Psoriasis: diagnosis, treatment, prognosis

An important role in the fight against the symptoms of psoriasis are playing well-chosen external therapy and timely started treatment. A key principle in the choice of a treatment regimen, especially in the early stages of the development of psoriasis, is the principle of "do no harm" — the treatment should not affect the health of the skin, causing the occurrence of unwanted consequences in the shape of atrophy of the skin or of a withdrawal syndrome. After all, the main goal of therapy is to extend the periods of rest and the health of the skin without sudden and painful relapses and exacerbations.

the treatment of psoriasis

How long have people known about psoriasis?

With psoriasis the humanity of the family for many centuries. Traces of psoriatic skin lesions, the archaeologists found the mummified bodies of ancient peoples, preserved up to our days. Description very similar to psoriasis, rashes you may encounter in the writings of Herodotus and Plato.

The first description of the clinical manifestations of psoriasis belongs to the old scientist Cornelia. The term psoriasis – psoriasis – comes from the Greek "psora" (itch, the crust). Is the title frequently in the writings of Hippocrates.

However, the scientific research of psoriasis, as a disease independent, started only at the beginning of the nineteenth century with a description of the clinical symptoms by the English physician Robert. In 1798 took away from him leproux, mycosis, eczema, and then, in his book "diseases of the Skin" in 1808, as identified in typical and atypical for psoriasis, but also emphasized the role of genetic factors in the development of dermatoses.

So what now is known about the genetic basis of disease? How to affect it to external factors: stress, environment, bad habits, the power?

The report of the psoriasis and the nervous system is quite complex, more like a vicious circle and the character in the bipolar model. On the one hand, stress and prolonged nervous stress lead to the worsening of the process, and with another – the condition of the skin (the presence of psoriatic lesions) causes the anxiety of the patient, leads to development of chronic stress, which, in turn, worsens the course of disease and close this is the vicious circle.

Some drugs, taken in the treatment of other diseases, in some cases, may worsen during the psoriasis. Among these we can mention the antibiotics (tetracycline, penicillin, bitsillin, chloramphenicol, etc.), drugs lithium, vitamin C and vitamins of the B group, beta-blockers, nonsteroidal anti-inflammatory drugs, estrogen funds (contraceptive drugs), anticonvulsants, immunomodulatory. Can lead to an aggravation of the process and vaccines, and also the serum.

Ecology, the profile of nutrition, bad habits – all this has a negative impact on the whole psoriasis, and treatment.

What is the prevalence of psoriasis in the countries?

The prevalence of psoriasis worldwide is estimated to be around 1-3% of the population. According to the international organization, in 2010, on the planet was recorded 125 million patients with psoriasis. In Europe, suffer from it 5 million people, which is comparable with the frequency of coronary heart disease and diabetes.

Higher in countries of northern Europe (4%), and lowest in africa and Latin america, in Japan (minus 0.5%).

As of now diagnosed with psoriasis? What diseases can be confused?

psoriasis

Psoriasis skin smooth, it shows the typical skin rash and the diagnosis is exposed clinically. There are diagnostic test: psoriatic triad – the strengthening of the peeling when poskablivanii, the appearance of the blood spots after the removal of flakes.

How you were treated with the psoriasis first, and how to treat now? If the treatment is more advanced and efficient?

Until the middle of the last century, the basic techniques, including the use of medications with salicylic acid and helio-, thalassotherapy. Then there are the topical steroids (in the following: — analogs of vitamin D3), and the immunosuppressive drugs. But a step forward in the therapy of psoriasis may be considered the emergence in the early years of the 21st century biologic drugs. And, certainly, the arsenal of topical and system of medications, phototherapy techniques now allow you to choose an effective therapy for each patient.

As you apply the approaches for the treatment of children and some adults?

First of all, psoriasis is necessary to divide for a limited and common (severe and medium-severe forms). The therapy is necessary to allocate, taking account of these data.

The difference in the treatment of adults and children is due only to the age limitations for the use of drugs (for example kaltsipotriol is assigned with 6 years of age) or the techniques of phototherapy (such as PUVA-therapy is assigned with 18 years of age).

What are the most common myths about the disease?

  • Psoriasis is contagious. No, psoriasis, chronic non-infectious skin disease that is not transmitted from person to person and does not migrate with one part of the body to another. A patient suffering from psoriasis, can freely attend places of public steam baths, saunas, swimming pools, using common objects in daily life, subjected to treatment for common diseases, hospitals.
  • Climate impacts on the incidence, and whether to move in the warm countries of the psoriasis will not be. No, the climate on the prevalence of psoriasis does not affect. At the same time, one of the methods for its treatment therapy for special – treatment of the sun and sea water, however, the accommodation in the regions with the most warm, maritime climate we don't know the sick of exacerbations. A simple example is Israel: there successfully to treat psoriasis in the resorts of the Dead sea, but the incidence among the population of not less in the world.
  • The psoriasis may experience. The factors that cause the deterioration, either for themselves, or in various combinations are not the cause of the disease. Unknown today, which serves a primordial impulse to the development of psoriasis, but why take preventive measures impossible. No recipe, I have to do, or, on the contrary, you must not do do to not get sick of psoriasis, no. Increase the remission period, when eruptions of the skin are damaged, it is possible, avoiding actions that provoke or worsen during the psoriasis factors, that marks a proper lifestyle and applying the maintenance treatment.
  • Psoriasis can be treated with methods of the so-called popular medicine. Relation to these methods, patients should be extremely careful. From the one hand, we know that there is psoriasis tools that will take care of, but the desire is to get rid from the disease prompts patients to several questionable actions (appeal to healers, traditional healers), but it is wasted money spent. On the other hand, these "healers" offer to the patients, such as, for example, external funds "their own development", in which, usually, there are hormones, but in this case, the mode, and even more so their dosage cannot be controlled.

What is important to know the patient with psoriasis, and that we need to remember?

The principal can be regarded as a principle: "learn to live with psoriasis." Today the techniques of the therapy can achieve remission (cleansing and purification of the skin), but also a certain degree of control the psoriasis (a long remission).

It is necessary to follow the doctor's recommendations and have patience, because everyone needs time, between which, and the medicines have acted. Incomplete, the use of multiple methods at the same time (in particular, the series of "recommended"), lead to what the patient, not seeing the correct result, disappointed, and believes that these methods did not help.

10.09.2018