Psoriasis is a common skin disease of neurogenic etiology. The disease is not contagious and is not transmitted from person to person. Most often, psoriasis becomes chronic due to its latent course. The disease usually develops in people under the age of 30, but can also occur in old age.
External symptoms may be absent, the clinical picture of the disease depends on its type and stage. Most often, psoriasis begins with the appearance of bright red spots, which are covered with dry scales, so the disease has a second name - squamous cell lichen.
The spots on the skin can be of different sizes, some can combine in one affected area of the skin and protrude significantly above the surface.
Psoriasis causes physical and mental discomfort to the patient, the disease periodically worsens, between them there is a period of remission and the symptoms subside.
Skin spots are called psoriatic plaques or papules, most often they affect the elbows and knees, spread to the head and lumbar region. Plaques can affect other parts of the body, depending on the type of disease. The treatment can last more than a year.
Causes of the onset of the disease
Psoriasis causes several causes related to various factors, both external and internal:
- a common cause is genetic inheritance;
- the disease can develop due to constant stress, anxiety, shock, depression and mental disorders;
- various autoimmune diseases and a malfunction of the immune system create ideal conditions on the surface of the skin for the onset of the disease;
- chronic psoriasis can also cause metabolic disorders as well as endocrine system malfunction.
The type of psoriasis and its course depend on the etiology of the disease.
Classification of psoriasis
The disease has different forms, on which the external manifestation and symptoms depend:
- The most common form of the disease is scaly psoriasis. The surface of the skin is covered with red or pink spots covered with scales. They are in stark contrast to healthy skin, thicker and raised above the underlying surface. The scaly layer is easily removed and, if disturbed, begins to bleed, causing severe itching and burning. When the disease worsens, the spots can grow and merge with each other, forming large areas of damage.
- Guttate psoriasis looks different, the spots may be pink or purple, during the period of exacerbation become brighter. The scales may be larger and look like droplets in appearance; they can also merge into large areas.
- Another form of psoriasis, which affects only the places of the folds and skin folds - elbows, armpits, areas under the fatty folds of the abdomen or chest, in the groin. The spots are smooth, even, do not itch and have no scales. If there is friction with clothing in the affected areas, the surface of the stains is easily injured.
- The chronic form of psoriasis of the nails is also common, mainly affecting the nail plate of the fingers or toes. Nails lose their shape, deform and change color. The nails begin to thicken and exfoliate, the disease can provoke the loss of the nail plate. In the initial stage, nail psoriasis is easily confused with a fungal infection, so you should visit a doctor for diagnosis and appropriate treatment.
- The most severe form of the disease is pustular, characterized by the appearance of blisters filled with a light-colored fluid that can be easily broken by rubbing clothing. When the pustules are destroyed, pus forms in them and a secondary skin infection occurs. This form of psoriasis is dangerous because it can affect almost the entire body, making it difficult to walk.
- Rheumatoid psoriasis affects not only the surface of the skin, but also the joints and periarticular soft tissues. This applies mainly to the knees, shoulders and hips. The lesions are manifested not only by external symptoms, but also by pain inside the joint, which brings additional suffering to the patient. If the hands or feet are affected, swelling of the fingers is observed, their sensitivity decreases and deformation begins. In the most severe and neglected form, the patient may lose limb sensitivity and become disabled.
All these forms can progress on their own or can appear together, it all depends on the severity of the disease.
Stages of psoriasis
The chronic form of the disease has different stages, each of which has its own symptoms and characteristics:
- with a progressive stage, spots covered with scales appear quickly and increase in size. They are usually red in color, but can change their shades depending on the form of the disease. The skin in these places is very itchy, burning and painful;
- in a stable stage the disease does not cause painful sensations, flows moderately, the scales grow gradually, may periodically merge;
- with a regressive stage, the papules can resolve on their own, they do not cause any concern except external signs.
Psoriasis is a chronic disease that alternates between exacerbation and remission.
Causes of exacerbation
Exacerbation of the disease can be caused by many reasons, both external and internal:
- prolonged exposure to cold with frostbite of the skin;
- violation of the hormonal background of the body during puberty, pregnancy or menopause;
- long-term therapy with certain drugs (antibiotics), self-medication, violation of the dosage when taking complex vitamins and herbal supplements;
- the disease can be exacerbated by climate change or exposure to sunlight;
- alcohol abuse can not only provoke an exacerbation of the disease, but also complicate its course;
- injuries, burns, frostbite and other mechanical damage to the skin always cause exacerbation of psoriasis;
- infection with viruses and bacteria can cause an outbreak of the disease, sometimes a common respiratory disease causes an exacerbation of skin diseases.
The rheumatoid form of psoriasis has a seasonal exacerbation:
- in summer - when exposed to the sun;
- in winter - due to hypothermia.
Ultraviolet rays help the papules heal, but the sun's infrared rays irritate the skin.
Psoriasis is diagnosed without much difficulty, the disease has vivid symptoms, additional tests are performed in the form of a blood test and skin biopsy to rule out other diseases.
Treatment
Today's medicine has made great strides in the treatment of skin diseases, including psoriasis; There are several methods that can be used to treat an advanced form of the disease. The doctor determines the method of treatment on a purely individual basis, based on the form, stage, causes and symptoms. The treatment is always carried out in a comprehensive way, combining drug therapy and physiotherapy.
Drug treatment includes the use of both internal and external drugs:
- ointments based on salicylic acid, sulfur, dithranol and urea are used to eliminate skin pathologies;
- glucocorticoid ointments;
- lotions for the treatment of the scalp.
In the exacerbation stage, hormonal ointments are used to eliminate the inflammatory process, treatment always begins with less strong. If the disease begins to progress again, use strong fluoridated agents. They are used for two weeks to achieve a result.
Ointments with the least side effects are used for adults and children.
With increasing dose, ointments based on dithranol are prescribed to eliminate the inflammatory process, itching and swelling.
Preparation with kalcipotriolhas a direct drug effect on pathogenetic provoking factors. It has anti-inflammatory and immunomodulatory effects. Usually the course of treatment after two months has a noticeable positive result, the skin rash may disappear completely. This drug has no side effects in the form of skin atrophy and has a permanent effect. The drug is used to treat a droplet form of psoriasis that is difficult to treat.
All medications must be alternated, otherwise addiction may occur and the body will stop responding to them.
Aromatic retinoid treatment is also considered effective.
In addition to drug therapy, a number of requirements must be met for successful treatment:
- follow a diet;
- take the necessary vitamins under the supervision of a doctor;
- avoid stressful situations, in case of depression, you should consult a doctor to prescribe the necessary means;
- protect the affected areas as much as possible from contact with chemicals, especially hands and nails;
- wear only cotton clothes so as not to cause additional skin irritation;
- do not consume alcoholic beverages and confectionery, and contact with allergens should also be avoided.
If all the recommendations and rules of treatment are followed, it is possible to achieve remission of the disease, and in some cases - a complete cure.