Psoriasis: types, treatment, doctor's tips

Psoriasis is a chronic skin disease with an unknown cause, manifested by the appearance of red peeling stains on the skin.

Treatment is carried out by a dermatologist.Synonym - scaly lichen.MKB code 10: L40.According to the international classification, it refers to papulloskvamous skin diseases.

Psoriasis as a disease is studied for about 200 years.Prior to this period, such patients were considered patients with leprosy and treated them accordingly as lepers.Difference: leprosy (lepra) - infectious disease (pathogen - Mycobacterium Leprae).Psoriasis is non -infectious.

Symptoms

The main symptom of psoriasis: the appearance of pink-red spots on the skin, the surface of which is covered with silver scales of the keratinizing layer of the skin (epidermis).

1. The symptom of the "stearin spot".This is a pathognomonic (that is, characteristic only for a given disease) a sign.Speaking (grantage) of psoriatic spots.It is produced with a dull scalpel or object glass (not with a fingernail !!).With a slight sling, the surface of the spot becomes white, as if covered with wax - this is a symptom of the “stearin spot”.
2. Symptom of "psoriatic film."Another pathognomonic symptom for psoriasis.With a further scrap, neatly removes scales from a psoriatic plaque, a brilliant surface is visible under the scales - the so -called symptom of psoriatic, or terminal, film.
3. The symptom of "blood dew Poltebnov" (Auspitz symptom).Another pathognomonic symptom for psoriasis.With further propagation (grottowing) of plaques, that is, when removing the terminal film, point bleeding is manifested, which do not merge with each other.This is the symptom of "blood dew".
4. Symptom Pilnov.Characteristic for the initial stage and stage of progression.A rounded pink spot without peeling, with clear boundaries.With the progression of the disease along the periphery, the spots (plaques) marks the rim of red skin, not yet covered with scales.
5. Kebner's symptom.Psoriatic foci appear on the skin in places of injury - in places of scratches, scuffs, in places of friction about clothes.
6. Symptom of Kartamyshev.When the fingers are examined (palpated) plaques on the scalp (hCH), a clear border of plaques is felt with the fingers.Unlike seborrheic dermatitis, when there is no clear border between spots and healthy skin on palpation.
7. Voronov’s symptom is a symptom of the regressive (passing) spots.For some time, wrinkled skin remains along the periphery of the psoriatic spot, lighter and brilliant than healthy skin.
8. The symptom of the “thimble” on the nails is a sign of damage to the nails.The nail is all in point recesses, like a thimble.
9. The symptom of the "oil spot" on the nails: a yellow-brown stain under the nail plate is also a sign of nail psoriasis.
10. Onichogrifosis - deformation of the nail plate with psoriasis of nails.The nail acquires ugly forms, sometimes similar to a claw of birds.
11. Bo-Rile line.The longitudinal line passing through the entire nail is a sign of violation of the nail plate.

Types of psoriasis and clinic

Generalized pustulent psoriasis (L40.1) and pustulose palmar and plantar (L40.3)

These two forms of the disease differ only in the prevalence of the process.The mechanisms of pathogenesis are the same.Pusture forms are found in 1% of patients with psoriasis.Vesicula (bubbles) and pustules (pustules) appear on the skin, which can merge with each other, forming “purulent lakes”.Around may be present peeling of the skin.It can be disturbed by skin itching.The skin around the pustules is red, inflamed, hot to the touch.

Improving body temperature.In the blood - an increase in leukocytes (leukocytosis).These are rare and most severe types of psoriasis.But they require an immediate examination of the doctor and prescribing complex treatment.And generalized pustular psoriasis requires inpatient treatment.In very rare cases, when the bacterial infection is joined, even cases of sepsis and deaths are described in the literature.

One of the varieties of pustular psoriasis is an exudative form.At the same time, there are no abscesses and bubbles on the skin, but there is a weeping of affected skin, the formation of crusts and skin itching.

Acrodermatitis is persistent allopo

MKB code 10: L40.2.

On the skin of the fingers and legs, pustular (pustular) psoriatic changes and peeling appear.The process involves the nail plates.The nails are deformed, exfoliated in places from the nail bed, have point recesses.

A lighter form is psoriasis of nails without pustular changes, that is, without abscesses on the skin.

Psoriasis is a rocky

MKB code 10: l40.4

Survatory, haloid spots with a size of pink with peeling appear on the skin.There may be light skin itching.Localization: The whole body is on the body, on the arms and on the legs.Rarely - on the face.

Often a drop -shaped form appears after infectious diseases (tonsillitis, acute respiratory viral infections).

Psoriasis is arthropathic

MKB code 10: l40.5

Other names are psoriasis of the joints, psoriatic arthropathy, psoriatic arthritis.

It develops in 10% of patients with psoriasis.The articular surfaces and periarticular fabrics are affected - ligaments, tendons, articular bags.

Localization - any joints, but the small interfalancing joints of the fingers are mainly affected.However, there are cases, for example, psoriatic spondylitis - damage to the intervertebral joints, or psoriatic coxarthrosis - damage to the hip joint.

Complaints of patients: pain, stiffness in the joints.Swelling and redness of the skin appears in the joints.There are frequent cases when patients do not bother anything at all, however, arthrose -like changes on the joint surfaces are noted on the radiographs.

Joint pain and restriction of movement in the joints lead to disability of patients.Such patients should be directed to the examination of the ITU to determine the disability group.

Another psoriasis

MKB code 10: l40.8

This type includes psoriasis in the reverse (inverse, intertrigonic).

Localization - on the contrary - not on extensor surfaces, but on flexion.The elbow bends, popliteal pits, axillary cavities, inguinal folds, under the mammary glands.At the same time, there are no rashes in the rest of the body.

It develops in patients with obesity and diabetes.
Manifestation: red spots appear on the skin, almost without peeling, slightly raised above the surrounding skin.

Psoriasis is unsuitable

MKB code 10: l40.9

All other species that, by one or another, cannot be attributed to the above species, are attributed to this group.

Seasonal forms of psoriasis

1. Winter form (photosensitive psoriasis).Rashes appear in the cold season.Well treated with ultraviolet radiation.
2. Summer form (phototoxic psoriasis).Exacerbations occur in the summer.UFO-prostration leads to an exacerbation of illness.

Diagnostics

The diagnosis is made on the basis of clinical symptoms and complaints of the patient.

• The presence of certain symptoms of damage to the skin, nails, joints, etc.- See above.
• In difficult cases - a biopsy of the skin for verification (installation of an accurate diagnosis).At the same time, infiltration of lymphocytes, neutrophils and macrophages, thickening of skin capillaries, immature keratinocytes are found in the thickness of the skin.
• Joint radiography - ideally, all patients should be done.But most often it is performed according to indications - in the presence of complaints about pain in the joints.
• A general blood test is most often normal.Inflammatory changes are detected only in severe course of the disease.
  Recently, it is common to diagnose blood test under a microscope.This does not matter to the diagnosis of psoriasis!

Differential diagnosis of psoriasis is carried out with diseases:

• Red flat lichen 
• Pink lichen 
• Parapsorize,
• Atopic dermatitis
• Eczema
• Papular syphilid
• Seborrheic dermatitis on the head
• Dermatophytia on the head
• Reuters' disease, rheumatoid arthritis, arthrosis
• Medicinal allergic dermatoses
• Hives

Treatment of psoriasis

Remember: it is impossible to completely cure psoriasis.You can only achieve long -term remission.

Local treatment

Attention: If pustules appeared from the ointment, then the ointment should be canceled and consult your doctor to correct treatment!

1. Ointments and creams with vitamin D. For example, drugs containing substances synthesizing vitamin D.
2. Corticosteroid ointments and creams.These drugs reduce the immune response in the skin, reduce the activity of inflammation.
3. Combinations in one composition of vitamin D and corticosteroid preparations.
4. Naphthalan -based preparations.Lubricate the affected area of the skin 2-3 times a day-4 weeks.
5. Birch tar and drugs based on it.Berritin, birch tar.Lubricate the affected areas and give an excerpt for 15-30 minutes, then washed off with warm water and soap.
6. Creams and ointments based on solidol.You can use solidol itself, but you need to find the old Soviet solidol, and not the solidol that is now sold in car shops with different additives.Creams and ointments.Solidol and creams based on it help in half cases with psoriasis.Itching decreases on the 3rd day, peeling leaves and the spot itself gradually decreases.
7. Keratolytic (exfoliating) ointments and creams.Used unstable!Only for removing excessive peeling.Often - in combination with corticosteroid preparations to reduce itching and inflammation.You can not use with exudative psoriasis!Keratolytic agent salicylic acid.
8. Zinc drugs.  Reduces irritation and redness of the skin, dries the skin.It does not contain hormones.
   Attention: Do not use tar and salicylic acid on "duty plaques"!The irritation of the on -duty plaques can provoke the spread of pathological rashes further on the skin.

Instrumental treatment methods

Photo Cabinet for bullet therapy

We look at the video how the Puva therapy is carried out:

• Eximer laser.

Treatment with an eximer laser of psoriasis of the scalp:

• Plasmapheresis, hemosorption - purification of blood plasma on a special apparatus.At the same time, toxic immune complexes from the blood, which lead to skin infiltration with lymphocytes, occurs.The effectiveness of the procedure is high, especially in the severe course of the disease.But the procedure is expensive and is essentially aimed at eliminating the mechanisms of the development of the disease, and not its causes.According to patients, plasmapheresis is tolerated satisfactorily, the effect appears from several procedures.

Diet with psoriasis

Exclude:

Citrus fruits, tomatoes, pineapples and other overseas fruits, honey, sweets, sugar, cookies, spices, alcohol, spicy and salty dishes, coffee, white bread, smoked meats, products with dyes and sugar -replacements, potatoes and semolina.

Do not overeat!

Necessarily:

Porridge (buckwheat, oatmeal), vegetable oils (sunflower, olive), fruits and vegetables - apples, carrots, beets, cabbage, cucumbers, boiled meat, fish, one day a week (usually Saturday) - post (or even starvation).On this day, drink only water or eat buckwheat porridge flooded with water.

Folk remedies

At home, you can use various folk remedies for psoriasis.But the effect of them is minimal or zero.

Remember: independent treatment at home in half of cases leads to the progression of the disease and the transition in a more severe form.

List of folk remedies from psoriasis used in the reviews by patients:

1. Solidol.
2. Therapeutic mud of salty lakes.
3. Baths with sea salt.
4. Birch tar.
5. Naphthalan oil.
6. A decoction of a series - compresses (applications) to the affected areas of the skin.
7. A decoction of celandine herbs.
8. A decoction of nettles.
9. Aloe juice.
10. Dripidar baths.
11. Starvation.
12. ASD faction 3.
13. Linseed oil.
14. Milk thistle.
15. Bades and anthelmintic drugs.Ineffective or with zero efficiency.In the best case, extracts of ordinary grasses are contained, or even ordinary starch with vitamins and trace elements.Very expensive and bring good profit to manufacturers and dashes of dietary supplements.They are not a medicine, so you cannot expect help from them in the treatment of psoriasis.
16. Ointment from psoriasis.In fact, the current remedy is solidol.At the same time, there are many more extracts of herbs, bee products that can cause an allergic reaction and exacerbation of the disease.
17. Chinese lotion.The drug contains acids that can lead to skin irritation and the progression of the disease.

Exotic types of treatment

Ichthyotherapy.
In black MRU there are Gara-Ruf fish.They pinch off the dead areas from human skin and contribute to “rejuvenating” the skin.This effect is also used in the treatment of patients with psoriasis.

The effect of ichthyotherapy is positive only with thorough observance of the technique and the choice of exactly the same fish.There are similar fish -chin fish - they pluck scales with sharp teeth, thereby injure psoriatic plaques.The effect of the exposure of the Chin-Chin fish is exactly the opposite-the spread of plaques by the type of phenomenon of Kebner.

Failure to comply with hygiene in some spa canalons can lead to the appearance of fungal or viral lesions on the skin (mycosis, warts).

Registration prevention

• Exclude risk factors!
• Observe the regime of the day, the regime of labor and rest
• Proper nutrition
• Timely treatment of infectious and endocrine diseases
• UFO and Puva-therapy courses
• Complex vitamins
• Sanatorium-resort treatment, swimming on the sea
• A healthy lifestyle!

Is psoriasis

No, not contradictory!This is a non -infectious disease.