Psoriasis is often a non-communicable skin disease that is associated with inflammatory lesions. It is chronic - the acute period is followed by periods of relief or disappearance of symptoms - and is caused by a combination of different factors.
The disease is widespread and occurs slightly more often in women than in men. It is not completely cured, but it is possible to relieve symptoms and improve the patient's quality of life.
Psoriasis can lead to arthritis, inflammation of the joints.
Synonyms of Russian
Scaly lichen.
English synonyms
Psoriasis.
Symptoms
The symptoms and signs of psoriasis depend on the type of psoriasis.
- Plaque psoriasis. It is accompanied by specific inflammatory skin formations - raised, oval, sharply outlined reddened lesions, scaly and covered with silvery scales. Most often, formations appear on the outer surface of the elbows, knees, scalp and trunk. The elements of a skin rash can be painful and itchy. In severe cases, the skin near the joints of the affected areas cracks and bleeds.
- Guttate psoriasis. This type is associated with the appearance of numerous papules (nodules) of orange-pink color, with a size of 1-10 mm. The rash usually appears on the torso, shoulders and thighs, but can be found all over the body. As a rule, it affects people under the age of 30, as well as 2-3 weeks after suffering from infectious diseases of the upper respiratory tract, after superficial bacterial infections in the anus.
- Nail psoriasis. It is characterized by thickening, exfoliation, discoloration of the nail plates, discoloration, yellowing of the nails, the presence of spots on them, the formation of pits, cracks, damage to the nails. Nail plates are destroyed, nail growth is impaired, they can be separated from the nail bed. It occurs in 30-50% of patients with psoriasis.
- Psoriasis of large folds. In this case, skin lesions in the form of red inflammatory spots appear in the folds of the armpits, under the mammary glands, in the neck folds, in the genital area, in the foreskin. Cracks may appear at the edges and in the center of the lesions. Psoriasis with large folds is most common in people who are overweight and obese. Sweating and rubbing aggravate the disease.
- Psoriasis of the head. It is accompanied by redness of the scalp, itching, scaling of the scalp with the appearance of white scales on the hair and shoulders - particles of dead skin.
- Psoriatic arthritis. Skin lesions are accompanied by joint pain, swelling, curvature and deformity of the joints. The joints of the fingers, wrists, feet, knees can be affected.
- Pustular psoriasis. This type is characterized by reddening of the skin and the formation of a large number of pustules - small blisters filled with pus. Formations can appear on the palms and soles or all over the body. When multiple pustules appear on the body, fever and weakness join.
- Psoriatic erythroderma. Areas of skin become red, plaques may appear. Lesions are usually accompanied by severe itching. Most often, psoriatic erythroderma is associated with sunburn or drug abuse.
Usually in different types of psoriasis the disease manifests itself gradually, skin lesions spread and are observed for several weeks. Then the symptoms disappear. After exposure to a factor that contributes to the development of psoriasis (or spontaneously), the symptoms reappear after some time.
General information about the disease
Psoriasis is often a non-communicable skin disease that is associated with inflammatory lesions.
It is chronic and often recurrent - the acute period is followed by periods of weakening or disappearance of symptoms, after which after some time the symptoms reappear.
Psoriasis is widespread, especially among people aged 16-22, 57-60 years. Women are more susceptible to this than men. People with fair skin are at increased risk of developing the disease.
Despite the fact that psoriasis is synonymous with scaly lichen, it is absolutely not contagious to others.
The causes of psoriasis are not yet fully understood. Its occurrence is associated with genetic predisposition, immune system disorders and environmental factors affecting the body.
The development of psoriasis is associated with one of the types of cells of the immune system (with T-lymphocytes), while T-cell hyperactivity is observed. They usually travel with the blood throughout the body, finding foreign agents - viruses and bacteria. In psoriasis, for unknown reasons, T cells begin to accumulate in the skin. Their hyperactivity causes dilation of blood vessels in the affected area, disrupts the cycle of formation of new skin cells - they are formed much faster than usual. Dead skin cells, meanwhile, do not have time to exfoliate and accumulate on the surface of the skin, forming plaques.
Psoriasis can be caused by one of the following factors:
- infections (tonsillitis, thrush, HIV);
- skin damage - cuts, scratches, bites or burns;
- hypothermia;
- Sunburn;
- emotional stress;
- smoking, alcohol abuse;
- the use of drugs (antimalarial, etc. ).
At the same time, some patients with psoriasis develop rashes without the obvious influence of environmental factors.
There are the following main types of psoriasis.
- Plaque psoriasis. It is the most common.
- Guttate psoriasis. It usually affects people under the age of 30. It occurs 2-3 weeks after the transmitted infectious diseases of the upper respiratory tract, as well as after superficial bacterial infections in the area around the anus.
- Nail psoriasis.
- Psoriatic arthritis. In this type of psoriasis, skin lesions are accompanied by arthritis - inflammation of the joints.
- Psoriatic erythroderma. It is most commonly associated with sunburn and drug abuse.
- Pustular psoriasis. This is quite rare, in severe cases threatening the patient's life.
- Psoriasis of the head. In this case, hair loss caused by the disease usually does not occur because the hair roots are located much deeper than the scaly formations.
Classification of psoriasis according to the severity of the course:
- soft (less than 2% of all skin is affected);
- moderate (skin lesions occupy no more than 3-10% of the skin surface);
- severe psoriasis (more than 10% of the skin is affected).
Depending on the type, location and extent, psoriasis can cause complications:
- thickening of the skin, adding secondary infection by scratching and scratches that appear due to itching with psoriasis;
- psychological problems (stress, low self-esteem, depression, social self-isolation);
- joint damage (deformity with stiffness and reduced joint mobility);
- increased risk of developing various diseases and conditions: high blood pressure, inflammatory bowel disease, cardiovascular disease, skin cancer.
Psoriasis is usually relatively mild. However, for most patients, social adaptation becomes a major problem, especially in the presence of skin lesions in visible areas of the skin - the hostility of others to the type of skin lesions, their fear of infection (many do not know that the disease is not contagious).
Who is at risk?
- People with a hereditary predisposition (more than 40% of patients with psoriasis have a relative with psoriasis).
- Persons with viral, bacterial, fungal infections (streptococcus, thrush, HIV, etc. ).
- Emotionally stressed.
- People with obesity and overweight.
- Smokers.
- Alcohol abusers.
- Taking certain medications (antimalarial drugs, etc. ).
- Burned by the sun.
Diagnosis
The diagnosis of psoriasis is usually based on the typical type of lesion, taking into account their location. In difficult cases, additional testing may be needed to rule out other skin conditions.
Laboratory researches
- General blood test. In psoriasis, leukocytosis and anemia can be found.
- Rheumatoid factor (RF) is a protein whose level in the blood can increase in systemic inflammatory diseases accompanied by joint damage, especially in rheumatoid arthritis. The result of the psoriasis test is negative. This allows you to distinguish psoriasis from rheumatoid arthritis, in which RF increases.
- The erythrocyte sedimentation rate (ESR) is usually normal, except for pustular psoriasis and psoriatic erythroderma.
- Uric acid. Uric acid levels in psoriasis can be elevated (especially in pustular psoriasis), leading to confusion of psoriatic arthritis with gout, in which the concentration of uric acid increases significantly.
- Antibodies against HIV (human immunodeficiency virus). The sudden onset of psoriasis may be due to HIV infection.
Other research methods
- Radiography of the joints. Allows you to assess the severity of joint damage in psoriatic arthritis.
- Skin biopsy. The examination involves taking a small sample of the skin for later examination under a microscope. It is performed in difficult cases to distinguish psoriasis from other skin diseases.
Treatment
Therapy for psoriasis includes topical treatment of skin lesions, medication, phototherapy, prevention of exposure to factors that provoke rashes. Depends on the type and severity of psoriasis.
Softeners (creams, Vaseline, paraffin, vegetable oils) can be used to get rid of skin lesions. They are most effective when used twice a day after a shower. Salicylic acid, anthralin, tar preparations, ointments, solutions, shampoos containing coal tar are also used. These drugs are anti-inflammatory and slow down the formation of new skin cells.
The use of corticosteroid ointments makes the treatment more effective. They are indicated for mild to moderate psoriasis. However, their long-term use is not recommended (skin atrophy, drug addiction is possible).
Light therapy - exposing the skin to ultraviolet radiation - can be helpful. In this case, burns should be avoided.
Topical treatment of lesions in more severe cases is combined with medication - retinoids, vitamin D preparations, methotrexate and others.
Treating psoriasis can be difficult because the disease is chronic and recurs after the symptoms disappear. The effectiveness of a particular method of treatment depends on the patient's susceptibility to it.
Daily baths (bath oil, oatmeal or sea salt are recommended; hot water and scrubs should be avoided) and moisturizing after bathing can help soften the skin and reduce the inflammation of psoriasis.
Prevention
- Avoid hypothermia, sunburn.
- Avoid emotional stress whenever possible.
- Quit smoking and alcohol abuse.
- Take certain medications (antimalarials, etc. ) with caution.
Recommended analyzes
- General blood test
- Erythrocyte sedimentation rate (ESR)
- Rheumatoid factor
- Serum uric acid
- HIV 1, 2 Ag / Ab Combo (determination of antibodies to HIV type 1 and 2 and p24 antigen)