Psoriasis - what kind of disease is it?

Although psoriasis is a common and long-known disease, it is still not fully understood.And patients often don't know that psoriasis is not a bacterial infection or fungus, but an abnormal response of the immune system caused by unknown causes.Information about the causes and symptoms of psoriasis will be very useful for patients, as it will help to eliminate the disease.

What disease is this?

Lichen squamosus is another name for psoriasis, and this name perfectly characterizes this disease.Psoriasis is manifested by the formation of inflammatory plaques of various sizes on the skin, densely covered with thick skin scales.

Undoubtedly, almost everyone has heard about such a disease as psoriasis.And this is not surprising, because scaly lichen is quite widespread.This disease is diagnosed in 4-10% of the world population.Moreover, statisticians who collect information about the prevalence of psoriasis claim that the number of patients is constantly increasing.

Scaly lichen has been known to people since ancient times;even healers in Ancient Greece tried to cure this disease.The modern history of the study of psoriasis goes back about 150 years.However, during this rather significant period of time, researchers did not get enough information about the causes and treatment of psoriasis.

Wide spread, uncertainty of etiology (causes of appearance), fairly effective treatment - all this characterizes psoriasis as one of the most difficult problems in dermatology.

Today, dermatologists consider psoriasis as a complex systemic disease associated with disturbances in the work of the immune system, failure of metabolic processes and the appearance of trophic disorders.The result of these failures are specific skin changes.

Therefore, when answering the question of what psoriasis is, a modern dermatologist will answer that it is a violation of trophism and metabolic processes in the skin as a result of a malfunction of the body's systems.Today, two theories regarding the etiology of psoriasis are considered the most likely: genetic and viral.

• The genetic theory has many supporters, because psoriasis often acts as a hereditary or familial dermatosis.A comprehensive examination of the patient's family history confirms the presence of psoriasis in one form or another in the patient's relatives in 60-80%.However, it is not possible to confirm the fact of hereditary origin of psoriasis in some patients.This situation leads to the separation of these cases into a special group, where the main cause is not genetic, but phenotypic failures.
• The viral theory that psoriasis develops as a result of an infection has its supporters.Confirmation of information about the viral origin of psoriasis is the detection of antibodies in the blood of patients, as well as "elementary bodies" in the cells of the epidermis.According to this theory, psoriasis develops not only when infected with a virus, but also when there are certain conditions.

There are other theories that explain the appearance of psoriasis.For example, endocrine, neurogenic, metabolic, etc.Of course, all these theories are not unfounded, and their study allows obtaining more important information about psoriasis.However, today it is already certain that the state of the endocrine and nervous systems, as well as the activity of the gastrointestinal tract, do not cause psoriasis, but significantly affect the course of this disease.

For example, pathologies affecting the liver cause a significant decrease in the quality of blood purification performed by this organ.And this, in turn, can provoke the appearance of various skin lesions, including psoriasis.

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc.) lead to degeneration of the tissues of this organ, which means that 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 development of skin diseases, including psoriasis, is also possible.

There is also a reverse relationship: 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 in order not to burden the liver unnecessarily.Patients are advised to limit fatty foods and completely avoid alcohol.

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

Classification according to the international system

Psoriasis manifests itself in different forms.To facilitate the navigation of specialists, the generally accepted classification of psoriasis is used.

Psoriasis is also included in the International Classification of Diseases (ICD) system.Today, the 10th revision of the International Register of Diseases is already in use, so the abbreviation ICD 10 is used.Work on the 10th revision of the International Classification of Diseases began in 1983 and was completed in 1987.

In fact, ICD 10 is the standard assessment tool used in medicine and healthcare management.The 10th revision of the data book is used to monitor the spread of various diseases and other public health problems.

Using the 10th version of the ICD, it is possible to compare morbidity and mortality rates in different countries, which allows obtaining statistical data and systematizing diagnostic data.As agreed upon by WHO members, ICD 10 is used to assign codes to various diseases.In the 10th version of the classification, alphanumeric codes are accepted, with the help of which it is convenient to store data in electronic form.

All types of psoriasis are included in ICD 10, and each of them is assigned a special code.In dermatology, the following forms and types of psoriasis are distinguished:

• Common psoriasis(synonyms: vulgar, plain, board-like).The disease was assigned a code according to ICD 10 - L-40.0.This is the most common form, observed in 80-90% of patients.The main symptoms are the formation of plaques, covered with white-gray skin flakes, rising above the surface of the unchanged skin.This form is characterized by light peeling of the scales.After their removal, inflamed red skin appears, which is easily injured and begins to bleed.As the inflammatory process progresses, plaques can significantly increase in size.
• Reverse psoriasis.It is a disease that affects skin folds (bend surfaces).The ICD 10 code for this form of the disease is L83-4.Dermatosis appears with the formation of folds of smooth or minimal scaly spots on the skin.The condition worsens when the skin is damaged 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 numerous small red or purple spots on the skin that look like water droplets.According to the 10th version of the international classification, this disease received the L4 code.Most often, guttate psoriasis affects the skin of the feet, but the rash can also occur on other parts of the body.At the same time, it is known about guttate psoriasis that it develops as a complication after streptococcal infections - pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasis– this is a severe skin form, according to ICD 10 it is coded L1-3 and L 40.82.It is characterized by the formation of blisters or pustules.The skin on the lesions swells, reddens, becomes inflamed and peels off easily.If fungus or bacteria penetrate the pustules, the contents of the pustules become pus.Pustular psoriasis most often affects the distal parts of the limbs, but in the most severe cases, a generalized process can develop with the rash spreading to the whole body.
• Arthritis psoriatic or arthropathic psoriasis.According to the 10th version of the ICD, the pathology is coded L5.It manifests itself with inflammation of the joints.Arthropathic psoriasis can affect all types of joints, but most often the joints in the phalanges of the toes and hands are inflamed.Knee, hip or shoulder joints can be affected.Lesions can be so severe that they cause disability to the patient.Therefore, you should not think that psoriasis is only a skin disease.Severe forms of psoriasis can cause systemic damage, disability, and even death.

• Erythrodermic psoriasis.A rare but severe type of psoriasis, according to ICD 10, this disease received the L85 code.Erythrodermic psoriasis is often generalized;the affected area may cover all or almost all of the surface of the skin.The disease is accompanied by severe itching, swelling and pain.
• Psoriatic onychodystrophy or nail psoriasis.According to the 10th version of the ICD, the disease is coded L86.The pathology manifests itself as changes in the appearance of the nails on the toes and fingers.Nails may become discolored, thickened, and begin to break.It is possible to completely lose nails.

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

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

Considering all types of the disease, widespread psoriasis is more common than other forms.

Flow stages

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

The advanced stage of psoriasis is characterized by:

• the appearance of new rashes;
• growth of existing boards;
• the appearance of new elements of the rash at the site of skin injuries (scratches, abrasions);
• excessive stripping of existing boards.

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

• lack of emergence of new elements;

• moderate stripping of elements;
• no signs of element growth.

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

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

• reduce the intensity of peeling;
• element solution.

After the resolution of psoriatic plaques, hypo- or hyperpigmented spots remain in place.

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

• winter (with exacerbation in autumn and winter);
• summer (with exacerbation in the hot season);
• non-seasonal psoriasis is the most severe type, because there is no clear connection between relapses and the seasons of the year, periods of remission may be practically absent.

Diagnostic features

If psoriasis has a typical clinical picture, the diagnosis will not be so difficult.However, this disease is often disguised as other pathologies.

For example, nail psoriasis is often mistaken for nail fungus, because the external manifestations are very similar in the initial stages of these diseases.However, nail fungus and psoriasis have completely different natures, so the treatment should be different.

A non-expert can mistake it for fungus and skin psoriasis.Cutaneous mycosis (skin fungus) manifests itself with similar symptoms - the formation of scaly plaques.Therefore, if you notice suspicious symptoms on your body or nails, it is not necessary to diagnose yourself and start treating the fungus using pharmaceutical or folk methods.

If the diagnosis is wrong and psoriasis is not the cause of the symptoms, the treatment will not be helpful, but will make the symptoms worse.

When contacting a dermatologist, a fungal test will be performed and a scraping from the nail or skin will be taken.Then the resulting material is placed in the nutrient medium.If the material contains fungus, after a few days a large colony will grow on the test sample.By the appearance of the material, it will be possible to understand what kind of fungus is causing the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, which can be bacterial or fungal.Therefore, patients who change the clinical picture (appearance of purulent discharge, discoloration of plaques, etc.)You should periodically undergo tests for fungi and other infectious agents.

In the diagnostic process, a certain role is given to a number of events called the psoriatic triad.Events appear sequentially when a rash element is scratched.

The psoriatic triad manifests itself as follows:

• when the rash element is scraped off, scales are removed in the form of "chips";
• after removing the chips, a thin transparent film similar to polyethylene appears;
• Precise bleeding occurs when the film is damaged.

A dermatologist diagnoses psoriasis, but if necessary, a doctor can refer the patient to other specialists - rheumatologist, gastroenterologist, surgeon, etc.

Interesting facts about psoriasis

People have known about psoriasis since ancient times.Even the name of the disease entered our language from ancient Greek.During the heyday of ancient Hellas, the word "psora" meant all skin diseases manifested as crusts and itching.

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

They knew about psoriasis, but this disease was not evaluated unambiguously, because it was called either the "emperor's" disease or the "devil's" disease.

Of course, 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 Willan, who identified psoriasis from a large group of skin diseases characterized by itching and peeling.

Not only ordinary people, but even famous political figures knew about psoriasis.For example, Winston Churchill, who suffered from this disease, promised to erect a monument of pure gold to the person who could learn everything about psoriasis and offer an effective treatment for this disease.

Modern ideas about the disease

It must be said that modern science does not know much about this mysterious disease.There are various theories regarding the origin, course, and treatment of psoriasis.

Here are some undisputed facts about psoriasis among experts:

• Although the causes of the disease are not clear, we have been able to learn the nature of psoriasis.This disease is autoimmune, that is, it is caused by a malfunction of the immune system;
• Another fact about psoriasis: the disease can be hereditary.However, this is not always the case;even if both parents are sick, the risk of developing the disease in their child is 65%.At the same time, some patients develop psoriasis, although none of their relatives have the disease;
• An interesting fact about psoriasis is that this disease is characterized by the Koebner phenomenon.This phenomenon is manifested by the formation of rash elements in places where the skin is damaged - scratches, burns, frostbite.Sometimes psoriasis appears after a while, in the place of scars;
• An important observation that allows us to learn more about psoriasis is the relationship of this disease with climatic factors.Exacerbations and relapses often coincide with the change of season;
• Patients probably noted the relationship between exacerbations and stress in practice.All patients should be sure that the disease recurs or worsens against the background of nervous tension and anxiety;
• a new fact about psoriasis is that the disease can make its debut at any age, although previously it was believed that pityriasis versicolor appears after the age of 30;
• It is important for all people to know that psoriasis is not contagious.Even in close contact with the patient, there is no risk of infection;
• Almost everyone has heard about the incurability of psoriasis, and this is true, because no treatment has been found that can guarantee to defeat the disease.However, patients should know that psoriasis can be managed.Adequate and timely treatment allows to achieve long-term remission.

Modern treatment methods

When talking about the common disease psoriasis, we can not talk about the treatment of this common disease.It should be said that it is not possible to treat psoriasis only with tablets or ointment.

In order to forget the manifestations of psoriasis for a long time, the patient should make an effort in close cooperation with the doctor.It will be necessary to organize the food properly.Some experts say that you can forget psoriasis forever only with the help of a properly designed diet and regular cleaning of the body.

The doctor will draw up an initial treatment regimen.As a rule, external (ointments, creams) and systemic (tablets, injections) therapy methods are used.In addition, physiotherapeutic methods will be used, treatment in spas will be recommended.It is recommended to treat psoriasis with healing mud, mineral and thermal water.

Spas can also offer non-traditional treatments.For example, with the help of fish living in thermal waters.These little healers effectively remove dead skin flakes and disinfect the skin, promoting faster healing.

Spas may offer other ways to treat lichen planus.For example, leech therapy, therapeutic baths and applications, sun therapy, etc.

You should be prepared that the treatment regimen will change from time to time.Because not all methods are suitable for a particular patient.If the selected treatment methods do not work, they should be changed.

Traditional methods of treating psoriasis are also widely advertised.Indeed, some of them can help achieve remission.But when choosing a method, you need to remember common sense in order not to harm your health.If any recipe or recommendation is in doubt, it is better not to use it.Consult your doctor before using any treatment method.

You should understand that it will be possible to forget psoriasis forever only if the patient himself and his close environment are in a positive mood.Only faith in success and an optimistic attitude will help to overcome this mysterious and insidious disease.