Psoriasis is a non -communicable skin disease associated with inflammatory lesions. It is chronic - an acute period followed by a period of relief or disappearance of symptoms - and is caused by a combination of various factors.
The disease spreads and occurs more often in women than men. It is not completely cured, but it is possible to relieve symptoms and improve the patient’s quality of life.
Psoriasis can cause arthritis, inflammation of the joints.
Russian synonyms
Scaly lichen.
English synonyms
Psoriasis.
Symptoms
The symptoms and signs of psoriasis depend on the type of psoriasis.
- Psoriasis plaque. It is accompanied by the formation of certain inflammatory skin - raised reddish lesions, oval, sharp lines, flaking and covered with silvery scales. Often, formations appear on the outer surfaces of the elbows, knees, on the scalp and trunk. Elements of a skin rash can be painful and itchy. In severe cases, the skin near the joints of the affected area cracks and bleeds.
- Intestinal psoriasis. This type is associated with the appearance on many papules (nodules) of orange-pink color, measuring 1-10 mm. The rash usually appears on the trunk, shoulders, and thighs, but can be found all over the body. As a rule, the disease affects people under the age of 30, as well as 2-3 weeks after suffering from infectious diseases of the upper respiratory tract, after a superficial bacterial infection in the anus.
- Nail psoriasis. It is characterized by compaction, peeling, discoloration of the nail plate, discoloration, yellowing of the nail, the presence of spots on it, the formation of holes, cracks, damage to the nail. 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.
- Psoriasis of large folds. In this case, skin lesions in the form of red inflammatory spots appear in the area of the armpit folds, under the mammary glands, in the folds of the cervix, in the genital area, in the foreskin. Cracks can appear along the edges and in the middle of the lesion. Most often, large fold psoriasis occurs in overweight and obese people. Sweating and friction make the disease worse.
- Psoriasis of the head. It is accompanied by redness of the scalp, itching, peeling 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, curvature, and deformity of the joints. Finger joints, wrists, feet, knee joints may be involved.
- Pustular psoriasis. This type is characterized by redness on the skin and the formation of a large number of pustules - small blisters filled with pus. The formation can appear on the palms and soles of the feet or all over the body. When many pustules appear on the body, fever and weakness combine.
- Psoriatic erythroderma. Areas of reddened skin, plaques may appear. Lesions are usually accompanied by severe itching. Often, psoriatic erythroderma is associated with sunburn or drug abuse.
Usually, with various types of psoriasis, the disease appears gradually, the skin lesions spread and are observed for several weeks. Then the symptoms disappear. After exposure to factors that contribute to the development of psoriasis (or spontaneously), symptoms reappear after some time.
General information about the disease
Psoriasis is a non -communicable skin disease associated with inflammatory lesions.
It is chronic and often recurrent - the acute period is followed by a period of weakness or disappearance of symptoms, then after a while the symptoms reappear.
Psoriasis is widespread, especially in people aged 16-22, 57-60 years. Women are more vulnerable to it than men. People with fair skin have an increased risk of this disease.
Although psoriasis is synonymous with scaly lichen, it is not at all contagious to others.
The cause of psoriasis has not been fully determined. Its appearance is associated with genetic predisposition, with damage to the immune system and with environmental factors that affect the body.
The development of psoriasis is associated with one type of immune system cell (with T-lymphocytes), while T cell hyperactivity is observed. Usually, they travel with blood throughout the body, detecting foreign agents - viruses and bacteria. In psoriasis, for unknown reasons, T cells begin to accumulate in the skin. Their hyperactivity causes the expansion of blood vessels in the affected area, disrupting the cycle of formation of new skin cells - they form faster than usual. Dead skin cells, meanwhile, do not have time to peel and accumulate on the surface of the skin, forming plaques.
Psoriasis can be triggered by one of the following factors:
- infections (tonsillitis, thrush, HIV);
- damage to the skin - cuts, scratches, bites, or burns;
- hypothermia;
- sunburn;
- emotional stress;
- smoking, alcohol abuse;
- use of medications (antimalarial, etc. )
At the same time, in some patients with psoriasis, the rash appears without the obvious influence of environmental factors.
There are the following main types of psoriasis.
- Psoriasis plaque. It is the most common.
- Intestinal psoriasis. Often affects people under 30 years of age. It occurs 2-3 weeks after an infectious disease is transferred from the upper respiratory tract, as well as after a superficial bacterial infection 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. Often associated with sunburn and drug abuse.
- Pustular psoriasis. It is quite rare, in severe cases, it is life threatening for the patient.
- Psoriasis of the head. In this case, hair loss caused by the disease usually does not occur, because the hair roots are located much deeper than the scaly formation.
Classification of psoriasis according to the severity of the course:
- soft (less than 2% of all affected skin);
- simple (skin lesions occupy no more than 3-10% of the skin surface);
- severe psoriasis (more than 10% of skin is affected).
Depending on the type, location and stage, psoriasis can cause complications:
- skin thickening, addition of secondary infection through scratches and scratches that appear due to itching with psoriasis;
- psychological problems (stress, low self -esteem, depression, social isolation);
- joint damage (deformation with 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 mild. However, for most patients, social adjustment becomes a major problem, especially when there are skin lesions in visible skin areas - other people’s hostility to the type of skin lesion, their fear of being infected (many don’t know that the disease is not contagious).
Who is at risk?
- People with hereditary predisposition (more than 40% of patients with psoriasis have relatives with psoriasis).
- People with viral, bacterial, fungal infections (streptococcus, thrush, HIV, etc. ).
- Emotional stress.
- People who are obese and overweight.
- Smokers.
- Alcohol abuse.
- Taking certain medications (antimalarial medications, etc. ).
- Sunburn.
Diagnostics
The diagnosis of psoriasis is usually based on a specific type of lesion, taking into account their location. In difficult cases, additional testing may be needed to rule out other skin conditions.
Laboratory research
- General blood analysis. With psoriasis, leukocytosis and anemia can be detected.
- Rheumatoid factor (RF) is a protein, the level of which in the blood can increase in systemic inflammatory diseases accompanied by joint damage, especially in rheumatoid arthritis. Test results for psoriasis were negative. This allows you to distinguish psoriasis from rheumatoid arthritis, in which RF is increased.
- Erythrocyte sedimentation rate (ESR) is usually normal, except for pustular psoriasis and psoriatic erythroderm.
- Uric acid. Uric acid levels in psoriasis can increase (especially in pustular psoriasis), which causes psoriatic arthritis to be confused with gout, in which uric acid concentrations increase significantly.
- Antibodies to HIV (Human Immunodeficiency Virus). The sudden onset of psoriasis may be due to HIV infection.
Other research methods
- X-ray of the joint. Allows you to assess the severity of joint damage in psoriatic arthritis.
- Skin biopsy. Examination involves taking a small skin sample for later examination under a microscope. It is done in difficult cases to distinguish psoriasis from other skin diseases.
Treatment
Therapy for psoriasis includes local treatment of skin lesions, medications, phototherapy, prevention of exposure to factors that cause the appearance of the rash. 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. It is most effective when used twice a day after bathing. Also used are salicylic acid, anthraline, tar preparations, ointments, solutions, shampoos containing coal tar. These agents are anti-inflammatory and slow down the formation of new skin cells.
The use of corticosteroid ointments makes treatment more effective. They are indicated for mild to moderate psoriasis. However, their long -term use is not recommended (skin atrophy, drug addiction possible).
Light therapy - skin exposure to ultraviolet radiation - may be beneficial. In this case, burns should be avoided.
Local wound treatment in more severe cases is combined with the intake of drugs - retinoids, vitamin D preparations, methotrexate, etc.
Treatment of psoriasis can be difficult, as the disease is chronic and recurs once symptoms disappear. The effectiveness of a particular treatment method depends on the patient’s susceptibility to it.
Bathing every day (bath oil, oatmeal, or sea salt is recommended; hot water and scrubs should be avoided) and moisturizing after a bath can help soften the skin and reduce psoriasis inflammation.
prevention
- Avoid hypothermia, sunburn.
- Avoid emotional stress if possible.
- Quit smoking and alcohol abuse.
- Take certain medications (antimalarial, etc. ) with caution.
Recommended analysis
- General blood analysis
- Erythrocyte sedimentation rate (ESR)
- Rheumatoid factor
- Serum uric acid
- HIV 1, 2 Ag / Ab combo (determination of antibodies to HIV type 1 and 2 and p24 antigens)