Psoriasis is a chronic skin disease of non-infectious origin. According to statistics, 3. 7% of the world's population suffers from psoriasis. The people call the disease "scaly lichen".
Psoriasis does not depend on gender, is not contagious; most often develops at the age of 14-27 years. The disease is characterized by the appearance of red scaling in the form of a plaque (spot) covered with white scales. A spot (or several spots) can be on any part of the body, but most often in places with thin and dry skin: elbows, knees, lower back, scalp.
The spots are of different sizes and disturb in different ways: in some patients only skin irritation is noted; in other patients, large areas of the skin are involved, which is accompanied by discomfort, itching, pain, insomnia, and a decrease in the quality of life.
Psoriasis is a chronic disease, characterized by periods of exacerbations (rashes) and remission (subsiding of symptoms).
Psoriasis often complicates pregnancy.
Causes of psoriasis
Psoriasis is a systemic process that involves not only the skin, but the entire body. The causes of psoriasis are not fully understood, but it is assumed that there are several of them: neurogenic (due to stress), hereditary, infectious, viral, mixed (skin damage with the penetration of staphylococcus in combination with any of the above reasons), etc. In this case, cellular and humoral immunity is activated and an autoimmune process of damage to cells, primarily skin cells (epidermis), is triggered.
In addition to the activation of immunity, metabolism is disturbed. The disease is aggravated by a burdened heredity. As a result, the renewal (regeneration) of cells is accelerated 3-5 times - psoriatic plaques form on the skin.
Without timely treatment, the lesion is aggravated: skin spots grow, crack, fester; nails are destroyed, joints are involved, etc.
The quality of life of a patient with psoriasis is 80% dependent on timely diagnosis and proper treatment.
Once again, we list the factors contributing to the onset of the disease:
- bad heredity. Scientists have identified 9 genes that determine the development of the disease, but their interaction is not clear. It is well established that in 15% of cases, psoriasis is inherited by relatives of the 1st and 2nd generation;
- stress, nervous tension, depression. It has been proven that stress in 70% of cases provokes an exacerbation of psoriasis;
- hormonal imbalance;
- metabolic disorders, drug addiction;
- colitis and parasitic infections (roundworm, lamblia, intestinal infections, etc. );
- viral infections;
- streptoderma; candidiasis of the skin;
At the initial stage, psoriasis skin rashes are in the form of red plaques (spots) with flaky scales. The appearance of a skin plaque is accompanied by intense itching. A denser (keratinous) layer is found under the scales.
Here are the 6 main forms of psoriasis; each has its own symptoms:
Plaque psoriasis occurs in 85% of patients. It is characterized by dry, pink rashes, raised above the skin, covered with silvery scales. The skin in the affected areas often exfoliates; in this place, red spots remain, bleeding during trauma. In 60% of cases, plaques merge into large plates.
Guttate psoriasis is characterized by many small, dry lesions in the form of pink droplets raised above the surface of the skin. Rashes are localized on the thighs, legs, affecting large areas of the body. In 60% of cases, guttate psoriasis worsens after streptococcal infection.
Pustular psoriasis can be recognized by skin blisters filled with clear fluid. The blisters are surrounded by reddened, edematous peeling skin. The legs and thighs are more often affected.
Psoriasis of the flexor surfaces manifests itself in the form of smooth, non-flaky red spots, which are located in the area of skin folds: the lateral surface of the thighs, armpits, and the area of the external genitalia. Due to mechanical irritation (physiological friction), the spots are injured, bleed and fester.
Psoriasis of the nails is manifested by discoloration, the appearance of spots and transverse lines on the nails. The skin around the lesion is hardened. As the disease progresses, the nail exfoliates, thickens and then dries out or falls off.
Psoriatic arthritis (15% of cases). Any joints are affected, but more often the small ones - the phalanges of the hands and feet. The fingers become like sausages. Psoriasis of the joints leads to bursitis, disability of a person.
Let's talk separately about lesions of the head and elbows.
Scalp psoriasis (primarily the scalp) is the most common form of the disease. It is more common at a young age. It manifests itself as red flaky spots that itch and itch. Redness is almost always noticeable, therefore it causes emotional discomfort and leads to social isolation of a person.
Elbow psoriasis is a disease of middle-aged people. It manifests itself in the form of rashes on the extensor surfaces of the elbow joints. The rash spreads outwards and merges - a large plaque (plaques) is formed, covered with silvery easily falling off scales. Together with the scales, a thin protective film is detached, exposing the bleeding surface. In 80% of cases, the spots go away on their own, without treatment, but sometimes they thicken (get old) and persist for years, provoking psoriatic lesions of the elbow joint.
Diagnostics of the psoriasis
The diagnosis and treatment of psoriasis is carried out by a dermatovenerologist.
Due to the characteristic skin lesions, the diagnosis of psoriasis is straightforward. As additional laboratory tests, a general blood test and determination of rheumatoid factor are used. For the diagnosis of psoriatic arthritis, a consultation with a rheumatologist and an X-ray of the affected joints are indicated. In rare cases, a skin biopsy is done for differential diagnosis.
Psoriasis should be distinguished from similar skin diseases: seborrhea, lupus, etc.
Psoriasis is a chronic disease with periods of exacerbation (reappearance of skin rashes) and remission (disappearance of rashes). It is impossible to recover from psoriasis forever. You can lengthen remission and reduce the intensity of exacerbations.
Only in 40% of cases is it possible to immediately find an effective treatment. Sometimes it takes months and years. Therefore, psoriasis is treated at home, with the exception of severe exacerbations and complications. The effectiveness of treatment is influenced by the type of psoriasis, age, concomitant diseases, etc. With a mild degree of psoriasis, topical preparations are prescribed: ointments and creams based on:
- salicylic acid;
- vitamin D3.
In severe cases of psoriasis (25% of the skin surface is affected, joint damage) and the ineffectiveness of local treatment, complex therapy is prescribed:
- cytostatics that inhibit epidermal cell division;
- immunomodulators that normalize immune responses;
- glucocorticosteroids, which regulate metabolic processes and reduce inflammation;
- non-steroidal anti-inflammatory drugs (to reduce itching of the skin);
Physiotherapy is prescribed: ultraviolet irradiation, cryotherapy, plasmapheresis, hirudotherapy. Folk remedies are also used: ointments based on celandine and lard, meadowsweet and petroleum jelly, beeswax and lard. To normalize immunity, they drink homemade kvass from oats, an infusion of bay leaves, and a decoction of dill.
Diet, especially with exacerbations of psoriasis, plays an important role. Spicy and sweet dishes are excluded from the diet. Fast food and alcohol are prohibited. Nutrition should be balanced, rich in vitamins and minerals.
To avoid exacerbations of psoriasis, you need to improve your health, avoid stress, hypothermia and seasonal illnesses.
Here are the simple rules for preventing exacerbations of psoriasis:
- do not overdry the skin;
- avoid prolonged exposure to the sun;
- avoid skin injuries;
- avoid stress;
- do not smoke or abuse alcohol.
Is psoriasis contagious?
There is not a single proven case of transmission of psoriasis from a sick person during household or other contacts. Therefore, it is believed that psoriasis is not contagious.
Which doctor to contact
To start timely treatment and avoid the spread of psoriasis, consult a dermatovenerologist. In the presence of psoriatic arthritis, a consultation with a rheumatologist is indicated.