Psoriasis is a common non-communicable skin disease related to inflammatory lesions. It is chronic-the acute phase is followed by the period of remission or disappearance of symptoms-and is caused by a combination of many factors.
This disease is very common and it is more common in women than men. It cannot be completely cured, but it can relieve symptoms and improve the patient's quality of life.
Psoriasis can cause arthritis, which is inflammation of the joints.
Synonyms in Russian
Scaly lichen.
English synonyms
psoriasis.
symptom
The signs and symptoms of psoriasis depend on the type of psoriasis.
- Plaque psoriasis. It is accompanied by the formation of specific inflammatory skin-raised, oval, sharply contoured red lesions, flaky and covered with silver scales. In most cases, formation occurs on the outer surface of the elbows, knees, scalp, and trunk. The components of the rash may be painful and itchy. In severe cases, the skin near the joints in the affected area may crack and bleed.
- Guttate psoriasis. This type is related to the appearance of a large number of orange-pink papules (nodules) on the body, which are 1-10 mm in size. The rash usually appears on the trunk, shoulders, and thighs, but can be found all over the body. Usually, it affects people under the age of 30, and 2-3 weeks after suffering from an upper respiratory infection after a bacterial infection on the anal surface.
- Nail psoriasis. It is characterized by compaction, peeling, discoloration of the nail plate, discoloration and yellowing of the nail, spots on it, formation of pits, cracks, and damage to the nail. The nail plate is destroyed, the growth of the nails is disturbed, and 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 inflammation spots appear on the axillary fold area, under the breast, cervical fold, genital area, and foreskin. Cracks may appear at the edges and center of the lesion. In most cases, large fold psoriasis occurs in people who are overweight and obese. Sweating and friction can make the disease worse.
- Head psoriasis. It is accompanied by redness, itching of the scalp, peeling of the scalp, and the appearance of white scales-dead skin particles on the hair and shoulders.
- Psoriatic arthritis. Skin lesions are accompanied by joint pain, swelling, bending and deformation. Fingers, wrists, feet, and knee joints may be affected.
- Pustular psoriasis. This type is characterized by the redness of the skin and the formation of large numbers of pustules-small blisters filled with pus. Formation can appear on the palms and feet or on the whole body. When multiple pustules appear on the body, fever and weakness appear.
- Psoriasis erythroderma. The skin area turns red and plaques may appear. The lesions are usually accompanied by severe itching. In most cases, psoriatic erythroderma is related to sunburn or drug abuse.
Usually, for different types of psoriasis, the disease will gradually appear, and the skin lesions will spread and be observed for several weeks. Then the symptoms disappeared. After exposure to factors (or spontaneous) that lead to the development of psoriasis, symptoms will reappear after a period of time.
General information about the disease
Psoriasis is a common non-communicable skin disease related to inflammatory lesions.
It is chronic and often recurs-the acute phase is followed by a period when symptoms diminish or disappear, and then symptoms reappear after a while.
Psoriasis is very common, especially in people aged 16-22 and 57-60. Women are more susceptible to it than men. People with fair skin are at higher risk of developing this disease.
Although psoriasis is synonymous with scaly lichen, it will never be transmitted to other people.
The cause of psoriasis has not been fully determined. Its appearance is related to genetic predisposition, immune system malfunction and environmental factors that affect the body.
The development of psoriasis is related to a cell type of the immune system (T lymphocytes), and overactive T cells have been observed. Under normal circumstances, they will be spread throughout the body with the blood to detect foreign substances-viruses and bacteria. In psoriasis, for unknown reasons, T cells begin to accumulate in the skin. Their overactivity can cause the blood vessels in the affected area to dilate, disrupting the cycle of new skin cell formation-their formation rate is much faster than usual. At the same time, dead skin cells do not have time to exfoliate and accumulate on the surface of the skin, forming plaques.
Psoriasis can be caused by one of the following factors:
- Infection (tonsillitis, thrush, HIV);
- Skin injuries-cuts, scratches, bites or burns;
- Low temperature;
- sunburn;
- Emotional stress
- Smoking, alcoholism;
- Use drugs (antimalarial drugs, etc. ).
At the same time, in some patients with psoriasis, rashes appear without obvious environmental factors.
There are the following main types of psoriasis.
- Plaque psoriasis. It is the most common.
- Guttate psoriasis. It usually affects people under 30 years of age. It occurs 2-3 weeks after the upper respiratory tract has metastatic infectious disease, and 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.
- Psoriasis erythroderma. It is most often related to sunburn and drug abuse.
- Pustular psoriasis. This is very rare, and in severe cases, it can threaten the life of the patient.
- Head psoriasis. In this case, hair loss caused by the disease usually does not occur because the roots of the hair are much deeper than the scaly structure.
Psoriasis is classified according to the severity of the disease:
- Soft (less than 2% of the entire skin is affected);
- Moderate (skin lesions do not exceed 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, increased secondary infections by scratching and scratches due to psoriasis itching;
- Psychological problems (stress, low self-esteem, depression, social self-isolation);
- Joint damage (deformation, stiffness, and decreased joint mobility);
- Increased risk of various diseases and conditions: high blood pressure, inflammatory bowel disease, cardiovascular disease, skin cancer.
Psoriasis is usually relatively mild. However, for most patients, social adaptation becomes a major problem, especially when there are skin lesions in the visible area of the skin-other people are hostile to the type of skin lesion, and they are afraid of being infected (many people don’t know that the disease is not contagious).
Who is at risk?
- People with a genetic predisposition (more than 40% of relatives of people with psoriasis have psoriasis).
- People with viral, bacterial, or fungal infections (streptococcus, thrush, HIV, etc. ).
- Emotional tension.
- Obese and overweight people.
- Smoker.
- Alcoholics.
- Taking certain drugs (antimalarials, etc. ).
- Sunburn.
diagnosis
The diagnosis of psoriasis is usually based on the typical type of lesions, taking into account their location. In difficult situations, additional tests may be required to rule out other skin conditions.
Laboratory research
- General blood analysis. For psoriasis, leukocytosis and anemia can be detected.
- Rheumatoid factor (RF) is a protein whose blood levels increase in systemic inflammatory diseases with joint damage, especially rheumatoid arthritis. The test result for psoriasis was negative. This allows you to distinguish between psoriasis and rheumatoid arthritis, where RF increases.
- With the exception of pustular psoriasis and psoriatic erythroderma, the erythrocyte sedimentation rate (ESR) is generally normal.
- Uric acid. Patients with psoriasis have elevated levels of uric acid (especially pustular psoriasis), which can cause psoriatic arthritis to be confused with gout, and patients with gout have significantly higher levels of uric acid.
- HIV (Human Immunodeficiency Virus) antibodies. The sudden onset of psoriasis may be due to HIV infection.
Other research methods
- X-rays 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 skin for later examination under a microscope. It is performed under difficult circumstances to distinguish psoriasis from other skin diseases.
treatment
The treatment of psoriasis includes topical treatment of skin damage, medication, phototherapy, and prevention of exposure to factors that cause the rash. It depends on the type and severity of psoriasis.
To get rid of skin damage, emollients (cream, petrolatum, paraffin, vegetable oil) can be used. It is most effective to use twice a day after showering. Salicylic acid, anthracene, tar preparations, ointments, solutions, shampoos containing coal tar are also used. These drugs have anti-inflammatory effects and can slow down the formation of new skin cells.
The use of corticosteroid ointment can make the treatment more effective. They are suitable for mild to moderate psoriasis. However, long-term use of them is not recommended (skin atrophy, drug addiction is possible).
Phototherapy-exposing the skin to ultraviolet radiation-may be beneficial. In this case, avoid burns.
In more severe cases, local treatment of lesions is combined with the intake of drugs-retinoids, vitamin D preparations, methotrexate and so on.
Psoriasis can be difficult to treat because the disease is chronic and will recur after the symptoms disappear. The effectiveness of a particular treatment method depends on the patient's sensitivity to it.
Daily bathing (bath oil, oatmeal or sea salt is recommended; hot water and scrubs should be avoided) and moisturizing after bathing helps to soften the skin and reduce psoriasis inflammation.
prevention
- Avoid hypothermia and sunburn.
- Avoid emotional stress as much as possible.
- Quit smoking and alcoholism.
- Take certain medications with caution (antimalarials, etc. ).
Recommended analysis
- General blood analysis
- Erythrocyte Sedimentation Rate (ESR)
- Rheumatoid factor
- Serum uric acid
- HIV 1, 2 Ag / Ab Combo (determines antibodies against HIV types 1 and 2 and p24 antigen)