Psoriasis – what kind of disease is it?

Despite the fact that psoriasis is a common and long-known disease, it has not yet been fully studied.And patients most often do not know at all that psoriasis is not a bacterial infection or a fungus, but a non-standard reaction of the immune system, provoked by unknown reasons.Information about the causes and symptoms of psoriasis will be very useful for patients, as it will help overcome the disease.

What kind of disease is this?

Lichen squamosus is another name for psoriasis, and this name perfectly characterizes this disease.Psoriasis manifests itself in the formation of inflamed plaques of varying sizes on the skin, which are densely covered with thick skin scales.

Surely, almost everyone has heard about a disease such as psoriasis.And this is not surprising, since scaly lichen is quite widespread.This disease is diagnosed in 4-10% of the world's population.Moreover, statisticians who collect information about the prevalence of psoriasis claim that the number of patients is steadily growing.

Scaly lichen has been known to people since ancient times; even healers in Ancient Greece tried to treat this disease.The modern history of the study of psoriasis goes back about 150 years.But during this fairly significant period of time, researchers were able to learn not enough about the causes and treatment of psoriasis.

Widespread prevalence, uncertainty of etiology (reasons for appearance), insufficiently effective treatment - all this characterizes psoriasis as one of the most difficult problems of dermatology.

Today, dermatologists consider psoriasis as a complex systemic disease associated with disturbances in the functioning of the immune system, with the failure of metabolic processes and the appearance of trophic disorders.The result of these failures is specific skin changes.

Therefore, when answering the question of what psoriasis is, a modern dermatologist will answer that these are disorders of trophism and metabolic processes in the skin caused by a malfunction in the functioning of body systems.Today, two theories about the etiology of psoriasis are considered the most probable: genetic and viral.

• The genetic theory has many supporters, since psoriasis often acts as a hereditary or familial dermatosis.A thorough examination of the patient's family history confirms in 60-80% the presence of psoriasis in one form or another in the patient's relatives.However, in some patients it is not possible to confirm the fact of hereditary origin of psoriasis.This circumstance is the reason for separating these cases into a special group, in which the main cause is not genetic, but phenotypic failures.
• The viral theory, according to which psoriasis develops as a result of infection, has its supporters.Confirmation of information about the viral origin of psoriasis is the detection of antibodies in the blood of patients, as well as “elementary bodies” in the cells of the epidermis.According to this theory, psoriasis develops not only in case of infection with a virus, but also in the presence of certain conditions.

There are other theories that explain the appearance of psoriasis.For example, endocrine, neurogenic, metabolic, etc. Naturally, all these theories are not without foundation and their study allows us to obtain more important information about the disease psoriasis.However, today it is already known for sure that the state of the endocrine and nervous systems, as well as the functioning of the gastrointestinal tract, do not cause psoriasis, but have a significant impact on the course of this disease.

For example, pathologies affecting the liver lead to the fact that the quality of blood purification carried out by this organ is greatly reduced.And this, in turn, can provoke the appearance of various skin lesions, including psoriasis.

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc.) lead to the tissues of this organ degenerating, that is, the liver is gradually replaced by connective tissue.As a result, the liver ceases to cope with its cleansing functions.Externally, this is manifested by yellowing of the mucous membranes and skin, and the development of skin diseases, including psoriasis, is also possible.

There is also an inverse relationship: psoriasis is often accompanied by fatty degeneration that affects the liver.Therefore, in the treatment of this skin disease, it is important to follow a diet so as not to unnecessarily burden the liver.Patients are advised to limit fatty foods and completely eliminate alcohol.

Thus, despite numerous studies, it was not possible to obtain an exact answer to the question of what psoriasis is.However, work continues, so there is a chance that the mystery of this mysterious disease will be solved, and we will learn a lot about the skin disease psoriasis.

Classification according to the international system

The disease psoriasis manifests itself in various forms.To make it easier for specialists to navigate, a generally accepted classification of psoriasis is used.

Psoriasis is also included in the International Classification of Diseases (ICD) system.Today, the 10th revision of the international registry of diseases is already in use, which is why the abbreviation ICD 10 is used. Work on the 10th revision of the international classification of diseases began in 1983, and was completed in 1987.

In essence, ICD 10 is the standard assessment tool used in medicine and health care management.The 10th revision of the reference book is used to monitor the prevalence of various diseases and other problems related to public health.

Using version 10 of the ICD, it is possible to compare data on morbidity and mortality in different countries, which allows one to obtain statistical data and systematize diagnostic information.As agreed by WHO members, ICD 10 is used to assign codes to various diseases.In version 10 of the classifier, alphanumeric codes are adopted, with the help of which it is convenient to store information in electronic form.

All types of psoriasis are included in ICD 10, and each of them is assigned a specific code.In dermatology, the following forms and types of psoriasis are distinguished:

• Common psoriasis(synonyms: vulgar, simple, plaque-like).The disease was assigned a code according to ICD 10 – L-40.0.This is the most common form, it is observed in 80-90% of patients.The main symptoms are the formation of plaques raised above the surface of unchanged skin, covered with white-gray skin flakes.This form is characterized by slight peeling of scales.After their removal, inflamed red skin is revealed, which is very easily injured and begins to bleed.As the inflammatory process progresses, plaques can increase significantly in size.
• Inverse psoriasis.This is a disease that affects skin folds (flexural surfaces).For this form of the disease, the ICD 10 code is L83-4.Dermatosis appears with the formation of folds of smooth or minimally flaky spots on the skin.The condition worsens when the skin is injured by friction.The disease is often complicated by an associated streptococcal infection or fungus.
• Guttate psoriasis.This form of psoriasis is characterized by the formation on the skin of a large number of small red or purple spots, shaped like droplets of water.According to the 10th version of the international classifier, this disease received code L4.Most often, guttate psoriasis affects the skin of the legs, but rashes can also occur on other parts of the body.At the same time, it is known about guttate psoriasis that it develops as a complication after streptococcal infections - pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasis– this is a severe cutaneous form, according to ICD 10 it is assigned the code L1-3 and L 40.82.Characterized by the formation of blisters or pustules.The skin in the lesions is swollen, red, inflamed, and peels off easily.If fungus or bacteria penetrate the pustules, the contents of the pustules become purulent.Pustular psoriasis most often affects the distal parts of the extremities, but in the most severe cases, a generalized process may develop with the rash spreading throughout the body.
• Arthritis psoriatic or arthropathic psoriasis.According to the 10th version of the ICD, the pathology is coded L5.Manifested by inflammation of the joints.Arthropathic psoriasis can affect all types of joints, but in most cases the joints on the phalanges of the toes and hands become inflamed.The knee, hip or shoulder joints may be affected.The lesions can be so severe that they lead to disability of the patient.Therefore, you should not think about psoriasis that it is exclusively a skin disease.Severe types of psoriasis can lead to systemic lesions, disability, or even death of the patient.

• Erythrodermic psoriasis.A rare but severe type of psoriasis, according to ICD 10 this disease received code L85.Erythrodermic psoriasis often manifests itself in a generalized manner; the affected area may include the entire or almost the entire surface of the skin.The disease is accompanied by severe itching, swelling, and pain.
• Psoriatic onychodystrophy or nail psoriasis.According to version 10 of the ICD, the disease is coded L86.The pathology manifests itself as changes in the appearance of the nails on the toes and fingers.Nails may change color, become thicker, and begin to break down.Possible complete loss of nails.

In psoriasis, the classification of the disease takes into account not only the types of the disease, but also the severity of symptoms:

• limited psoriasis is a disease in which less than 20% of the skin is affected;
• widespread psoriasis affects more than 20% of the body surface;
• When almost the entire surface of the skin is affected, we are talking about universal psoriasis.

If we consider all types of the disease, then widespread psoriasis is more common than other forms.

Stages of flow

Limited or widespread psoriasis goes through three stages in its course: progressive, stable and regressive.

The progressive stage of psoriasis is characterized by the following:

• the appearance of new rashes;
• growth of existing plaques;
• the appearance of new elements of the rash at the site of skin injuries (scratches, abrasions);
• excessive peeling of existing plaques.

The following symptoms are characteristic of the stationary stage of psoriasis:

• lack of emergence of new elements;

• moderate peeling of elements;
• no signs of element growth.

The appearance of folds in the stratum corneum around the elements is a sign of the transition of the stationary stage to a regressive one.

The regression stage is characterized by the following types of symptoms:

• reducing the intensity of peeling;
• element resolution.

After the resolution of psoriatic plaques, hypo- or hyperpigmented spots remain in their place.

Lichen squamosus is characterized by a long course with periodic exacerbations.The following types of psoriasis are distinguished:

• winter (with aggravation in autumn and winter);
• summer (with exacerbations in the warm period);
• non-seasonal psoriasis is the most severe type, since there is no clear connection between relapses and seasons of the year, periods of remission may be practically absent.

Diagnostic features

If psoriasis has a typical clinical picture, then the diagnosis will not be so difficult.However, this disease is often disguised as other pathologies.

For example, nail psoriasis is often mistaken for nail fungus, since the external manifestations in the early stages of these diseases are very similar.However, nail fungus and psoriasis have completely different natures, so the treatment should be different.

A non-specialist may mistake it for a fungus and skin psoriasis.Since cutaneous mycoses (skin fungus) manifest themselves with similar symptoms - the formation of flaky plaques.Therefore, if you notice suspicious symptoms on your body or nails, you do not need to make a diagnosis yourself and start treating the fungus using pharmaceutical or folk remedies.

If the diagnosis is erroneous, and in fact, the cause of the symptoms is not a fungus, but psoriasis, then the treatment will not be beneficial, but, on the contrary, will aggravate the symptoms.

When contacting a dermatologist, a fungal test will be performed and a scraping will be taken from the nail or skin.Then the resulting material is placed in nutrient media.If the fungus is present in the material, then in a few days a large colony will grow in the test sample.By the appearance of the material, it will be possible to understand what type of fungus caused the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, this can be a bacterial infection or a fungus.Therefore, patients who change the clinical picture (appearance of purulent discharge, change in color of plaques, etc.)You will have to be periodically tested for fungus and other infectious agents.

In the diagnostic process, a certain role is assigned to a set of phenomena called the psoriatic triad.The phenomena appear sequentially when an element of the rash is scraped.

The psoriatic triad manifests itself as follows:

• when an element of the rash is scraped, the scales are removed in the form of “chips”;
• after removing the chips, a thin transparent film similar to polyethylene is revealed;
• When the film is damaged, pinpoint bleeding occurs.

A dermatologist diagnoses psoriasis, but if necessary, the doctor can refer the patient for consultations with other specialists - a rheumatologist, gastroenterologist, surgeon, etc.

Interesting facts about psoriasis

People have known about the disease psoriasis since ancient times.Even the name of the disease came into our language from ancient Greek.During the prosperity of Ancient Hellas, the word “psora” meant all skin diseases that manifested themselves as peeling and itching.

The first person to write a detailed treatise on psoriasis was a Roman named Cornelius Celsus.In the fifth volume of his work “De medicina” there is an extensive chapter devoted to this disease.

They knew about psoriasis, but this disease was not assessed unambiguously, since it was called either the “imperial” or the “devil’s” disease.

Of course, ancient healers knew very little about psoriasis.Until the 19th century, this disease was often confused with other skin ailments.Psoriasis was first identified as an independent nosological form in 1799.This was done by the English dermatologist Robert Willan, who identified psoriasis from a large group of skin diseases manifested by itching and flaking.

Not only ordinary people, but also prominent political figures knew about psoriasis firsthand.For example, Winston Churchill, who suffered from this disease, promised to erect a monument made of pure gold to a person who could learn everything about psoriasis and offer effective treatment for this disease.

Modern ideas about the disease

It must be said that modern science does not know much about this mysterious disease.There are various theories about the origin, as well as the course and treatment of psoriasis.

Here are some facts about psoriasis that are beyond doubt among experts:

• Despite the fact that the causes of the disease are unclear, we managed to find out about the nature of psoriasis.This disease is autoimmune, that is, it is caused by a malfunction of the immune system;
• Another established fact about psoriasis: the disease can be inherited.However, this is not always the case; even if both parents are sick, the risk of developing the disease in their child is 65%.At the same time, some patients develop psoriasis, although none of their relatives are sick;
• An interesting fact about psoriasis is that this disease is characterized by the Koebner phenomenon.This phenomenon manifests itself in the fact that elements of the rash form at the sites of skin damage - scratches, burns, frostbite.Sometimes psoriasis appears after some time, at the site of scars;
• An important observation that allows us to obtain more information about psoriasis is the connection of this disease with climatic factors.Exacerbations and relapses are often timed to coincide with the change of season;
• Patients have probably noticed in practice the connection between exacerbations and stress.All patients should know for sure that the disease recurs or worsens its course against a background of nervous tension and anxiety;
• a new fact about psoriasis is that the disease can debut at any age, although previously it was believed that pityriasis versicolor appears after 30;
• It is important for all people to know that psoriasis is not a contagious disease.Even with close contact with a patient, there is no risk of infection;
• Almost everyone has heard about the incurability of psoriasis, and this is true, since no treatment has been found that could be guaranteed to defeat the disease.But patients should know that psoriasis can be controlled.Adequate and timely treatment allows you to achieve long-term remission.

Modern methods of treatment

Speaking about the common disease psoriasis, we cannot fail to talk about the treatment of this common disease.It must be said that it is impossible to cure psoriasis with tablets or ointments alone.

In order to forget about the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will need to make efforts.It will be necessary to organize food properly.Some experts say that you can forget about psoriasis forever only with the help of a properly formulated diet and regular cleansing of the body.

The doctor will draw up a preliminary regimen according to which the treatment will be carried out.As a rule, methods of external (ointments, creams) and systemic (tablets, injections) therapy are used.Additionally, physiotherapeutic methods will be used, and treatment at resorts will be recommended.It is recommended to treat psoriasis using healing mud, mineral and thermal water.

Resorts can also offer non-traditional treatment methods.For example, with the help of fish that live in thermal springs.These little healers effectively remove dead skin flakes and disinfect the skin, promoting faster healing.

Resorts may offer other methods of treating lichen planus.For example, leech therapy, healing baths and applications, sun treatment, etc.

You will need to be prepared for the fact that the treatment regimen will change periodically.Since not all methods are suitable for a specific patient.If the chosen treatment methods do not have an effect, they will need to be replaced.

Traditional methods of treating psoriasis are also widely advertised.Indeed, some of them can help achieve remission.However, when choosing a method, you need to remember common sense so as not to harm your health.If any recipe or recommendation is in doubt, then it is better not to use it.Consult your doctor before using any treatment method.

You need to understand that it will be possible to forget about psoriasis forever only if the patient himself and his immediate environment are in a positive mood.Only faith in success and an optimistic attitude will help defeat this mysterious and insidious disease.