Psoriasis is a chronic skin disease characterized by the appearance of a monomorphic rash in the form of pink nodules with loose, silvery-white scales on the surface. The disease persists for several years, alternating periods of relapse and remission.
The severity of the disease varies widely in different patients, and even in one patient during exacerbations and remissions—from small localized lesions to psoriatic plaques that completely cover the body. Often, the disease progresses over time (especially in the absence of treatment), with areas of lesions increasing with new areas of skin, and exacerbations becoming more frequent and exacerbated. Some patients may experience an ongoing course of disease without unexpected remission.
Fingernails or toenails are also often affected. Nail involvement may occur in the absence of skin lesions and is isolated.
The prevalence of psoriasis in the world is estimated to be approximately 1-3% of the population. According to the international organization Europso, there were 125 million people with psoriasis worldwide in 2010. In Europe, it affects up to 5 million people, which is comparable to the incidence of coronary heart disease and diabetes.
Generally, the classification is as follows:
- Pustular psoriasis
- Generalized psoriasis;
- Psoriasis annulare (pustulosis annulare);
- Palmoplantar psoriasis (extremity psoriasis, palmoplantar persistent chronic pustular disease, Barbera pustular psoriasis);
- Chronic forms of persistent acrodermatitis (plantar and palmar psoriasis, palmoplantar psoriasis);
- Psoriasis herpetiformis pustulosis.
- non-pustular psoriasis
- Psoriasis vulgaris or psoriasis vulgaris, simple psoriasis (chronic forms of plaque-like, stable psoriasis);
- Psoriatic erythroderma (psoriatic erythroderma).
Many authors insist that this classification needs to be supplemented, as types or forms of psoriasis can be added to the following editions:
- Seborrheic psoriasis (seborrheic psoriasis);
- psoriasis napkins;
- drug-induced psoriasis;
- "Reversible psoriasis" (psoriasis of skin folds, flexing surfaces).
Doctors cannot compile a list of the exact causes of psoriasis. I suggest considering the reasons in terms of nature.
- immunity. recognized cause. The triggering mechanism is thought to be a genetic process in which the immune link is disrupted. Infectious diseases, tonsillitis or sinusitis, can lead to the appearance of psoriasis.
- contagious. Initially, scientists thought spirochetes, streptococci and even epidermophytes were to blame. The findings do not support this theory. The new hypothesis suggests that the development of psoriasis is caused by infectious diseases, including tonsillitis and the flu.
- hereditary. We're talking about the inheritance of disease susceptibility. Clinical practice shows that many people face manifestations of lichen squamous, however, it is not always possible to trace the link to genetic susceptibility.
triggers and triggers
- Psychological - Short-term effects of severe stress, as well as unexpressed but long-term or frequently recurring negative psychological effects, moral dissatisfaction, sleep disturbances, depressive states.
- Metabolic disorders in the body, dysfunction of digestive organs, especially the exocrine functions of the liver and pancreas.
- Disease or dysfunction of the endocrine glands (hypothalamus, thyroid, parathyroid and thymus, endocrine activity of the pancreas).
- Immune system disorders (allergic reactions and immune disorders).
course of disease
Psoriasis is a chronic disease, usually characterized by an undulating course, with periods either spontaneously or due to remission or improvement by some therapeutic effect, and due to adverse external influences (drinking alcohol, concurrent infections, stress)Spontaneous phase or relapse phase or exacerbation phase.
What are the most common misconceptions about this disease?
- Psoriasis is contagious. No, psoriasis is a chronic, non-contagious skin disease that does not spread from person to person or move from one part of the body to another. People with psoriasis have free access to public places - baths, saunas, swimming pools, use common household items, and receive non-dermatological treatments in general hospitals.
- The climate can affect the incidence, and if you move to a warmer country, psoriasis won't appear. No, climate does not affect the prevalence of psoriasis. At the same time, one of its treatments is tanning therapy - treatment with sunlight and sea water, however, living in a region with a warm marine climate does not protect the patient from deterioration. Israel is a simple example: they successfully treated psoriasis at the Dead Sea resort, but the incidence in the population is not lower than the world average.
- Psoriasis is preventable. The factors that lead to exacerbation, either by themselves or in various combinations, are the cause of the disease. It is not known what the initial impetus for the development of psoriasis is, so preventive measures are not possible. There is no recipe for what to do, or, conversely, what not to do in order not to get psoriasis. When there is no rash on the skin, the period of remission can be increased by avoiding the action of factors that trigger or worsen the course of psoriasis, leading a correct lifestyle, and using supportive care.
There are several scales for assessing the severity of psoriasis. Assessment of disease severity is usually based on an assessment of the following factors: lesion area (percentage of body surface involved in the process), degree of disease activity (degree of redness, swelling, congestion of psoriatic plaques or pustules, severity of pruritus, degree of skin thickening, degree of peeling, presence of bleeding or oozing, secondary infection of plaques, degree of joint swelling and tenderness), presence of general symptoms of process activity (eg, increased fatigue, increased ESR, uric acid in blood tests)elevated levels, etc. ), the patient's response to previous treatment attempts, the impact of the disease on the general condition and the patient's daily life, on his social functioning.
Symptoms of Psoriasis
People with psoriasis develop dense areas on the skin that appear white, red, or silver due to the dense growth of skin cells. In a healthy person, the development of skin cells occurs gradually, and their shedding occurs about once a month. Therefore, new cells gradually move to replace the old cells in the top layer of the skin.
In people with psoriasis, new cells develop much faster: Instead of a few weeks, they form in a few days. Therefore, during this period, the upper skin cells do not have time to die, so the main symptoms of psoriasis - the layering and the formation of plaques on the skin - appear. These plaques vary in size in people with psoriasis. Their manifestations have been observed on different parts of the body - scalp, knees, hands, elbows, lower back. Most of the time, symptoms of psoriasis occur in adults, but the disease can manifest in children and adolescents.
The first symptoms of psoriasis can appear at any age -- whether it's in a two-month-old child or the elderly. However, psoriasis most commonly occurs in people between the ages of 20 and 40.
It develops in the context of active skin contact, progressive psoriasis with certain irritants already present, especially sun rays or specific creams, as well as other types of irritants that affect plaque. These patches, in turn, became more convex in shape, became cherry red in color, and formed high temperature zones within the surrounding area, so the sharp boundaries became somewhat blurred. The band takes on a wrinkled appearance as the plaque fades.
This form of psoriasis is characterized by an excessively severe exudate during the inflammatory response, which occurs in the advanced stages of the psoriasis course. The exudate reaches the surface of the pimple, saturating the accumulated scales, resulting in a crust-like structure on the outside.
Symptoms of guttate psoriasis appear suddenly and are characterized by the formation of multiple spots within the skin. Most diseases are diagnosed in patients between the ages of 8 and 16. Often, streptococcal infection is a factor that precedes guttate psoriasis.
This form of the disease is manifested by mild infiltration of the components of the rash (in the general definition, infiltration is the impregnation of tissue with one or another substance). In turn, they look like spots (rather than pimples). Spotted psoriasis usually develops rapidly and is also characterized by similarities to topoderma. As the main technique for disease identification, the correspondence of the disease process with its characteristic psoriatic triad was used.
This form of the disease can be considered a symptom of severe infiltration of plaques, their general cyanosis, with hyperkeratotic or verrucous surfaces. Lesions of this type are particularly difficult to cure, and their future transformation into malignancy cannot be ruled out (this is a rare occurrence, but unfortunately, this option cannot be ruled out).
As the name suggests, this form of psoriasis occurs in people with seborrhea who have been associated with them. The disease manifests on the scalp, the area behind the pinna, the chest, the nasolabial fold area, and the subscapular and scapular parts of the back. The psoriatic scales that appear are strongly impregnated with sebum, so they stick together and remain within the surface of the plaque, making the disease mimic the picture features of seborrheic eczema.
The disease can manifest itself in the form of ordinary psoriatic plaques and papules, or in the form of hyperkeratotic formation that mimics calluses and calluses. In some cases, the symptoms of psoriasis on the hands, in this case on the palms (or on the legs - respectively, on the soles of the feet) are continuous in the form of thickening or increased keratinization. Such lesions are characterized by clear borders, and in rarer cases, this form of psoriasis is limited to the appearance of large annular exfoliations.
The process of diagnosing psoriasis is not particularly difficult and is based on studies of the appearance of a patient's skin features. There are usually no laboratory tests or specific studies for psoriasis. However, in some cases of progressive severe psoriasis, blood tests are still required to detect inflammatory, autoimmune, rheumatic processes.
What Psoriasis Looks Like: Early Photos
The main component of psoriasis is a single pink or red papule covered with a large number of loose silvery white scales. An important diagnostic marker is the triad of psoriasis: stearic staining, terminal membranes, and speckle hemorrhages when the scales are scraped.
Quality of life in patients with psoriasis
Psoriatic plaques on exposed areas of the arms or legs may prevent people from doing certain jobs, participating in certain sports, caring for family members, pets, or households. Psoriatic plaques on the scalp often cause specific psychological problems for sufferers and can create enormous stress and even social phobia, as pale patches on the scalp can be mistaken for the result of dandruff or lice. Greater psychological problems are caused by psoriatic rashes on the skin of the face, earlobes. Treatment of psoriasis can be expensive, requires a lot of time and effort, and interferes with the patient's work, school, social, and personal life arrangements.
Treating Psoriasis at Home
Psoriasis is a chronic disease. Its treatment involves the use of initially milder drugs and methods, and in the future, appointments can be changed based on observations of the patient's disease progression. The goal of treatment is to get a positive result, making the rash disappear and not appear for as long as possible. In some cases, psoriasis does not require any treatment.
Questions about how to treat psoriasis at home should be divided into 3 main categories: internal medicine, mainly medicine, topical (ointment, etc. ) and physical therapy. Minor is more commonly used as an adjunct to the treatment of psoriasis.
No matter which psoriasis treatment a dermatologist chooses, the greatest effect is to address the problem through a comprehensive approach that includes:
- use external means;
- Use of drugs, vitamins, dietary supplements;
- connection to physical therapy procedures;
- Treatment in sanatoriums with mineral water, mud, leeches;
- Schedule a diet to treat hunger.
When prescribing treatment, physicians must take into account a wealth of data about patients:
- the complexity of disease development,
- function of digestive organs
- metabolic disorder
- accompanying disease,
- study the function of the nervous and endocrine systems,
- environmental impact,
- genetics, etc.
- Hepatoprotective drugs;
- energy adsorbent;
- non-steroidal anti-inflammatory drugs;
- Biological product.
Hormonal drugs are used in complex stages of disease. Use only as directed by your doctor. In other cases, their use is not recommended. Since they are addictive, while they cause quick effects, they don't last long. In addition, hormonal drugs have many side effects.
In the case of mild forms of this pathology, it is sometimes possible to get rid of its symptoms only by external means. The pharmaceutical market is simply flooded with such drugs. Now, some of them will catch your attention:
- Naftalan ointment is used in the quiescent and regressive phases of this pathology.
- Glucocorticoid drugs can reduce the inflammatory process, however, they are not intended for long-term use.
- Salicylic acid ointment helps soften the skin's horny scales and removes them quickly.
- The 5% and 10% sulfur tar ointments help reduce inflammatory processes in the skin and should not be used by exudative patients.
- Psoriasis ointments containing vitamin D are quite powerful anti-inflammatory and help make the treatment of this pathology more effective.
One of the treatments for psoriasis is phytochemical therapy, which involves the use of ultraviolet light.
This is the therapeutic effect of long-wave ultraviolet radiation combined with special medicines for the most severe forms of psoriasis, which are difficult to respond to other treatments.
Distributes up to 25 exposures evenly in mild mode. The system includes summer vacations, a maximum of two courses in the first year, etc. , on the recommendation of a doctor. Relapses may occur after influenza, SARS or tonsillitis, and in rare cases after neurological shock.
Innovative Treatments - A New Approach to Treating Psoriasis
Surgical treatment of psoriasis
It has long been shown that after a diagnosis of cutaneous psoriasis, treatment with topical preparations alone does not achieve the desired results. For several years, surgeons have been performing a unique procedure that surgically repairs the valve in the small intestine, protecting this part of the intestine from pathogenic bacteria. After surgery, the protective ability of the immune system was strengthened, the skin healed and long-term relief was observed.
Narrowband UVB therapy using a wavelength of 311 nm
More recently, this approach has been used as monotherapy. Compared to other UV exposures, this method has minimal side effects, is well tolerated, and is a short-acting technique - 1 procedure takes only a few minutes, and the course of treatment is 2. 5 months. Significant clinical improvement and long-term remission up to 2 years in such a short time.
List of products that form bases in the body:
- Any vegetables except rhubarb, squash, and Brussels sprouts. It is important to remember that potatoes, peppers, eggplants and tomatoes are strictly prohibited.
- Fruits are not excluded. The main thing is to avoid plums, cranberries, currants and blueberries. It is worth noting that bananas, melons and apples should not be eaten at the same time as other products.
- Be sure to drink fresh vegetable juices made from carrots, beets, parsley, celery, and spinach.
- You can drink the juices of grape, pineapple, pear, orange, papaya and grapefruit, mango, lemon and apricot every day. It is important to add lecithin and lemon juice to food.
Psoriasis Week Menu
Consider a one-week sample menu recommended for exacerbations, relapses, and prevention during times of risk.
- Breakfast: Fresh cabbage salad, a slice of whole grain bread, green tea.
- Second breakfast: 2 hard boiled eggs, toast, dried fruit preserves.
- Lunch: Broccoli Soup, Whole Wheat Bread, Second Serving - Buckwheat Porridge with Mushrooms or Vegetables, Green Tea.
- Dinner: A little unsweetened cheese and sour cream, kefir.
the next day
- Breakfast: cucumber tomato salad, apple, green tea.
- Second breakfast: one slice of brown bread with butter, 1
- Boiled eggs, green tea.
- Lunch: Meatless cabbage soup, a slice of brown bread, green tea. Dinner: An apple, a glass of fermented baked milk.
- Breakfast: fruit salad with yogurt, gooseberry compote.
- Second breakfast: vegetable salad, a slice of whole-wheat bread, green tea.
- Lunch: Poached fish (perch, catfish) with a pinch of salt, a slice of whole-wheat bread, candied gooseberries.
- Dinner: yesterday's buns, gooseberry compote.
- Breakfast: Cucumber egg salad with sour cream, whole grain toast, apple juice.
- Second breakfast: 2 bananas, 1 cup fermented toasted milk or kefir.
- Lunch: A cup of broth, a piece of boiled meat, cucumber and tomato salad.
- Dinner: A slice of whole-wheat bread with butter, a cup of kefir.
- Breakfast: carrot salad, whole grain toast, green tea.
- Second breakfast: boiled fish (not red).
- Lunch: river fish soup, a slice of whole wheat bread, green tea.
- Dinner: yesterday's buns, a cup of yogurt.
- Breakfast: water oatmeal, a piece of bread with bran, green tea.
- Second breakfast: cheese with fruit (bananas, apples, apricots), kefir.
- Lunch: Meatless pea soup, a slice of bread (optional), an apple.
- Dinner: a glass of kefir.
- Breakfast: Buckwheat porridge with milk and kefir. Second breakfast: a sandwich with butter and a piece of boiled meat, apple juice.
- Lunch: meatball soup, green tea. Dinner: 2 apples.
Proper nutrition will help avoid frequent relapses. To choose a personal diet, you will need to contact a nutritionist.
folk remedy for disease
All treatments can be conditionally divided into oral and topical agents.
Oral prescription drugs
To cleanse the skin and eliminate the main symptoms of psoriasis, the following recipes are recommended:
- Use flax seeds. To prepare the product, pour one tablespoon of seeds into a glass of boiling water and mix thoroughly. The drug should be infused for at least 12 hours. It is best to leave the medicine overnight. Take on an empty stomach in the morning.
- Dill seeds. Plant seeds in 2 tablespoons. l. Pour in a glass of boiling water and hold for 2-3 hours. After taking the medicine, you need to filter and take half a cup 2-3 times a day.
To remove plaque and cleanse the skin, use the following recipe:
- Treat lesions with flaxseed oil. You can apply the oil 5-6 times a day.
- Ointment based on tar and propolis. For cooking, you need to take 50 grams of tar and 30 grams of propolis. The product must be heated in a water bath and mixed thoroughly. After cooling, apply the ointment to the patches 3-4 times a day.
Psoriasis Treatment: Hydrotherapy
In the regression phase of psoriasis, balneotherapy is prescribed.
- Climotherapy is the use of climatic factors, the body's natural biostimulants, for medicinal purposes.
- Air therapy is accommodation prescribed and supervised by a doctor, sleeping in fresh air, air bathing.
- Hyperthermia is a type of thermal therapy that includes methods such as mud, paraffin, ozokerite and clay therapy, shamo and naftalanotherapy.
There is no specific preventive measure for psoriasis, but after the onset of the disease, sedatives, a course of vitamin therapy and correction of the disease causing the recurrence are required.
What is the forecast?
Since psoriasis is a chronic disease with no complete cure, the prognosis is conditional. It progresses slowly, and prompt and adequate treatment only improves quality of life, but does not eliminate the disease itself.
During exacerbations, the ability to work is lost. It can lead to disability without adequate medical care.