effective treatment for psoriasis

Although psoriasis is a persistently recurrent disease, it can be completely eliminated as long as you consult a dermatologist in a timely manner, who can identify the true causes of psoriasis. In the last decade, many drugs with systemic and local action have appeared, aiming to eliminate the cause and suppress the disease development mechanism. Drugs that interact with each other through chemical signals (cytokines) have shown themselves to be very well. They eliminate the increased proliferation of creatinocytes from the skin.

Phototherapy

In 1994, the team from the Department of Dermatovenereology at MAPO SPb introduced a method of treating psoriasis throughUFO blood- photomodification of blood with ultraviolet light.

The ability of sunlight to have a beneficial effect on the skin in various diseases, including psoriasis, has been known since time immemorial. In the early 20th century, a group of German scientists suggested that since ultraviolet light has a healing effect on exposed skin, this effect is likely to occur when ultraviolet radiation is applied to the blood. After all, it's also a kind of fabric. This assumption was confirmed by the first session of exposure to ultraviolet rays in blood, held in Germany in 1924.

The therapeutic effect of ultraviolet rays on the blood is associated with profound structural changes at the atomic molecular level, which are captured by immunocompetent organs - liver, spleen, bone marrow and lymphoid tissue. These changes are considered by the organs as an alarm signal and, therefore, produce dozens of times more immune complexes. In this case, ultraviolet light is a kind of "whip" that forces the body to dramatically increase its defenses to fight the disease.

UFO blood for psoriasis

Also noteworthy is the PT effect -lineless ultraviolet therapy. . . This method of treatment is important given the chronic nature of psoriasis associated with numerous internal organ complications caused by a variety of microbial pathogens. The longer microbes remain in the body, the wider their habitat becomes. These microscopic creatures capture more and more anatomical areas through blood and lymph flow. Once in the tissues, they strive to penetrate as deeply as possible into the intercellular spaces. There they form microcolonies, protected by the remains of destroyed dead cells and a white blood cell. Because of this, microorganisms can be out of reach of antibiotics for years. They easily make up for the lack of nutrients by entering a state of suspended animation - something between life and death.

The ability of ultraviolet rays helps to destroy microbial "shelters". They create favorable conditions for the penetration of antibiotics and other drugs that affect the cause of psoriasis.

The cutaneous application of ultraviolet radiation is also relevant. The most famous treatment method using this principle isPUVA therapy. . . Although it is less effective than ultraviolet irradiation of blood. The therapeutic effect is short-lived, with recurrence two weeks after the end of treatment.

puva therapy for psoriasis

drug treatment

Regarding medications, the following worked well:

  • vitamin A derivatives, which reduce the rate of keratinocyte maturation and normalize cell differentiation;
  • immunosuppressants that reduce the activity of T lymphocytes, which contribute to increased epidermal cell division;
  • drugs for the treatment of malignant tumors that inhibit the reproduction and growth of atypical skin cells.

What ointments and creams are effective in treating psoriasis

Ointments and creams with anti-inflammatory components will help alleviate the patient's condition.

How to Treat Scalp Psoriasis

Ointments are not effective in treating scalp psoriasis. In addition to medication and ultraviolet treatment, a special shampoo can be used.

How to Treat Psoriasis on Elbows and Arms

Psoriasis on the elbows and arms is treated with the same methods as the rest of the body. The peculiarity of the course of psoriasis in this area is that the skin on the hands is subject to physical, mechanical and chemical influences, which is considered an aggravating factor in the course of the disease.

Is monoclonal antibody treatment for psoriasis effective?

Monoclonal antibody therapy for psoriasis is very effective. Monoclonal antibody drugs are laboratory-produced antibodies similar to those produced by human immune cells. Monoclonal antibodies selectively target the targets responsible for the development of the disease.

How to Recognize and Treat Psoriasis in Children

In children, psoriasis is usually more violent and disguises itself as other diseases (eczema, erysipelas, herpes), which complicates the diagnosis. The therapy methods are similar to those of the adult: phototherapy, medication and topical treatment.

What baths to take with psoriasis

Aloe baths can help reduce inflammation and itching.

How to Treat Psoriasis According to Pegano

The Pegano method for treating psoriasis involves bowel cleansing, diet and herbal teas. The effectiveness of this method has not been proven by clinical studies.

Role of nutrition in treatment

Nutrition greatly affects the course of psoriasis. In the treatment, it is necessary to exclude alcohol, salty, spicy, canned, nuts, citrus fruits, honey, chocolate and smoked meats.

Which sanatoriums show rest for the treatment of psoriasis

For psoriasis, a spa treatment at sea is preferable, in a region with a hot, dry climate and many sunny days. The most suitable for this are the Crimean resorts.

popular ways

Some folk remedies can help reduce itchiness and flaking of the skin in patients with mild to moderate psoriasis. These methods include:

  • cream with aloe extract;
  • fish oil applied to the skin with a coated dressing for six hours a day for four weeks;
  • cream with oregon grape extract.

Forecast. Prevention

Psoriasis is not a phrase. If the patient has timely requested qualified help from a specialist who can establish the true causes of the disease and prescribe an effective treatment, then the disease will be defeated.

The simple form of psoriasis is only manifested by a defect in the skin. Therefore, the patient does not need special conditions to work. The exception is work in a chemical plant: in this case, permanence in the workplace must be excluded.

Remember that psoriasis can cause complications. Most of the time, psoriatic arthritis develops. Its severe forms can limit the performance of functions at work and, in the future, lead to total disability.

Prevention of psoriasis is an integral part of therapeutic measures to eliminate one of the most serious skin diseases. After recovery, the patient needs to completely review their lifestyle, eliminate bad habits, pay attention to the treatment of chronic diseases of other organs, adjust their diet, include outdoor walking and sports in their daily routine.

Do they take psoriasis in the army?

Severe forms of psoriasis are sufficient grounds for declaring a recruit unfit for military service, mild forms - of limited fitness.