Psoriasis - what is this disease?

Despite the fact that psoriasis is a common and well-known disease, it is still not fully understood. And patients most often do not know at all that psoriasis is not a bacterial infection or fungus, but an abnormal reaction of the immune system, provoked by unknown causes. Information about the causes and symptoms of psoriasis will be very useful for patients as they will help to overcome the disease.

What is this disease?

Scaly lichen is another name for psoriasis and this name perfectly describes this disease. Psoriasis is manifested by the formation of inflamed plaques of various sizes on the skin, they are densely covered with thick skin scales.

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

Scaly lichen has been known to people since ancient times, even healers in ancient Greece tried to cure this disease. The current history of psoriasis research is about 150 years old. But during this considerable period of time, researchers have been unable to learn enough about the causes and treatment of psoriasis.

Widespread, uncertain etiology (causes), insufficient effective treatment - all this characterizes psoriasis as one of the most difficult problems in dermatology.

Today, dermatologists view psoriasis as a complex systemic disease associated with immune system disorders, metabolic dysfunction, and the appearance of trophic disorders. These failures lead to specific skin changes.

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

• Genetic theory has many proponents, as psoriasis often acts as a hereditary or familial dermatosis. Careful examination of the patient's family history in 60-80% confirms 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 hereditary origin of psoriasis. This circumstance is the reason for the distribution of these cases in a special group, in which the main reason is not genetic but phenotypic failures.
• The viral theory that psoriasis develops as a result of an infection has its supporters. Confirmation of the information about the viral origin of psoriasis is the detection of antibodies in the blood of patients, as well as "elemental bodies" in the cells of the epidermis. According to this theory, psoriasis develops not only when infected with a virus, but also under certain conditions.

There are other theories that explain psoriasis. For example, endocrine, neurogenic, metabolic and others. Of course, all these theories are not unfounded and their study allows you to get more important information about the disease psoriasis. Today, however, it is already known with certainty that the condition of the endocrine and nervous systems, as well as the work of the digestive tract, do not cause psoriasis, but they have a significant effect on the course of this disease.

For example, pathologies affecting the liver lead to the fact that the quality of blood purification performed by this organ is significantly reduced. And this in turn can provoke various skin manifestations, including psoriasis.

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

There is also feedback, psoriasis is often accompanied by fatty degeneration affecting the liver. Therefore, in the treatment of this skin disease, it is important to follow a diet so as not to overload the liver. Patients are advised to limit fatty foods, completely eliminate alcohol.

Thus, despite numerous studies, it was not possible to obtain an accurate answer to the question of what psoriasis is. However, the 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.

International Classification

Psoriasis comes in many forms. To facilitate the navigation of specialists, a generally accepted classification of psoriasis is used.

Added psoriasis to the International Classification of Diseases (ICD). To date, 10 revisions of the International Register of Diseases have been used, which is why the abbreviation ICD 10 is used. Work began on 10 revisions of the International Classification of Diseases in 1983 and ended in 1987.

In essence, ICD 10 is a standard assessment tool used in medicine and health administration. The revision manual 10 is used to monitor the spread of various diseases and other health problems among the population.

Using version 10 of the ICD, it is possible to compare morbidity and mortality data in different countries, which makes it possible to obtain statistics and systematize diagnostic information. With the consent of WHO members, ICD 10 is used to assign codes to various diseases. In the tenth version of the classifier, alphanumeric codes are accepted, 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 has a specific code. In dermatology, the following forms and types of psoriasis are distinguished:

• Common psoriasis(synonyms: vulgar, simple, plaque-like). The disease has received 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 rising above the surface of unaltered skin, covered with white-gray skin scales. This form is characterized by a slight flaking of the scales. After their removal, the inflamed red skin opens, which is very easily injured and begins to bleed. As the inflammatory process progresses, the plaques may increase significantly.
• Reverse psoriasis. It is a disease that affects the folds of the skin (flexor surfaces). For this form of the disease, the code L83-4 is adopted in ICD 10. Dermatosis occurs with the formation of folds on the skin of smooth or minimally scaly spots. Deterioration is observed 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 of a large number of small patches of red or purple on the skin, resembling water droplets in shape. According to version 10 of the international classifier, such a disease has received the code L4. Guttate psoriasis most commonly affects the skin of the feet, but rashes can also occur in other parts of the body. At the same time, psoriasis of the tears is known to develop as a complication after streptococcal infections - pharyngitis, tonsillitis and others.
• Pustular or exudative psoriasisis ​​a severe skin form, according to ICD 10 it is assigned the code L1-3 and L 40. 82. It is characterized by the formation of blisters or pustules. The skin in the lesions is swollen, red, inflamed, easily detached. If fungi or bacteria enter the pustules, then the contents of the pustules become purulent. Pustular psoriasis often affects the distal limbs, but in the most severe cases, a generalized process can develop with the spread of rashes throughout the body.
• Arthritis psoriatic or arthropathic psoriasis. According to version 10, the ICD pathology is assigned code L5. Manifested by inflammation of the joints. Arthropathic psoriasis can affect all types of joints, but most of the joints in the phalanges of the toes and hands become inflamed. Knee, hip or shoulder joints may be affected. The lesions can be so severe as to injure the patient. That is why you should not think of psoriasis as an exclusively skin disease. Severe types of psoriasis can lead to systemic damage, injury or even death of the patient.

• Erythrodermic psoriasis. Rare but severe type of psoriasis, according to ICD 10, this disease has received the code L85. Erythrodermic psoriasis often manifests itself in a generalized way, the whole or almost the entire surface of the skin can enter the affected area. The disease is accompanied by severe itching, swelling, soreness.
• Psoriatic onychodystrophy or nail psoriasis. According to version 10 of the ICD, the disease has been assigned the code L86. The pathology is manifested by changes in the appearance of the nails on the toes and hands. Nails can change color, become thicker and begin to deteriorate. Complete loss of nails is possible.

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

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

If we look at all types of disease, then common psoriasis is more common than other forms.

Stream stages

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

The following is characteristic of the progressive stage of psoriasis:

• the appearance of new rashes;
• growth of pre-existing plaques;
• the appearance of new elements of the rash at the site of skin injuries (scratches, abrasions);
• abundant scaling of existing plaques.

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

• no new items appear;

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

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

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

• reduction of peeling intensity;
• element resolution.

After resolving psoriatic plaques, hypo- or hyperpigmented spots remain in their place.

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

• winter (worsens in autumn and winter);
• summer (with exacerbations during the warm period);
• Off-season psoriasis is the most severe type, as there is no clear link between relapses and seasons of the year, periods of remission may be virtually 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 confused with nail fungus, as the external manifestations of these diseases at an early stage are very similar. However, nail fungus and psoriasis are completely different in nature, so the treatment must be different.

The layman can confuse psoriasis and fungus with fungus. Because mycoses of the skin (skin fungus) manifest themselves with similar symptoms - the formation of scaly plaques. Therefore, once you have noticed suspicious symptoms on the body or nails, it is not necessary to diagnose and read about the treatment of the fungus with the help of pharmaceutical or folk remedies.

If the diagnosis is wrong and in fact the cause of the symptoms is not fungus but psoriasis, then the treatment will not be helpful, but, on the contrary, will worsen the symptoms.

Upon contact with a dermatologist, a fungal test will be performed, and a nail or skin scraping will be taken. The resulting material is then placed in a nutrient medium. If the fungus is present in the material, a large colony will grow in the test sample in a few days. Upon the appearance of the material it will be possible to understand what kind of fungus has provoked the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, it can be a bacterial infection or a fungus. Therefore, when the clinical picture changes (the appearance of purulent discharge, discoloration of plaques, etc. ), patients will need to be periodically examined for fungi and other infectious agents.

In the process of diagnosis, a certain role is determined by a set of phenomena called psoriatic triad. The phenomena appear sequentially, when scraping the element of the rash.

The psoriatic triad looks like this:

• when scraping the rash element, the scales are removed in the form of "sawdust";
• After removing the chips, a thin transparent film similar to polyethylene opens;
• when the film is damaged, accurate bleeding opens.

A dermatologist diagnoses psoriasis, but if necessary, the doctor can refer the patient for consultation to other specialists - rheumatologist, gastroenterologist, surgeon and others.

Interesting facts about psoriasis

People have known about psoriasis for a long time. Even the very name of the disease entered our language from ancient Greek. At the time of the prosperity of ancient Greece, the word "psora" meant all skin diseases that are manifested by peeling and itching.

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

They knew about psoriasis, but this disease was not unequivocally assessed, as it is called, sometimes "imperial", sometimes "devilish" disease.

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

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

Modern understanding of 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:

• Despite the fact that the causes of the disease are unclear, it was possible to understand the nature of psoriasis. This disease is autoimmune, ie it is caused by a malfunction of the immune system;
• Another established fact about psoriasis: the disease can be hereditary. However, this is not always the case, even if both parents are ill, their child's risk of developing the disease is 65%. At the same time, some patients develop psoriasis, although none of their relatives are ill;
• An interesting fact about psoriasis is that this disease is characterized by the Kebner phenomenon. This phenomenon is manifested in the fact that the elements of the rash are formed at the sites of skin lesions - scratches, burns, frostbite. Sometimes psoriasis appears after a while, at the site of the scars;
• An important observation that allows you to get more information about psoriasis is the connection of this disease with climatic factors. Exacerbations and relapses are often synchronized with the change of seasons;
• In practice, patients have noticed a link between exacerbations and stress. All patients should know for sure that the disease recurs or worsens against the background of nervous tension and experiences;
• A new fact about psoriasis is that the disease can debut at any age, although previously it was thought that scaly lichens appear after 30;
• It is important for all people to know that psoriasis is not a contagious disease. Even in close contact with the patient there is no risk of infection;
• Almost everyone has heard of the incurability of psoriasis and this is true as no cure has been found that could certainly defeat the disease. But patients should be aware of the fact that psoriasis can be controlled. Adequate and timely treatment allows long-term remission.

Modern methods of treatment

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

To forget about the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will have to make an effort. Proper food organization will be required. 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 prepare a preliminary treatment plan. As a rule, methods of external (ointments, creams) and systemic (tablets, injections) therapy are used. In addition, physiotherapy methods will be used and spa treatment will be recommended. It is recommended to treat psoriasis with the help of healing mud, mineral and thermal water.

Resorts can also offer non-traditional methods of treatment. 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 its fastest healing.

Spas may offer other treatments for scaly lichens. For example, therapy with leeches, healing baths and applications, sun therapy, etc.

You will need to be prepared for the fact that the treatment regimen will change periodically. Because not all methods are suitable for a particular patient. If the selected treatments do not work, they will need to be replaced.

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

It should be understood that it will be possible to forget about psoriasis forever only if the patient himself and his immediate environment are positive. Only faith in success and optimism will help to overcome this mysterious and insidious disease.