Psoriasis is a non-communicable, chronic disease that until recently was considered simply a skin disease. A feature of the inflammatory process in certain areas of the skin in patients with psoriasis is that the life cycle of normal skin cells is approximately 30-40 days, when, as in psoriasis, it is 4-5 days, that is, after 4 days, skin cells gradually die off, forming plaques, dryness, flaking of the skin and so on.
The problem of treating this complex and difficult to treat disease today is urgent not only for dermatologists, many doctors of other specializations are often involved in determining the causes of psoriasis in a patient, and are also directly involved in the complex treatment of this disease. Today, medicine considers psoriasis in terms of a systemic failure in the body, and not just as a skin inflammatory process.
Even its name has changed, now it is a psoriatic disease. Why is psoriasis a systemic pathology? Because patients have several different disorders in the work of the body as a whole - in the nervous, endocrine, immune. In medicine, there are several types of psoriasis, there are also a large number of reasons for the occurrence of this ailment, mainly these are theories, since there is no convincing evidence of these alleged causes, we will consider them in more detail.
A few facts:Psoriasis is not contagious as it is believed to be caused by a malfunction in the human immune system, namely the overactive T-lymphocytes on the skin. Psoriasis is classified as a hereditary disease, with psoriasis in 1 of the parents, the risk of developing psoriasis in a child is 25%, if both parents have 65%. In addition to the hereditary factor, the trigger mechanism for the onset of psoriasis or relapse is the intake of antibiotics, NSAIDs, B vitamins, as well as stress, alcohol, and skin injuries.
Viral theory of the cause of psoriasis
A number of studies conducted among patients with psoriasis have found various changes in peripheral lymph nodes, which may indicate the viral nature of the development of this disease. It is suspected that it is retroviruses that are genetically transmitted by inheritance that may be one of the causes of psoriasis, but to prove the viral nature of the origin of psoriasis, it is necessary to identify the virus, isolate it and select the habitat, and so far no one can do this.
The fact is that retroviruses have the ability to change the genetic code of the host, they, with the help of the reverse transcriptase enzyme, have the ability to synthesize DNA, and a “false program” is formed in the cells that changes the human genome. However, it has been established that even with blood transfusions from psoriasis patients to healthy persons, infection or transmission of the disease has never been noted. Therefore, the version about the viral cause of psoriasis has not yet been proven.
The immune cause of psoriasis
This is one of the generally accepted theories of the causes of psoriasis, since cellular immunity disorders are considered the leading trigger mechanism of the disease. It was noticed long ago that in persons with a genetic predisposition to psoriatic disease, in the event of chronic foci of infection - tonsillitis, sinusitis, which indicate impaired immunity - are provoking factors for the onset of psoriasis.
When a primary focus of psoriasis occurs, medicine also suggests that damage to the epidermis is caused by autoimmune aggression. In numerous studies of patients with psoriasis, abnormalities in immune complexes, antibodies, immunoglobulins, which cause Munro's microabscesses, have been identified.
In the process of activating the inflammation of psoriasis, the hypersensitivity of the skin increases sharply, therefore, in places of physical or chemical irritation, rashes characteristic of psoriasis appear. When examining skin scales, antigenic components were found, and autoantibodies to them in the blood, which are not found in healthy people either on the skin or in the blood.
This fact gives grounds to assert that the autoimmune process plays an important role in the cause of psoriasis. But any processes, even immune reactions, are played out in the body as in a whole system, therefore, a combination of other factors, such as endocrine influence, hereditary factors, metabolic disorders, should be taken into account.
Infectious theory of psoriasis development
Many researchers a hundred years ago stubbornly searched for an infectious agent of psoriatic disease, and streptococci, and spirochetes, and epidermophytos were considered guilty of its occurrence. However, none of these pathogenic microorganisms, fungi, after research, were not found to be the cause of psoriasis.
However, infectious diseases, tonsillitis, ARVI influenza affect the exacerbation or trigger the primary onset of psoriasis, especially in the cold season, when the immune system weakens and psoriasis patients are often admitted to the hospital.
Some authors believe that the development of psoriasis against the background of acute and chronic infection is explained by the influx of impulses from the focus of infection into the endocrine system and the vegetative section, which leads to a restructuring of the body's reactivity. Very often, namely in 90% of cases, chronic tonsillitis accompanies psoriasis, which confirms the influence of infectious processes and impaired immunity on the development of psoriasis.
Also, according to many experts, there is an infectious-allergic cause of psoriasis. Its supporters believe that psoriasis is an allergic tissue reaction to viruses, streptococci and their metabolic products. However, neither the viral nor the infectious theory has yet been confirmed.
This cause is based on a familial manifestation of psoriasis among close and distant relatives. However, psoriasis should not be considered a strictly hereditary disease, as well as diabetes, cancer, ischemic heart disease, since not psoriasis itself is inherited, but only a genetic predisposition to it. Yes, 60% of patients with psoriasis have ancestors or close relatives suffering from this disease, and if one of the parents is sick, then, according to the theoretical probability, the child's risk of developing psoriasis increases by 25%, and if both parents are sick, up to 75%.
However, not always with psoriasis, the cause is only a genetic factor. This disease has recently become very common in clinical practice, and there is not always a direct relationship to related predisposition. In psoriasis, the causes of occurrence are so multifactorial that it is impossible to unequivocally indicate one specific cause. Since the pathogenic factors are also violations of protein or carbohydrate metabolism, and changes in lipid, enzymatic metabolism, a combination with foci of streptococcal infection or a viral nature.
Metabolic disorders as factors in the development of psoriasis
If we consider metabolic disorders in psoriasis, then in many patients there is a slight decrease in body temperature, and this is one of the symptoms of a slowed metabolism, an increased cholesterol content is also noted, which indicates changes in lipid metabolism. Given the high level of cholesterol, many researchers consider psoriasis as cholesterol diathesis, and consider its increase to be the initial manifestation of dermatosis, since a violation of lipid metabolism stimulates the formation of keratinization of the skin.
Also in psoriasis, the metabolism of vitamins is disturbed, especially vitamin C, A, B12, B6, while the content of vitamin C in the skin is increased. Also, shifts in the content of iron, copper, zinc were noticed, which significantly reduces the adaptive properties of the human body. Almost 25% of patients with psoriasis also suffer from diabetes mellitus, however, some researchers regard this fact not as the cause of psoriasis, but, on the contrary, as a manifestation of psoriatic disease.
With the progression of the disease, the basal metabolism in patients with psoriasis is most often increased, and in those patients who have a reduced metabolism, symptoms of hypothyroidism, endocrine glands, and gonads are often manifested, in 60% of patients with psoriasis, general carbohydrate metabolism is disturbed. Low-calorie food, or even moderate fasting, reduces the body's self-poisoning, therefore, a diet for psoriasis therapy improves the patient's condition.
Provoking factors for the onset of psoriasis
At the present stage of medical research in the field of determining the cause of psoriasis, we can say that it is a constantly recurrent systemic disease that appears in genetically predisposed people, with concomitant disruption of various metabolism of the central nervous system.
Both for the onset of psoriasis and for the exacerbation of existing chronic psoriasis, the main triggers are most often stress, psychological trauma, prolonged fatigue and nervous tension.
Stress triggers immunological and biochemical reactions that contribute to the development of psoriasis. However, sometimes negative emotions serve, on the contrary, to complete the clinical symptoms of psoriasis. According to a survey of patients with psoriasis, this provoking factor causes the onset of the disease in 49% of patients and in 41% gives a relapse of psoriasis.
Infectious diseases, vaccination, chronic foci of infection
Tonsillitis, sinusitis, STIs, otitis media, and so on, especially highly virulent streptococcus is often detected. For an exacerbation of the disease, this factor is relevant in 21% of patients, and for the onset of the development of psoriasis, infection is a triggering mechanism in 15% of patients.
Hormonal changes in women
During pregnancy, breastfeeding, during menopause or during adolescence - in 6% of patients surveyed, this was also a provocative factor in the development of psoriasis.
Injuries, bites, burns
Any trauma to the skin - in 12-14% of patients, the appearance of psoriasis is caused by physical trauma.
Is the cause of psoriasis or its exacerbation in 5% of patients.
Such as any type of antibiotic, NSAID. Vitamin therapy - especially vitamins C, B, beta-blockers, cytostatics, vaccination, the use of herbal remedies in the treatment - this provokes psoriasis in 6% of patients.
Food poisoning, abuse of certain foods
Chocolate, citrus fruits and other products - according to a survey of patients, this is the cause of psoriasis in 4% of patients.
Also, a provocative factor causing generalization of the inflammatory process shortens the period of remission and increases the risk of complications, this is indicated by 3% of respondents.
High humidity, prolonged exposure to intense ultraviolet radiation, sudden changes in temperature and humidity - causes an exacerbation in 2% of patients.
The first symptoms of incipient psoriasis can occur regardless of age, it appears equally often in infants and in people 20-40 years old, even in old age, psoriasis may begin to develop. Naturally, the earlier it appears, the more severe the consequences it causes in the patient. If psoriasis begins in a person after 30 years of age, it is usually accompanied by gastritis, liver disease, overweight, various neuroses, diabetes, arthritis and other diseases.