Psoriasis is a common non-contagious skin disease that is associated with inflammatory lesions. It is chronic - the acute period is followed by periods of relief or disappearance of symptoms - and is caused by a combination of several factors.
The disease is widespread and occurs slightly more often in women than in men. It is not fully cured, but it is possible to alleviate the symptoms and improve the patient's quality of life.
Psoriasis can cause arthritis, an inflammation of the joints.
Russian Synonyms
Squamous lichen.
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 reddish lesions, oval, sharp-edged, scaly and covered with silvery scales. Most often, formations appear on the outer surface of the elbows, knees, scalp, and torso. The elements of a rash can be painful and itchy. In severe cases, the skin near the joints in the affected areas cracks and bleeds.
- Guttate psoriasis. This type is associated with the appearance on the body of numerous orange-pink papules (nodules), 1-10 mm in size. The rash usually appears on the trunk, shoulders, and thighs, but it can be found all over the body. As a rule, it 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, exfoliation, discoloration of the nail plates, discoloration, yellowing of the nails, presence of stains on them, formation of pits, cracks, damage to the nails. Nail plates are destroyed, nail growth is disturbed, they can be separated from the nail bed. It occurs in 30-50% of patients with psoriasis.
- Large fold psoriasis. In this case, skin lesions in the form of red inflammatory patches appear in the region of the armpit folds, under the mammary glands, in the cervical folds, in the genital region, in the foreskin. Cracks may appear along the edges and in the center of the lesions. Most of the time, psoriasis in large folds occurs in overweight and obese people. Sweating and friction make the disease worse.
- Head psoriasis. It is accompanied by redness of the scalp, itching, scaling of the scalp with the appearance of white scales on the hair and shoulders - dead skin particles.
- Psoriatic arthritis. Skin lesions are accompanied by joint pain, swelling, bending and deformation of the joints. Finger, wrist, foot, and knee joints may be involved.
- Pustular psoriasis. This type is characterized by reddening of the skin and the formation of a large number of pustules - small blisters filled with pus. Formations can appear on the palms and feet or all over the body. When multiple pustules appear on the body, fever and weakness combine.
- Psoriatic erythroderma. Areas of skin turn red, plaques may appear. Lesions are usually accompanied by intense itching. Most of the time, psoriatic erythroderma is associated with sunburn or medication misuse.
Usually, in different types of psoriasis, the disease manifests itself gradually, the skin lesions spread and are observed over several weeks. Then the symptoms disappear. After exposure to a factor that contributes to the development of psoriasis (or spontaneously), symptoms reappear after some time.
General information about the disease
Psoriasis is a common non-contagious skin disease that is associated with inflammatory lesions.
It is chronic and often recurrent - the acute period is followed by periods of weakening or disappearing of symptoms, and after a while the symptoms reappear.
Psoriasis is widespread, especially among people aged 16-22, 57-60 years. Women are more susceptible to this than men. People with fair skin are at greater risk of developing the disease.
Although psoriasis is synonymous with squamous lichen, it is absolutely not contagious to other people.
The causes of psoriasis have not been fully established. Its appearance is associated with a genetic predisposition, with immune system dysfunctions and with environmental factors that affect the body.
The development of psoriasis is associated with one of the immune system cell types (such as T lymphocytes), while T cell hyperactivity is observed. Normally, they travel with blood throughout the body, detecting foreign agents - viruses and bacteria. In psoriasis, for unknown reasons, T cells start to accumulate in the skin. Its hyperactivity causes the expansion of blood vessels in the affected area, interrupts the cycle of formation of new skin cells - they form much faster than normal. Dead skin cells, in turn, do not have time to exfoliate and accumulate on the skin's surface, forming plaques.
Psoriasis can be triggered by one of the following factors:
- infections (tonsillitis, thrush, HIV);
- skin damage - cut, scratch, bite or burn;
- hypothermia;
- sunburn;
- emotional stress;
- smoking, alcohol abuse;
- the use of medications (antimalarials, etc. ).
At the same time, in some patients with psoriasis, the rash appears without obvious influence from environmental factors.
There are the following main types of psoriasis.
- Plaque psoriasis. It's the most common.
- Guttate psoriasis. It usually affects people under 30 years of age. It occurs 2-3 weeks after transfer of upper respiratory tract infectious diseases, 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. Most often associated with sunburn and misuse of medications.
- Pustular psoriasis. It is quite rare, in severe cases, it threatens the patient's life.
- Head psoriasis. In this case, hair loss caused by the disease usually does not occur, as the hair roots are located much deeper than the scaly formations.
Classification of psoriasis according to course severity:
- soft (less than 2% of all skin is affected);
- moderate (skin lesions occupy no more than 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, the addition of a secondary infection from scratches and scratches that have arisen due to itching with psoriasis;
- psychological problems (stress, low self-esteem, depression, social self-isolation);
- joint damage (deformity with stiffness and decreased joint mobility);
- increased risk of developing various diseases and conditions: hypertension, inflammatory bowel disease, cardiovascular disease, skin cancer.
Psoriasis is usually relatively mild. However, for most patients, social adaptation becomes the main problem, especially in the presence of skin lesions in visible areas of the skin - the hostility of other people to the type of skin lesions, the fear of becoming infected (many do not know that the disease is not contagious).
Who is at risk?
- People with a hereditary predisposition (more than 40% of patients with psoriasis have a relative with psoriasis).
- People with viral, bacterial, fungal infections (streptococci, thrush, HIV, etc. ).
- Stressed out emotionally.
- Obese and overweight people.
- Smokers.
- Alcohol users.
- Taking certain medications (antimalarial drugs, etc. ).
- Sunburned.
Diagnosis
Diagnosis of psoriasis is usually based on the type of typical lesion, taking into account its location. In difficult cases, additional tests may be needed to rule out other skin conditions.
laboratory research
- General blood analysis. In psoriasis, leukocytosis and anemia can be detected.
- Rheumatoid factor (RF) is a protein whose blood level can increase in systemic inflammatory diseases accompanied by joint damage, especially in rheumatoid arthritis. The test result for psoriasis is negative. This makes it possible to distinguish psoriasis from rheumatoid arthritis, in which the RF is increased.
- Erythrocyte sedimentation rate (ESR) is usually normal, with the exception of pustular psoriasis and psoriatic erythroderma.
- Uric acid. Uric acid levels in psoriasis can be elevated (especially pustular psoriasis), which leads psoriatic arthritis to be confused with gout, in which the uric acid concentration increases significantly.
- Antibodies to HIV (human immunodeficiency virus). Sudden onset of psoriasis may be due to HIV infection.
Other research methods
- X-ray of the joints. Allows you to assess the severity of joint damage in psoriatic arthritis.
- Skin biopsy. The examination involves taking a small sample of the skin for further examination under a microscope. It is performed in difficult cases to distinguish psoriasis from other skin conditions.
Treatment
Psoriasis therapy includes local treatment of skin lesions, medications, phototherapy, prevention of exposure to factors that cause the appearance of rashes. It depends on the type and severity of psoriasis.
To get rid of skin lesions, emollients (creams, petroleum jelly, paraffin, vegetable oils) can be used. 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 delay the formation of new skin cells.
The use of corticosteroid ointments makes the treatment more effective. They are indicated for mild to moderate psoriasis. However, its long-term use is not recommended (skin atrophy, drug addiction are possible).
Light therapy - exposure of the skin to ultraviolet radiation - can be beneficial. In that case, burns should be avoided.
Local treatment of lesions in more severe cases is combined with the ingestion of medications - retinoids, vitamin D preparations, methotrexate, etc.
Treating psoriasis can be difficult as the disease is chronic and reappears after the symptoms subside. The effectiveness of a particular treatment method depends on the patient's susceptibility to it.
Daily bathing (bath oil, oats, or sea salt are recommended; hot water and scrubs should be avoided) and post-bathing hydration can help smooth the skin and reduce psoriasis inflammation.
Prevention
- Avoid hypothermia, sunburn.
- Avoid emotional stress whenever possible.
- Stop smoking and alcohol abuse.
- Take certain medications (antimalarials, etc. ) with caution.
Recommended reviews
- 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)