Psoriasis or psoriasis – is a chronic disease, striking the skin and its appendages: nails and hair. Characterized by periods of worsening condition (relapses) and the temporary bliss, when the manifestations of the disease are still smaller. This disease is not infectious and the patient is not dangerous for the surroundings. Because the formation of psoriasis is not associated with the microorganisms.
Psoriasis most often occurs in the age of 15-45 years. Him more exposed to people who are fair-skinned. In developed countries the number of patients with psoriasis reaches 2-4% of the population. From it suffers every 25-th of the country's population on all continents.
This problem deals with a huge amount of medical equipment. So psoriasis was elected the very disease they studied. But it's still the disease is not up to the end studied. Officially, it is considered incurable and raises a lot of questions.
Psoriasis is caused by your own cells cells of the immune system of the body. They rise from the lower to the upper layers of the skin, causing inflammation, swollen cells of the epidermis and the formation of small capillaries.
Manifestations of psoriasis on the skin are very diverse. Most often the disease causes the formation of red spots – psoriatic plaques. They are dry to the touch, rises above the surface of the skin and are covered with a white bloom.
Types of psoriasis
The disease is divided into two large groups: pustular and non-pustulous psoriasis.
Non-pustulous psoriasis
- ordinary (vulgar) or a simple psoriasis (plaque-like psoriasis, chronic stable psoriasis)
- psoriatic erythroderma or erythrodermal psoriasis
Pustular psoriasis
- pustular psoriasis background Tsumbush or generalized pustular psoriasis
- palmoplantary psoriasis (pustular psoriasis of the extremities, chronic persistent palmoplantary pustules)
- annulary pustular psoriasis
- Palmar-plantar psoriasis
- herpetiform psoriatic impetigo
In addition they make these types of psoriasis
- seborrheic psoriasis
- psoriasis flexion surfaces and skin folds
- psoriasis Napkin
- psoriasis caused by drugs
According to the severity of the issue of such forms of psoriasis
- Easy – bito less than 3 % of the skin.
- Medium severity – 3-10% of the skin sheets is covered with a plate.
- Heavy – is the destruction of the joints, or is involved more than 10% of the skin.
Causes of psoriasis
To date there is no clear answer to the question: "why appear psoriasis?". Scholars have presented several theories.
Psoriasis – an autoimmune disease. On the basis of the failure of immunity. Immune cells T-killer cells and T-helpers function to protect the organism from viruses, bacteria and cancer cells, for some reason, to penetrate into the upper layers of the skin. Then produce the neurotransmitters of inflammation – substances that "trigger" an inflammatory response. His result becomes stronger the division of skin cells and their reproduction (proliferation).
Psoriasis – a disease that is caused by a disorder of growth, division and maturation of epithelial cells - keratinocytes. The result of these changes in the skin becomes attack immune cells T-lymphocytes and macrophages to the diseased cells of the skin.
Factors that contribute to the development of psoriasis
Physicians have noted several factors that may cause the emergence of the disease. Of course, most often scabies arises when the organism operates several such conditions.
- A hereditary predisposition. There is a version that the genes that are responsible for the work of the immune system and T-lymphocyte function, are carriers of the disease. Therefore, have parents who suffer from the manifestations of psoriasis, it is great probability to give birth to children, which will develop the same symptoms.
- Thin, dry skin. It was found that people with such qualities of the skin sheets get sick more often than those who have skin is oily and well moisturized. It probably has to do with the protective functions of sebum and peculiarities of structure of the skin sheets.
- External irritating factors. A high percentage of patients among those people who are constantly in contact with alcohol solutions, solvents, household chemicals, cosmetics (lotions, cream for the hands).
- Excessive hygiene – excessive love to cleanliness also disrupts the protective properties of the skin. Soaps, shower gels and washcloths to wash off the natural protective barrier and leaving a microscopic injury.
- Bad habits – addiction to alcohol, smoking and drugs bad effect on the skin condition. Impairs its nutrition and blood circulation.
- HIV – Aids patients more prone to the occurrence of psoriasis. Scientists cannot explain this phenomenon. The problem is that psoriasis is caused by the increased activity of lymphocytes, and in Aids, their number decreases.
- Medications – taking certain medications can trigger the disease. These include beta-blockers, antidepressants, anticonvulsant and antimalarial medications, lithium carbonate.
- Infection (fungi and staphylococcus). Quite often were observed cases where psoriasis is appeared just after the fungal lesions or diseases caused by Streptococcus.
- Moving – change of climate or even the time of year, worsening the state of the environment can be the trigger mechanism for this disease.
- Stress – severe emotional confusion or physical exertion (long periods of cold, overheating, accident) precedes the emergence of the first symptoms of psoriasis.
- Injuries – lasting effects on the skin: pressure, friction, scratching. It's a regular injury can become the cause of the first psoriatic plaques.
- Allergic conditions – allergic rash on the skin and the processes that arise when this, in all layers of the skin, also increase the risk of developing the disease.
What are the signs and symptoms of psoriasis?
Psoriasis is a systemic disease that affects not only the skin and nails. It affects the joints, tendons, and spine, immune, nervous and endocrine system. Often affects the kidneys, the liver, the thyroid gland. The patient feels a strong weakness, suffer from chronic fatigue and depression. In conjunction with this comprehensive exposure on the organism, the disease in recent years, the custom called psoriatic diseases.
But all the same basic manifestations of the disease occur in the skin cover. The name "psoriasis" is quite accurately conveys the symptoms of psoriasis. The first manifestations often become papules pink or bright red color correctly rounded shape, covered in scales – psoriatic plaque. Are symmetrically placed, basically, on the extensor surfaces, back, and the hair of the head. But you can hit any spots on the skin and the mucous membrane of the genital organs. Their size is from a few millimeters, in the initial stages, up to ten centimeters and more.
Depending on the nature of the rashes, they share these forms of psoriasis:
- Point psoriasis – the size of the elements of the less pins the head.
- Teardrop psoriasis – papules have the shape of tears and reach the size of grains.
- Nummular psoriasis – food stamps grow to 3-5 mm and have rounded edges.
There are also forms of acne, where its elements have a view of circles, arches and garlands, geographical cards with uneven edges.
Papules covered with bloom, which is easily removed. It consists of keratinized cells of the epidermis. Psoriatic food stamps are starting to be covered by scales from the center, then the plaque spreads to the edges. Its free and bright appearance is explained by the fact that the Horny cells is interwoven with the gaps filled with air. Around the the elements can form a rose ring – it is the site of inflammation, the zone of growth of the plaque. The skin around the elements of the rash is not changed.
Under the primers detected a smooth glossy bright red finish. It is the blood capillaries with a thin wall, covered by the thinnest foil. They are well visible due to the thinning of the upper layers of the skin. The normal structure of the skin sheets is disturbed due to the fact that cells are the keratinocytes are not mature and are not able to correctly distinguish.
Psoriasis of the scalp is psoriatic plaques that significantly rises above the surrounding skin. They are densely covered with scales, resembling dandruff. While the hair remain disabled. Rashes can not only be under the hair, but also on the smooth skin on the neck and behind the ears. These changes are explained by the active division of keratinocytes in the affected areas
Psoriasis feet and palms causes severe thickening of the horny layer of the skin on these areas of the body. The skin becomes thick, coarse. Often it penetrate into the cracks. It is caused by an intensive division of cells, which multiply in the 8-times faster than usual, but they are not removed in a timely manner from the surface of the skin.
Nail psoriasis is different different symptoms. But the greatest importance are the two main types of lesions of the nail plates:
- According to the type "no bigger than thimbles". The nail plate forms a small fossa, like the traces of jabs a needle.
- According to the type of onychomycosis. Lesions resemble fungus on the nails. The nails to thicken, change color, exfoliate. Through, the nail plate is seen psoriatic papule, surrounded by a red rim. She has the appearance of oil stains, transmission through the nails.
Signs and symptoms of psoriasis depends on the stage of the disease, which decide cycled in the course of the year. So in the majority of patients are celebrating "winter" kind of the illness, in deterioration of the falls on the autumn-winter period. Improve the condition in the summer is due to the fact that the ultraviolet rays of sunlight has a therapeutic effect. But some patients suffer from "summer" type.
Be issued on such phase current of psoriasis:
- continues – the emergence of new elements, the active growth of the existing plaques, pink zone of growth around them, the intense peeling and itching.
- inpatient – stop the growth of the papules, the lack of a new rash, a little folding of the upper layer of the skin around the psoriatic plaques.
- regressing– no flaking, the disappearance of the plaque and the emergence in their place of the land of pigmentation, indicative of the attenuation process.
How to look skin rashes with psoriasis?
Every body is different and responds differently to the disease. So the character of the rash can be very diverse. It explains the diversity of forms and types of psoriasis.
However in most people symptoms of psoriasis are similar. Is it a stain of red paint – psoriatic food stamps, rising to 1-3 mm above the level of the healthy skin. Their appearance is due to the fact that the cells of the surface layer of the skin – keratinocytes, are very active, no management to mature and develop into a fully fledged cells of the epithelium. As a result of this increased unhealthy growth of individual sections of the skin thicken. This happens under the influence that immune cells secrete chemicals that cause inflammation in the skin cover.
The spots have a red color. And if you take off the top flakes of psoriatic food stamps, its surface begins to be covered by the blood of rosa. This is due to the fact that under the influence of T-lymphocytes and immune dendritic cells occurs paved the formation of new blood vessels under the plaque. They have pretty thin walls. It causes bleeding of psoriatic food stamps at the slightest damage.
Sometimes through the walls of these blood vessels leak lymph and inflammatory exudate. When this crust on the plate becomes thick, yellowish. Its surface is to the touch damp.
The above plaques can be covered in a gray, silver or yellowish tinge, which has a view of the paraffin. So they got the name – "paraffin lake". This Horny cells of the epithelium, the feeling of rejection which is broken, and they accumulate on the surface of the affected area of the skin.
Patches of bark, more hot to the touch, than the rest of the skin, they can reach large dimensions. Often the patient feels a strong itching in this place. This is due to the fact that the background of the inflammatory process creates a cascade of neuro-reflex effects and allergic reactions.
One more type of elements – the papules. It's the smaller elements of a rash resembling a bulge. The size is about 1 mm. In the middle of no cavities, filled with content. Often they are placed on the knee and elbow joints. They remain even at the time when the disease subsides.
The first plaques are formed in those places where the skin is more dry and is in contact with the domestic chemistry and cleansers – on the open surfaces of the arms, the neck. Can be placed on all parts of the body: on the scalp, face, torso, genitals, buttocks, extremities. Unlike fungal diseases, psoriatic rashes occur in the armpit of depression and the natural folds, where the skin more moist and oily. In some forms of the disease appear only a few commemorative plates, which are not expandable. In Palmar-plantar form of defeat are only at these locations.
During the exacerbations of the elements of the rash gradually grow in width and merging with neighboring boards. In the period of improving the condition (remission) stains are starting to lighten from the middle. Gradually acquire a view of the rings and may dissolve completely. After the plaques on the body remains, traces – pigmentation. It can be significantly lighter or darker around the site of the skin. After a person get a tan, the skin color is usually leveled.