Psoriasis is a common skin disease of neurogenic etiology. The disease is not contagious and does not spread from person to person. Most of the time, psoriasis becomes chronic due to its latent course. The disease usually develops in people under the age of 30, but it can also occur in old age.
External symptoms may be absent, the clinical picture of the disease depends on its type and stage. Most of the time, psoriasis starts with the appearance of bright red patches, which are covered with dry scales, so the disease has a second name - squamous lichen.
Skin blemishes can be of different sizes, some may combine in an affected area of the skin and protrude significantly above the surface.
Psoriasis causes physical and mental discomfort to the patient, the disease periodically worsens, in between, there is a period of remission and the symptoms decrease.
Skin patches are called psoriatic papules or papules and most often affect the elbows and knees, spreading to the head and lower back. Plaques can affect other parts of the body, depending on the type of illness. Treatment can take more than a year.
Causes of disease onset
Psoriasis causes several causes associated with several factors, both external and internal:
- a common cause is genetic inheritance;
- the illness can develop due to constant stress, anxiety, shock, depression and mental disorders;
- multiple autoimmune diseases and a malfunctioning immune system create ideal conditions on the surface of the skin for disease onset;
- Chronic psoriasis can also cause metabolic disturbances as well as endocrine system malfunction.
The type of psoriasis and its course depend on the etiology of the disease.
Psoriasis classification
The disease has several forms, on which the external manifestation and symptoms depend:
- The most common form of the disease is squamous psoriasis. The surface of the skin is covered with red or pink patches covered with scales. They contrast sharply with healthy skin, which is denser and elevated above the underlying surface. The scaly layer is easily removed and, if altered, begins to bleed, causing intense itching and burning. When the disease gets worse, the spots can grow and fuse, forming large areas of damage.
- Guttate psoriasis looks different, the spots may be pink or purple, during the exacerbation period they become brighter. The scales can be larger and have the appearance of droplets, but they can also merge over large areas.
- Another form of psoriasis that only affects the locations of the skin folds and folds - elbows, armpits, areas under the fat folds of the abdomen or chest, in the groin. The spots are smooth, regular, non-itchy and without scales. If there is friction with clothing in the affected areas, the surface of the stains is easily injured.
- The chronic form of nail psoriasis is also common, especially the nail plate of the fingers or toes is affected. Nails lose their shape, deform and change color. The nails start to thicken and exfoliate, the disease can cause the loss of the nail plate. In the early stage, nail psoriasis is easily confused with a fungal infection, so you need to see a doctor for proper diagnosis and treatment.
- The most serious form of the disease is pustular, characterized by the appearance of blisters filled with a clear liquid, which can be easily broken by rubbing clothes. When the pustules are destroyed, pus forms on them and a secondary skin infection occurs. This form of psoriasis is dangerous because it can cover almost the entire body, which worsens its course.
- Rheumatoid psoriasis affects not only the surface of the skin, but also the joints and periarticular soft tissues. This mainly concerns the knees, shoulders and hip joints. Lesions are manifested not only by external symptoms, but also by pain inside the joint, which brings additional suffering to the patient. If the hands or feet are affected, swelling of the fingers is seen, their sensitivity diminishes, and deformation begins. In the most severe and neglected form, the patient can lose limb sensitivity and become incapacitated.
All of these forms can progress on their own, or they can appear together, depending on the severity of the disease.
Stages of psoriasis
The chronic form of the disease has different stages, each with its own symptoms and characteristics:
- with progressive stage, spots, covered with scales, appear quickly and increase in size. They are usually red in color, but may change color depending on the form of the disease. The skin in these places itches a lot, burns and hurts;
- in a stable stage the disease does not cause painful sensations, it flows in moderation, the scales grow gradually, they may periodically merge;
- with a regression stage, the wheals can resolve on their own, they don't cause any concern other than outward signs.
Psoriasis is a chronic disease that alternates between exacerbation and remission.
Reasons for exacerbation
An exacerbation of the disease can be caused by several reasons, both external and internal:
- prolonged exposure to cold with skin burns;
- violation of the body's hormonal background during puberty, pregnancy, or menopause;
- long-term therapy with certain medications (antibiotics), self-medication, dosage violations when taking complex vitamins and herbal supplements;
- the disease can be aggravated by climate change or exposure to sunlight;
- alcohol abuse can not only provoke an exacerbation of the disease but also complicate its course;
- trauma, burns, ulcerations, and other mechanical damage to the skin always cause exacerbation of psoriasis;
- infection by viruses and bacteria can cause an outbreak of illness; sometimes a common respiratory illness causes an exacerbation of skin diseases.
The rheumatoid form of psoriasis has a seasonal exacerbation:
- in summer - if you are in the sun;
- in winter - due to hypothermia.
Ultraviolet ray helps heal the papules, but infrared rays from the sun irritate the skin.
Psoriasis is diagnosed without great difficulty, the disease has clear symptoms, additional studies are carried out in the form of blood tests and skin biopsies to exclude other diseases.
Treatment
Today's medicine has made great strides in the treatment of skin conditions, including psoriasis; there are several methods that can be used to treat an advanced form of the disease. The doctor determines the method of treatment on a purely individual basis, based on form, stage, causes and symptoms. Treatment is always carried out comprehensively, combining drug therapy and physiotherapy.
Drug treatment includes the use of internal and external medications:
- to eliminate skin pathologies, ointments based on salicylic acid, sulfur, dithranol and urea are used;
- glucocorticoid ointments;
- lotions for the treatment of the scalp.
In the exacerbation phase, hormonal ointments are used to eliminate the inflammatory process, the treatment always starts with the less strong ones. If the disease starts to progress again, use strong fluoridated agents. They are used for two weeks to achieve the result.
For seniors and children, ointments with fewer side effects are used.
With increasing dosage, dithranol-based ointments are prescribed to eliminate inflammation, itching and swelling.
Preparation with kalcipotriolhas a direct medicinal effect on pathogenic provocation factors. It has anti-inflammatory and immunomodulatory effects. Usually, a course of treatment in two months has a noticeable positive result, the skin rash may disappear completely. This remedy has no side effect in the form of skin atrophy and has a persistent effect. The drug is used to treat a tear-shaped form of psoriasis, which is difficult to treat.
All medications must be alternated, otherwise addiction can occur and the body will stop responding to them.
Treatment with aromatic retinoids is also considered effective.
In addition to drug therapy, a number of requirements must be met for successful treatment:
- follow a diet;
- taking the necessary vitamins under the supervision of a doctor;
- avoid stressful situations; in case of a state of depression, it is necessary to consult a doctor to prescribe the necessary resources;
- protect affected areas from contact with chemicals as much as possible, especially hands and nails;
- wear only cotton clothing so as not to cause additional skin irritation;
- do not consume alcoholic beverages and sweets, and contact with allergens should also be avoided.
If all treatment recommendations and rules are followed, it is possible to achieve remission of the disease and, in some cases, complete cure.