PsoriasisIt is a chronic disease that affects the skin, sometimes nails, joints and internal organs. It is manifested by itching and the appearance of a reddish-red rash-papules, which can merge into larger plaques. These papules rise above the surface of the skin. They are covered with silvery scales that easily peel off when peeling.
Often, the disease is combined with impotence, accelerated ejaculation and Reiter's syndrome. With extensive psoriasis, psoriatic arthritis can occur.
Risk factors
Causes of psoriasishas not been fully identified. Risk factors for this disease include:
- microbial factors - various types of fungi, mycoplasms;
- neuropsychic trauma, stress;
- endocrine diseases - diabetes mellitus, thyroid disease;
- foci of chronic infections, especially streptococcus;
- state of immunodeficiency;
- disorders of lipid and protein metabolism;
- injuries to the skin and joints.
Is psoriasis contagious?
Psoriasis is not contagious. Many researchers pay attention to the nature of familial psoriasis and are aware of its genetic nature. Moreover, the disease itself is not inherited, but rather a predisposition to the disease.
If you experience similar symptoms, see a doctor. Don’t treat yourself - it endangers your health!
Symptoms of psoriasis
The first symptoms of psoriasis:rash on the skin in the form of bright pink plaques with a scaly surface. The plaque is single, rising above the level of healthy skin, located at the elbow and in the popliteal opening.
More often, psoriatic plaques appear on the skin of the knees, elbows, chest, abdomen, back and scalp, but with the progression of the disease, they can appear elsewhere, most unexpectedly in this part.
Initially, the papules are small - 3-5 mm, their color is bright pink. Gradually in size, they are covered with silvery scales and merge into larger formations called plaques.
Elements of fresh papules, as a rule, are brightly colored, to red, the "old" more faded. In the early stages of psoriasis, the edges of the papule do not peel off. They represent hyperemic boundaries -corolla growth. . .
The hallmark of psoriasis is the Auspitz triad. This triad can be observed by scraping the surface of the papule with a sharp object. These include three phenomena:
- stearin spot phenomenon- a layer of a large number of silvery white scales, which are easily separated when scraped;
- psoriatic film symptoms- the emitted surface, made with a barbed layer, which is opened after peeling the lower layer of the stratum corneum;
- blood dew phenomenon- superficial capillary exposure in the form of small blood spots after detachment of psoriatic film.
Signs of various types of psoriasis
Types of clinical psoriasis:
- Psoriasis spots- represented by weak pale pink spots. It resembles toxidermia.
- Irritant psoriasis- occurs due to exposure to the skin of aggressive environmental factors (sunlight, cold, heat) and irritating drugs. The color of the plaque becomes more intense, its size increases, rises higher above the surface of the skin, a belt is formed on the edges in the form of redness.
- Seborrheic psoriasis- often develops in patients with seborrhea. The clinical picture is very similar to seborrheic eczema.
- Exudative psoriasis- occurs frequently. It occurs due to the secretion of inflammatory fluid - excessive exudate. This permeates the accumulation of scales, turning them into the crust of scales.
- Psoriasis of the palms and soles of the feet- is represented by common plaques and papules, or hyperkeratotic formations, similar to calluses and calluses.
- Follicular psoriasis- a rare form of the disease. The rash consists of white miliary nodules with a funnel -shaped depression in the middle.
- Psoriasis of the mucous membranes- a rare form of the disease. It occurs on the mucous membranes of the mouth and bladder. It manifests itself in the form of a gray-white area with a red border.
Frequency of psoriatic manifestations
Cyclic exacerbations are characteristic of psoriasis. Often it occurs in autumn and spring.
Pathogenesis of 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 of the epidermis, is accelerated.
Psoriasis, a type of dermatosis, is a chronic inflammatory disease. It is followed by the participation of microbial pathogens that can bind to the surface of the skin.
Everything that happens in the skin under the influence of pathogens is a classic inflammatory reaction according to the principle of RTCDF:
- Rubber - redness;
- Tumors - tuberculosis, edema;
- Calories - fever, fever;
- Pain - pain;
- Functia laesa - dysfunction.
Redness and thickening of the skin at the site of the lesion, itching, increased keratinization followed by the formation of scales - all these are manifestations of inflammatory processes, protective reactions of the body aimed at combating microbial pathogens. Without timely outside help, the body is often defeated.
A number of scientists adhere to the theory of genetic predisposition to violations of the process of cell division. With such violations, increased cell death and keratinization occur, followed by their growth and emergence of large numbers of incomplete epithelial cells. But this theory is in no way contradictory to the microbes above.
Classification and stage of development of psoriasis
There is no generally accepted classification of psoriasis.
Traditionallythere are four types of disease:
- psoriasis vulgaris - seborrheic, folicular, warty, exudative, bullous, psoriasis of the palms and soles of the feet, 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 tears;
- L40. 5 Arthropathic psoriasis;
- L40. 8 Other Psoriasis;
- L40. 9 Psoriasis, not specified
Complications of psoriasis
Without timely and accurate treatment, psoriasis begins to negatively affect vital organs and systems: joints, heart, kidneys and nervous system. This condition can lead to disability and even death.
What is psoriatic arthritis
Psoriatic arthritis is the most severe form of psoriasis, as it often results in deformities.
Doctors face these complications most often. It occurs as a result of inflammatory changes in the joints.
The joints of the hands, wrists, feet and knees are most affected. Over time, the disease can spread to the hip joints, shoulders and spine. With further development, the muscles begin to ache near the affected joint. Patients complain of stiffness of movement, especially in the morning. Their body temperature often rises throughout the day.
The clinical picture of psoriatic arthritis develops in the usual way of arthritis: first, there is pain, then swelling, stiffness and limitation of movement. The typical symptom of this complication is sausage fingers. It appears due to the defeat of all interphalangeal surfaces.
Other complications of psoriasis
A little less commonpsoriatic erythroderma. . .This condition occurs when the skin is completely affected. Patients worry about itching and burning, excessive exfoliation of dead tissue, strong skin reactions to temperature changes.
The next most common occurrence ispustular psoriasis. . .These complications are associated with the addition of secondary infections - staphylococci and streptococci. Clinically, pustular psoriasis is accompanied by the appearance of pustules - pustules the size of buckwheat grains. Pustules appear in different places. They rise above the surface of the skin, characterized by rapid growth and a tendency to merge. The symptoms are accompanied by high fever and signs of serious intoxication.
Lesions of internal organswith psoriasis is now very rare. As a rule, people who lead an asocial lifestyle are vulnerable to them. The genitourinary system is more often affected: the kidneys, the mucous membranes of the bladder and the urethra. This leads to the development of pyelonephritis, glomerulonephritis, cystitis and urethritis.
On the part of the heart, psoriasis can cause damage to the mitral valves, inflammation of the heart muscle and the outer layer of the heart - myocarditis and pericarditis. With damage to the nervous system, patients complain of creeping sensations, increased irritability or depression, constant fatigue, drowsiness and apathy.
Diagnostics of psoriasis
When to see a doctor
It is necessary to consult a doctor at the first symptoms of psoriasis: the appearance on the skin of bright pink plaques with a flaky surface.
Get ready to see a doctor
Three days before seeing a doctor, you should stop using the medicated ointment on the skin. No other special training is required.
Psoriasis is such a recognizable disease that it is difficult to diagnose it based on external signs. Often, a diagnosis can be made to the patient, as they say, "out of the box. " If necessary, the doctor scrapes the surface of the skin to detect the Auspitz triad.
OV Terletskiy, Candidate of Medical Sciences, together with co-authors, proposed a diagnostic scheme developed based on data from the American Society of Rheumatology. It includes the following examinations:
- complete blood count (with platelets);
- general urine analysis;
- blood chemistry;
- acute phase reactions of the body - C -reactive protein and rheumatoid factor;
- immunoglobulin - IgA, IgG, IgM, IgE)
- complementary binding reactions with gonococcal and chlamydial antigens;
- Wright and Heddelson's reaction;
- coagulogram - assessment of blood clotting;
- blood tests for borreliosis and toxoplasmosis (according to instructions);
- blood test for HLA.
However, there are many diseases with the disguise of psoriasis. Accordingly, it needs to be donedifferential diagnosis, particularly among papular syphilis, Reiter's syndrome, neurodermatitis, lichen rosacea, systemic lupus erythematosus and seborrheic eczema. For this purpose, use:
- biopsy - pinching a piece of skin with subsequent histological examination;
- laboratory diagnostics - often used to distinguish psoriasis from papular syphilis;
- blood tests for other latent infections for better antibiotic selection.
Instrumental diagnostic methodsmainly used for complicated forms of psoriasis associated with damage to joints and internal organs. These include: X-rays of the joints, ultrasound of the heart, kidneys and bladder.
Psoriasis treatment
Is there an effective treatment for psoriasis
Despite the fact that psoriasis is a persistent recurrent disease, it can be completely eliminated provided you see a dermatologist in a timely manner, who can identify the true cause of psoriasis. Over the past decade, many systemic and local drugs have emerged, aimed at eliminating the cause and suppressing the mechanism of progression of the disease. Drugs that interact using chemical signals (cytokines) have proven themselves well. They eliminate the increased proliferation of skin creatinosite.
Phototherapy
In 1994, the team of the Department of Dermatovenereology MAPO SPb introduced a method of treating psoriasis usingUFO blood- photomodification of blood with ultraviolet rays.
The ability of sunlight to have a beneficial effect on the skin for a variety of diseases, including psoriasis, has been known since time immemorial. In the early twentieth century, a group of German scientists suggested that because ultraviolet rays have a healing effect on exposed skin, this effect most likely occurs when ultraviolet radiation is applied to the blood. After all, this is also a kind of fabric. This assumption was confirmed by the first session of UV exposure on blood, held in Germany in 1924.
The therapeutic effect of ultraviolet rays on the blood is associated with profound structural changes at the molecular -atomic level, which are captured by immunocompetent organs - liver, spleen, bone marrow and lymphoid tissue. These changes are perceived by organs as alarm signals, and therefore they produce immune complexes tens of times more. In this case, ultraviolet rays are a kind of "whip" that forces the body to dramatically increase its defenses to fight the disease.
Also worth noting is the effect of PT -unlimited ultraviolet therapy. . . This method of treatment is important, given the chronic nature of psoriasis, is associated with many complications of internal organs caused by various microbial pathogens. The longer the microbe is in the body, the wider its habitat. These microscopic creatures capture more anatomical areas through blood and lymph flow. Once in the tissue, they try to penetrate as deep as possible into the intercellular space. There they form microcoli, protected by the remnants of dead, destroyed cells and leukocyte stems. Therefore, microorganisms can be infected with antibiotics for many years. They easily compensate for the lack of nutrients by entering a state of delayed animation - something between life and death.
The ability of ultraviolet rays helps destroy the "shelter" of microbes. They create favorable conditions for the penetration of antibiotics and other drugs that affect the cause of psoriasis.
The use of skin ultraviolet radiation is also relevant. The most well -known method of treatment using this principle isPUVA therapy. . . Although it is less effective than ultraviolet irradiation of blood. The effect of therapy does not last long, relapse may occur two weeks after the end of treatment.
Drug treatment
Of the medications, the following have worked well:
- vitamin A derivatives, which reduce the rate of keratinocyte maturation and normalize cell differentiation;
- immunosuppressants that reduce T-lymphocyte activity, which contributes 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 for treating psoriasis
Ointments and creams with anti-inflammatory components will help alleviate the patient’s condition.
How to treat scalp psoriasis
The ointment is not effective in treating scalp psoriasis. In addition to medications and ultraviolet treatments, special shampoos can be used.
How to treat psoriasis on the elbows and arms
Psoriasis on the elbows and arms is treated by the same method as on other parts of the body. The peculiarity of the course of psoriasis in this area is that the skin of the hands undergoes physical, mechanical and chemical influences, which are considered to be a factor that exacerbates the disease.
Is monoclonal antibody treatment for psoriasis effective?
Monoclonal antibody therapy for psoriasis is very effective. Monoclonal antibody drugs are laboratory -produced antibodies that are similar to those produced by human immune cells. Monoclonal antibodies selectively target targets responsible for the development of the disease.
How to recognize and treat psoriasis in children
In children, psoriasis often occurs more violently and masquerades as other diseases (eczema, eripelas, herpes), which complicates the diagnosis. Therapeutic methods are similar to methods for adults: phototherapy, medication and topical treatment.
What bath to take with psoriasis
An aloe vera bath can help reduce inflammation and itching.
How to treat psoriasis according to Pegano
Pegano’s method of treating psoriasis involves bowel cleansing, diet and herbal teas. The effectiveness of this method has not been proven by clinical studies.
The role of nutrition in treatment
Nutrition greatly affects the course of psoriasis. When treating, it is necessary to exclude alcohol, salty, spicy, pickles, nuts, citrus fruits, honey, chocolate and smoked meats.
Which sanatorium shows rest for psoriasis treatment
For psoriasis, spa treatments are best done at sea in areas with warm and dry climates and lots of sunny days. The most suitable for this are resorts in the Crimea.
The way of the people
Some folk remedies can help reduce itching and peeling of the skin in patients with mild to moderate psoriasis. These methods include:
- cream with aloe extract;
- fish oil is applied to the skin with a coated bandage for six hours a day for four weeks;
- cream with oregon grape extract.
Prediction. prevention
Psoriasis is not a verse. If the patient seeks qualified help from a specialist in a timely manner to determine the true cause of the disease and prescribe effective treatment, then the disease will be defeated.
Mild forms of psoriasis are only indicated by skin defects. Therefore, patients do not require special conditions to work. The exception is working in a chemical plant: in this case, staying at work should be excluded.
Keep in mind that psoriasis can cause complications. Often, psoriatic arthritis develops. Its severe form can limit task performance in the workplace, and in the future lead to complete disability.
Psoriasis prevention is an important part of therapeutic measures to get rid of one of the most serious skin diseases. Upon recovery, the patient needs to completely change his lifestyle, get rid of bad habits, pay attention to the treatment of chronic diseases of other organs, adjust the diet, include outdoor walks and sports in the daily routine.
Do they take with psoriasis in the military?
Severe forms of psoriasis are reason enough to state military compulsory ineligibility for military service, mild forms - limited suitability.