Psoriasis or scaly lichenIt is a chronic disease that affects the skin and its appendages: nails and hair. When the manifestations of the disease decrease, it is characterized by worsening (relapses) and periods of temporary well-being. The disease is not contagious and the patient is not dangerous to others. Because the appearance of psoriasis is not associated with microorganisms.
Psoriasis most commonly occurs between the ages of 15-45. People with fair skin are more sensitive to this. In developed countries, the number of patients with psoriasis reaches 2-4% of the population. Every 25th inhabitant of the planet suffers from it.
Many medical institutions deal with this problem. Therefore, psoriasis is recognized as the most studied disease. However, the disease is still not fully understood. Officially, it is considered incurable and raises many questions.
Psoriasis is caused by the body's own immune cells. They rise from the lower layers of the skin to the upper layers, causing inflammation, proliferation of epidermal cells and the formation of small capillaries.
The manifestations of psoriasis on the skin are very different. The disease often causes the appearance of red spots - psoriatic plaques. They are dried to the touch, rise above the surface of the skin and are covered with a white coating.
Types of psoriasis
The disease is divided into two major groups: pustular and non-pustular psoriasis.
Non-pustular psoriasis
- ordinary (vulgar) or simple psoriasis (plaque psoriasis, chronic stable psoriasis)
- psoriatic erythroderma or erythrodermic psoriasis
Pustular psoriasis
- pustular psoriasis background Tsumbusch or generalized pustular psoriasis
- palmoplantar psoriasis (pustular psoriasis of the extremities, chronic persistent palmoplantar pustulosis)
- annular pustular psoriasis
- palmoplantar psoriasis
- herpetiformis psoriatic impetigo
In addition, these types of psoriasis are different.
- seborrheic psoriasis
- psoriasis of flexor surfaces and skin folds
- Napkin psoriasis
- psoriasis caused by drugs
These forms of psoriasis differ in severity.
- Mild - less than 3% of the skin is affected.
- Medium - 3-10% of the skin is covered with psoriatic plaques.
- Severe - there are joint lesions or more than 10% of the skin is involved.
Causes of psoriasis
To date, there is no clear answer to the question: "Why does psoriasis appear? " Scientists have put forward several theories.
- Psoriasis is an autoimmune disease. Based on a malfunction of the immune system. Immune cells of T-killers and T-helpers, whose functions are to protect the body from viruses, bacteria and tumor cells, for some reason penetrate the upper layers of the skin. Here they produce inflammatory mediators - substances that "trigger" the inflammatory reaction. This leads to an increase in the division of skin cells and their proliferation (multiplication).
- Psoriasis is a disease caused by disruption of the growth, division and maturation of epithelial cells - keratinocytes. As a result of such changes in the skin, the immune cells of T-lymphocytes and macrophages attack the diseased skin cells.
Factors contributing to the development of psoriasis
Doctors have noted a number of factors that may contribute to the appearance of the disease. Of course, psoriasis is most common if several of these conditions affect the body at the same time.
- Hereditary predisposition.There is a version that the genes responsible for the immune system and the function of T-lymphocytes are carriers of the disease. Therefore, parents suffering from psoriasis are more likely to have children who develop the same symptoms.
- Delicate dry skin. . . It has been reported that people with this skin condition are more likely to get sick than those with oily and well-hydrated skin. This is probably due to the protective functions of sebum and the structural properties of the skin.
- External irritants. . . A high percentage of patients are among people who are in constant contact with alcohol solutions, solvents, household chemicals, cosmetics (lotions, hand creams).
- Excessive hygiene- Excessive love of cleanliness also violates the protective properties of the skin. Soaps, shower gels and laundry detergents wash away the natural barrier and leave microscopic lesions.
- Bad habits- Alcohol, smoking and drug addiction are bad for the skin. His nutrition and blood supply deteriorate.
- HIV- AIDS patients are more prone to psoriasis. Scientists cannot explain this phenomenon. The fact is that psoriasis is caused by increased activity of lymphocytes, and their number decreases with AIDS.
- Medications- Taking certain medications can cause the disease. Among them: beta-blockers, antidepressants, anticonvulsants and antimalarial drugs, lithium carbonate.
- Infections (fungi and staphylococci). . . There were often cases of psoriasis appearing immediately after fungal infections or diseases caused by streptococci.
- It moves- Climate change or even a season of the year, environmental degradation can be the trigger of this disease.
- Stress- Strong emotional shock or physical stress (prolonged hypothermia, overheating, accidents) before the first signs of psoriasis.
- Trauma- Constant exposure to the skin: pressure, friction, scratching. Such regular trauma can cause the first psoriatic plaques to appear here.
- Allergic conditions- Allergic skin rashes and processes occurring in all layers of the skin also increase the risk of disease.
What are the signs and symptoms of psoriasis?
Psoriasis is a systemic disease that affects more than just the skin and nails. Affects joints, tendons and spine, immune, nervous and endocrine systems.
However, the main manifestations of the disease still occur in the skin. The name squamous lichen conveys the symptoms of psoriasis very accurately. The first manifestations are often irregularly rounded pink or bright red papules, covered with scales - psoriatic plaques. They are located symmetrically, mainly on the extensor surfaces, lower back and scalp. However, they can affect any part of the skin and the mucous membranes of the genitals. Their size initially ranges from a few millimeters to ten centimeters or more.
Depending on the characteristics of the spill, e. g.psoriasis forms:
- Pitting psoriasis - the size of the elements is smaller than the head of the pin.
- Guttat psoriasis - papules are tearful and reach the size of a lentil grain.
- Coin psoriasis - plaques grow up to 3-5 mm and the edges are rounded.
They also distinguish the forms of rash when its elements are in the form of rings, arches and wreaths, geographical maps with uneven edges.
The papules are covered with a scaly coating that can be easily removed. It consists of keratinized cells of the epidermis. Psoriatic plaques begin to be covered with scales from the center, then the plaque spreads to the edges. Its loose and light appearance is due to the penetration of keratinized cells through air-filled cavities. A pink ring may form around the elements - this is the area of inflammation, the area of plaque growth. The skin around the rash elements does not change.
Scalp psoriasisrepresents psoriatic plaques that rise significantly above the surrounding skin. They are densely covered with dandruff-like scales. In this case, the hair remains ineffective. Rash can occur not only under the hair, but also on the smooth skin, neck and behind the ears. Such changes are explained by the active division of keratinocytes in the affected areas.
Psoriasis of the feet and palmscauses a strong thickening of the corneal layer of the skin in these areas of the body. The skin becomes thick and rough. Often cracks penetrate it. This is due to intensive cell division, which multiplies 8 times faster than usual, but is not removed from the skin surface in time.
Psoriasis of the nailsdiffers in various signs. But most importantly, there are two main types of nail plate damage:
- According to the "high" type. Small holes appear on the nail plate, resembling traces of needle sticks.
- According to the type of onychomycosis. The lesions look like nail fungus. Nails thicken, change color, peel. A psoriatic papule surrounded by a red ring appears on the nail plate. It looks like a sack that encloses with a drawstring.
The symptoms and signs of psoriasis depend on the stage of the disease, which alternates cyclically throughout the year. Thus, in most patients, when the exacerbation occurs in the autumn-winter period, there is a "winter" type of the disease. The improvement in summer is due to the therapeutic effect of ultraviolet light in the sun. But some patients suffer from the "summer" type.
There are the following stages of the course of psoriasis:
- progressive - the appearance of new elements, active growth of existing plaques, uncertainty of the pink growth zone around them, intense peeling and itching.
- stationary - to stop the growth of papules, the absence of new rashes, a thin fold of the upper layer of skin around the psoriatic plaques.
- regression - the absence of peeling, the disappearance of plaques and the appearance of areas of pigmentation in their place indicates a weakening of the process.
What do skin rashes with psoriasis look like?
Each organism reacts individually and to the disease differently. Therefore, the nature of the rash can be very different. This explains the different forms and types of psoriasis.
But for most people, the symptoms of psoriasis are similar. These are red spots - psoriatic plaques that rise 1-3 mm above the level of healthy skin. Their appearance is due to the fact that the cells of the surface layer of the skin - keratinocytes - do not have time to actively divide, mature and become full-fledged epithelial cells. As a result of this increased pathological growth, certain parts of the skin thicken. This is due to the release of chemicals by the immune cells that cause inflammation in the skin.
From above, the boards can be covered with paraffin-like gray, silver or yellowish blooms. That's why they got the name - "paraffin lakes". These are keratinized epithelial cells, their rejection is disrupted and accumulates on the surface of the affected skin area.
The spots are crusty, warmer than the rest of the skin, and can grow to large sizes. Often the patient feels severe itching in this area. This is due to the formation of a cascade of neuro-reflex reactions and an allergic reaction against the background of the inflammatory process.
Another type of element is papules. These are small elements of a tubercle-like rash. The size is about 1 mm. There is no space full of content in the middle. They are often located in the knee and elbow joints. They remain the same during periods when the disease is declining.
During aggravation, the debris elements gradually grow in width and merge with adjacent slabs. During remission, the spots begin to disappear. Gradually they take the shape of a ring and can completely dissolve. After the plaques, a mark remains on the body - pigmentation. It can be significantly lighter or darker than the surrounding skin. After a person darkens, the skin tone is usually even.
What do nail lesions look like in psoriasis?
Nail psoriasis is similar to a fungal infection of the nail plate. Laboratory tests are needed to make a correct diagnosis. Changes can affect only one nail or all at once and are very different. They occur in 10-15% of patients. Damage to the nails is often accompanied by joint pain caused by psoriasis. In this case, there may be no skin rash.
There are several stages of nail psoriasis:
- depressed points - high nails
- longitudinal depressive threads
- transverse compression in the center of the nail, these first symptoms are associated with damage to the nail root - nail matrix
- Irregularly shaped pink spots on the nail - this is the accumulation of serous fluid under the nail.
- Due to circulatory disorders, the nail becomes dull, cloudy, yellow and thick
- the nail plate takes on the appearance of a bird's paw accompanied by pain. This is due to the fact that the process captures the nerve endings.
Nail lesions start from the outside and gradually cover the entire surface, moving towards the root. Microcirculatory disorders cause the nail to become cloudy and change color from yellow to blue.
If you find similar symptoms, do not diagnose yourself. Similar changes can occur for other reasons: fungi, trauma and blood supply disorders.
Is Psoriasis Infectious?
This question is often asked by newly infected people and acquaintances of the patient. Scientists give an unequivocal answer. Psoriasis is not contagious and a sick person is completely safe for others. This is because psoriasis is not caused by a virus or bacteria, but by aggressive white blood cells. It causes skin inflammation by attacking its own immune cells for unknown reasons. The result of this process is rashes and thickening of the skin in some places (psoriatic plaques).
How is psoriasis treated?
Treatment of psoriasis depends on the form and stage of the disease and drug sensitivity. Traditional medicine focuses on the use of drugs. Treatment begins with topical preparations that act on the affected skin. Thus, they try to avoid side effects when taking oral medications. More information on the use of local remedies will be described below. Now let's focus on pills and capsules.
First, there is a technique in which the patient is offered a milder medication with the fewest side effects. If it is not effective, it is replaced by stronger ones, etc. Even if the treatment is appropriate for the patient, it is changed after a while. The fact is that the body gradually becomes accustomed to the drug and its effect decreases.
Oral systemic medications are very effective. They are prescribed for moderate and severe stages of the disease. They even help patients who have not been treated successfully by other means. However, they have significant disadvantages: they can cause serious side effects, and the situation worsens again after the abolition of these funds.
| Group of drugs | Dosage form of the drug and its effect on the body |
| Retinoids - Derivatives of vitamin A. | It affects the maturation of the surface layer of the skin and in this process eliminates the disorders caused by psoriasis. Release form - capsules. Depending on the stage, the dose according to the scheme is 30-75 mg / day. Reduces the rate of division of keratinocytes, promotes normal cell growth and differentiation. Available in capsulesThe daily dose is 25-50 mg. |
| Immunosuppressants - drugs that reduce the activity of the immune system | Reduces the activity of T-lymphocytes, which cause the division of skin cells. Sterile solution in ampoules. The initial dose is 3-5 mg / kg per day when administered intravenously, and 10-15 mg / kg per day for oral administration. |
| Drugs for the treatment of malignant neoplasms (Cytostatics) | Inhibits the overgrowth and proliferation of atypical cells of the epidermis. Available in tablets. Take 2, 5-5, 0 mg orally 2-3 times a day, once a week. |
Physiotherapy treatment for psoriasis is very effective. They bring significant relief to patients, stop the progression of the disease, and in some cases serve as a safe substitute for medication.
| Physiotherapy method | Effects on the body |
| PUVA therapy or photochemotherapy | Combination of long-wave ultraviolet radiation and internal photosensitizer. The course is 20-30 procedures. The method is based on the deep penetration of UV rays into the skin. The photosensitizer inhibits the DNA synthesis of skin cells and their rate of division. Special devices or cabins are used for treatment. |
| Selective phototherapy (S. F. T) | Irradiation of the skin with ultraviolet rays with a wavelength of 280-320 nm. The course is 15-35 procedures. A special cabin is required for therapy. |
| Monochromatic UV treatment | Separate exposure of each focus to UV radiation with a laser or lamp source. This allows you to irradiate the hearth, even in hard-to-reach areas, without affecting healthy skin. It is prescribed in cases where less than 10% of the skin is affected. The course of treatment is 15-30 procedures. |
| Laser therapy | Laser radiation of different wavelengths is used to treat rashes. The laser promotes rapid resorption of psoriatic plaques, preventing the appearance of scars in their place. The number of procedures is determined by the doctor for each patient individually. |
| Electric sleep | The procedure is performed on a device based on a light impact on the brain with weak electrical impulses. Duration 20-60 minutes. The number of procedures is 10-12. Electric sleep has a calming effect. As a result, the activity of the nervous system is normalized, the plaques begin to melt, and the period of well-being begins faster. |
| Magnetotherapy | Treatment with magnetic fields has a beneficial effect on the general condition. Itching and inflammation of the skin, swelling and pain in the joints are reduced, the psycho-emotional state improves. Betatron device is used for treatment. The duration of the procedure is 20 minutes. Number 10-15 for each course. |
| Ultrasound therapy | Used as an analgesic, antipruritic and decongestant. Promotes resorption of scarsThe procedure can be combined with medication (phonophoresis). The duration of exposure to an area is 15 minutes. It takes 7-14 sessions to achieve a therapeutic effect. |
| Hyperthermia | Heat the pieces to 40 degrees using special pads with a thermal mixture. This effect on the body normalizes the immune system, which reduces skin attacks. The duration of the procedure is about 2 hours. Their number is determined by a doctor. |
| Treatment of bee venom | The substance is injected into the body using electrophoresis or ultrasound. It has anti-inflammatory, anti-inflammatory and anti-itching effects. Metabolism is normalized. The minimum number of procedures is 10. |
It is very important for people with paid lichens to follow a diet. Eating disorders can make the disease worse. The menu should be rich in vitamins and simple at the same time. It should relax the intestines and liver, as well as not cause allergies to the body.
| Allowed products | Prohibited foods |
| Vegetables (pumpkin, watermelon, beets, carrots, potatoes, radishes) | Animal fats |
| Fruits (apricots, peaches, apples), juices | Alcohol |
| Berries (except red berries: strawberries, raspberries, red currants) | Fatty meat (pork, duck) |
| Fresh herbs | Smoked meats |
| Lean meat (beef, beef, rabbit, turkey) not more than 200 g per day | Red fish |
| Cheese, cottage cheese, dairy products | Carbonated drinks and coffee |
| nuts | eggs |
| Low-fat fish species | Ice cream and milkshakes |
| Seaweed | Minimum amount of confectionery and sugar |
| Whole wheat bread | Butter and dough |
It is necessary to fast twice a week to cleanse the body of toxins and metabolic products. Recommend kefir, apples, vegetables.
Which ointments are effective in the treatment of psoriasis?
The use of ointments for psoriasis has the greatest effect compared to other external drugs. The components of the ointment do not remain on the surface of the plaque, but soften the scales and penetrate the skin.
There are many ointments available to treat psoriasis. Assign in the early stagesnon-hormonal ointments.
If the treatment does not give the expected effect, prescribehormonal ointments. . . Treatment begins with milder medications with minimal side effects. If no improvement is achieved, stronger ointments with glucocorticosteroids are prescribed.
| The name of the ointment | Drug action | Side effects |
| Weak ointments | Suppresses the increased activity of leukocytes, prevents their penetration into the skin, eliminates the feeling of tightness and itching. | Swelling of the skin, itching, redness. |
| Moderate ointments | Has anti-inflammatory, antiallergic, anti-edematous, anti-pruritic effects. Suitable for patients with exudative forms of psoriasis, reduces bleeding. Apply a thin layer to limited areas 2-3 times a day. The treatment lasts 10-14 days. | Steroid acne, skin atrophy and stretch marks, burning, itching, hypopigmentation. |
| Strong ointments | Local anti-inflammatory, antipruritic and anti-allergic agent. Reduces skin moistureApply to the affected area 2-3 times a day for up to two weeks. Used during aggravation. | Atrophy of the skin. |
| Very strong ointments | Has a strong antipruritic and anti-allergic effect. Inhibits cell division and keratinization processes. Apply 1-2 times a day for no more than two weeks for each course. | Acne, hair loss, skin atrophy. Do not use for psoriasis and widespread plaque psoriasis. |
Pharmaceutical companies produce many drugs in the form of ointments. The doctor selects the drug for the patient individually and, if necessary, changes it to a stronger one.
Remember that you should never see a doctor with psoriasis. After all, this disease can hide the early stages of skin cancer.
Choosing a treatment regimen for psoriasis is a long process that involves many trials and errors. If you can't find your "own" medicine right away, don't despair. Remember that many people get continuous improvement when the disease does not return for years. You can too!