Psoriasis is a common non-infectious skin disease associated with inflammatory lesions. It is chronic - after the acute period there are periods when the symptoms disappear or disappear, and it is caused by a combination of different factors.
The disease is widespread and occurs more frequently in women than in men. It is not completely curable, but it is possible to eliminate the symptoms and improve the patient's quality of life.
Psoriasis can cause arthritis, which is an inflammation of the joints.
Synonyms in Russian
Paid lichen.
English synonyms
Psoriasis.
Symptoms
Symptoms and signs of psoriasis depend on the type of psoriasis.
- Plaque psoriasis. Accompanied by special inflammatory skin formations - raised, oval, sharply drawn reddish lesions, covered with crusts and silver scales. Formations are often seen on the elbows, knees, scalp, and torso. 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 species is associated with the appearance of numerous orange-pink papules (nodules) 1-10 mm in size on the body. The rash is usually seen on the body, shoulders and thighs, but can be found anywhere on the body. As a rule, people under the age of 30 are also affected after superficial bacterial infections in the anus, 2-3 weeks after suffering from infectious diseases of the upper respiratory tract.
- Psoriasis of the nails. It is characterized by compression, abrasion, discoloration, discoloration of nails, yellowing of nails, the presence of stains on them, the formation of holes, cracks, damage to the nails. Nail plates are destroyed, nail growth is impaired, can be separated from the nail bed. It is found in 30-50% of patients with psoriasis.
- Psoriasis of large wrinkles. In this case, skin lesions in the form of red inflammatory spots appear in the area of the armpit folds, under the mammary glands, in the cervical folds, in the genital area, in the foreskin. Cracks may appear at the edge and center of the lesions. Large psoriasis often occurs in overweight and obese people. Sweating and friction aggravate the disease.
- Psoriasis of the head. Reddening of the scalp, itching, accompanied by staining of the scalp with the appearance of white scales - particles of dead skin on the hair and shoulders.
- Psoriatic arthritis. Skin lesions are accompanied by joint pain, swelling, curvature and deformity of the joints. There may be seizures of the fingers, wrists, feet, and knee joints.
- Pustular psoriasis. This type is characterized by reddening of the skin and the formation of numerous pustules - small blisters filled with pus. The shapes can appear on the palms and soles of the feet or all over the body. When many pustules appear on the body, fever and weakness combine.
- Psoriatic erythroderma. Redness and plaques may appear on the skin. Lesions are usually accompanied by severe itching. Psoriatic erythroderma is often associated with sunburn or drug abuse.
Usually, different types of psoriasis manifest themselves gradually, skin lesions spread and are observed within a few weeks. Then the symptoms disappear. After exposure to a factor that contributes to the development of psoriasis (or spontaneous), the symptoms reappear after a while.
General information about the disease
Psoriasis is a common non-infectious skin disease associated with inflammatory lesions.
It is chronic and often recurrent - after an acute period there are periods of weakening or disappearance of symptoms, and then after a while the symptoms reappear.
Psoriasis is especially common among people aged 16-22, 57-60. Women are more sensitive to this than men. People with light skin are more at risk of developing the disease.
Although psoriasis is synonymous with lichen scales, it is not completely contagious to others.
The causes of psoriasis are not yet fully understood. Appearance is associated with a genetic predisposition, immune system malfunctions and environmental factors that affect the body.
The development of psoriasis is associated with one of the cell types of the immune system (T-lymphocytes), T-cell hyperactivity is observed. They normally travel through the body with the blood, detecting foreign agents - viruses and bacteria. In psoriasis, T cells begin to accumulate in the skin for unknown reasons. Their hyperactivity causes the blood vessels in the affected area to dilate, disrupting the cycle of new skin cells - forming faster than usual. Dead skin cells do not have time to erode and accumulate on the surface of the skin, forming plaques.
Psoriasis can be triggered by one of the following factors:
- infections (tonsillitis, swabs, HIV);
- skin damage - cut, scratch, bite or burn;
- hypothermia;
- sunburn;
- emotional stress;
- smoking, alcohol abuse;
- 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. The most common.
- Guttate psoriasis. It usually affects people under the age of 30. Occurs 2-3 weeks after transmissible infectious diseases of the upper respiratory tract, as well as superficial bacterial infections around the anus.
- Psoriasis of the nails.
- Psoriatic arthritis. Skin lesions in this type of psoriasis are accompanied by arthritis - inflammation of the joints.
- Psoriatic erythroderma. It is often associated with sunburn and drug abuse.
- Pustular psoriasis. Rarely, in severe cases, threatens the patient's life.
- Psoriasis of the head. In this case, the hair loss caused by the disease does not occur at all, because the hair follicles are located 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 do not cover more than 3-10% of the skin surface);
- severe psoriasis (more than 10% of the skin is affected).
Depending on the type, location and degree of psoriasis, complications can occur:
- thickening of the skin, the addition of a secondary infection through scratches and scratches caused by itching with psoriasis;
- psychological problems (stress, low self-esteem, depression, social isolation);
- joint damage (rigid deformation and reduced joint mobility);
- Risk of developing various diseases and conditions: high blood pressure, inflammatory bowel disease, cardiovascular disease, skin cancer.
Psoriasis is generally relatively mild. However, for most patients, social adaptation becomes a major problem, especially when there are skin lesions in visible areas of the skin - hostility to the type of skin lesions of others, fear of infection (many do not know the disease is not contagious).
Who is at risk?
- People with a genetic predisposition (more than 40% of patients with psoriasis suffer from a relative disease).
- People with viral, bacterial, fungal infections (streptococcus, sore throat, HIV, etc. ).
- Emotionally stressful.
- Overweight and obese people.
- Smokers.
- Those who use alcohol.
- Take certain medications (antimalarial drugs, etc. ).
- Sunburn.
Diagnostics
The diagnosis of psoriasis is usually based on the type of lesion, taking into account their location. In severe cases, additional tests may be required to rule out other skin conditions.
Laboratory research
- General blood test. With psoriasis, leukocytosis and anemia can be detected.
- Rheumatoid factor (RF) is an increased protein in the blood, especially in systemic inflammatory diseases accompanied by joint damage in rheumatoid arthritis. The test result for psoriasis is negative. This makes it possible to distinguish psoriasis from rheumatoid arthritis, in which RF is increased.
- With the exception of pustular psoriasis and psoriatic erythroderma, erythrocyte sedimentation rate (ESR) is generally normal.
- Uric acid. In psoriasis, uric acid levels can rise (especially in pustular psoriasis), which can be confused with gout, where uric acid concentrations increase significantly.
- Antibodies to HIV (Human Immunodeficiency Virus). The sudden onset of psoriasis may be due to HIV infection.
Other research methods
- Radiography of joints. Allows you to assess the severity of joint injury in psoriatic arthritis.
- Skin biopsy. The examination involves taking a small sample of skin for examination under a microscope. It is used in difficult cases to distinguish psoriasis from other skin diseases.
Treatment
Therapy for psoriasis is the local treatment of skin lesions, medications, phototherapy, prevention of the effects of factors that cause the appearance of rashes. It depends on the type and severity of the psoriasis.
Emollients (creams, petroleum jelly, 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, anthraline, resin preparations, ointments, solutions, shampoos with charcoal resin are also used. These substances have an anti-inflammatory effect and slow down the formation of new skin cells.
The use of corticosteroid ointments makes treatment more effective. Indicated for mild to moderate psoriasis. However, their long-term use is not recommended (skin atrophy, drug dependence is possible).
Light therapy - exposure of the skin to ultraviolet radiation may be beneficial. In this case, it is necessary to prevent burns.
In more severe cases, local treatment of lesions is combined with medication - retinoids, vitamin D supplements, methotrexate, etc.
Psoriasis can be difficult to treat because the disease becomes chronic and recurs after the symptoms have disappeared. The effectiveness of a particular treatment method depends on the patient's sensitivity to it.
Daily baths (bath oil, oatmeal or sea salt are recommended; hot water and palms should be avoided) and post-bath hydration can soften the skin and reduce psoriasis inflammation.
Prevention
- Avoid hypothermia and sunburn.
- Avoid emotional stress if possible.
- Quit smoking and alcoholism.
- Take certain medications (antimalarial, 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)