Despite the unknown etiology of psoriasis and the factors provoking it, the stages of its development are well studied.The classification of psoriasis at the stage facilitates the assessment of the course of the disease, helps to identify sensitivity to a certain method of treatment and determine the tactics of patients.
The stages of psoriasis are classified depending on the nature of the exacerbation (or activity of the process of inflammation) and severity.
Stages of psoriasis depending on the exacerbation
Psoriasis is a disease that has 3 stages:
- progressive;
- stationary;
- Retrogressive;
- remission.
Symptoms of the progressive stage
This stage is characterized by obvious signs of exacerbation.Multiple rashes appear on the skin, having the form of red nodules (papules, tubercles) having an oval or rounded shape.They merge and form foci occupying a large area, their surface is actively peeling, the patient at the same time experiences severe itching of the skin, and sometimes a burning sensation.Itching can be exhausting and disturb the patient, not only during ordinary life, but even in a dream, itching to intensify when contacting clothes.After the lag of scales, the surface can get wet and turn into a nutrient medium for the propagation of bacteria.
The main manifestations of the progressive stage are:
- the appearance of papules on extensor surfaces of the limbs and on the body;
- the fusion of papules into conglomerates ("plaques"), having a whitish color;
- peeling of the surface of conglomerates;
- There are no scales in the region of the edges of the plaques, but there is a Hyperemic rim;
- The edges of the plaques are compacted;
- The presence of a Kebner phenomenon: when mechanical damage (cut, scratch) appears on uninhabited skin, a new psoriatic plaque is formed in its place.
The more intense during the progressive stage the redness of the skin is, the more active the process of inflammation is.The most dangerous consequence of psoriasis is psoriatic arthritis, while severe articular pain occurs, as a result, the joints are deformed.
Symptoms of stationary stage
With the onset of the stationary stage, a gradual attenuation of the exacerbation process occurs.At the same time, the papules turn pale, they turn from red into pink, new rashes in this period do not appear.The surface of the knots has the form of “plaques”, it is dense, covered with a crust, which is represented by numerous dried skin scales.The nature of the healing of the papules begins from the center to the periphery.The presence of a stationary stage of psoriasis confirms the effectiveness of the treatment.
The main manifestations of this stage are:
- lack of rashes of new papules;
- existing plaques stop their growth;
- the surface of the plaques is covered with scales;
- Red rim disappears around the flaky plaques;
- Kebner's phenomenon disappears.
Symptoms of the stage of regression
At the stage of regression, the process is involution.The “plaques” are resolved, forming areas of skin depigmentation.Itching of the skin gradually disappears, signs of peeling decrease.
Signs of psoriasis regression:
- There is a rim of Voronov around the plaques (dense ring-visible folds located around psoriatic plaques);
- reduction and gradual disappearance of peeling;
- At the site of plaques, areas of depigmentation (white or dark) are formed.
At the stage of regression, plaques completely disappear, the remains of plaques are possible in the area: knees, elbows, abdomen, buttocks.
Remission
Remission is the stage of apparent recovery.During remission, psoriasis is in a “sleeping” state, but does not disappear from the body.Psoriasis remission lasts until the next exacerbation (progressive stage).
It should be noted that during the exacerbation of psoriasis, the general condition of a person does not change, he goes to work, is engaged in familiar household matters.Psoriasis brings only a aesthetic and cosmetic defect to a person: the patient's skin scratches a lot, a person cannot wear open clothes, if an exacerbation is observed in the summer, a person cannot visit the pool, go to massage, cosmetic procedures, etc.
Stages of psoriasis depending on the area of the lesion
The severity of psoriasis also depends on the area of skin lesions.So, at a slight stage, only 3%of the skin surface is affected, with an average - from 3 to 10%, and with a heavy one - more than 10%.Psoriasis, which caused damage to the joints, belongs to a severe degree, in which case the area of skin lesions is not taken into account.You can measure the area of damage yourself.For this purpose, the rule of the open palm is used (the area of the skin corresponding to the area of the human palm is 1% of the entire surface of the body).
PASI index
The general system for assessing the severity of psoriasis is evaluated using the PASI index, which includes an assessment of prevalence and severity, as well as the severity of the manifestation of the disease.This indicator is estimated from 0 to 72. At the same time, the mild degree of psoriasis has an indicator of less than 10, the average - from 10 to 20, the heavy - more than 20. Using the PASI index, the clinical effectiveness of treatment is also calculated.
In addition to different stages, psoriasis can have different types: seborrheic, exudative, plantar, intertriginous, old, rupioid, halted, psoriasis of nails and mucous membranes.It is impossible to completely cure psoriasis, but you can achieve a long remission.It is this goal that is pursued by modern methods of treatment.