Psoriasis - what is this disease?

Despite the fact that psoriasis is a common and well-known disease, it is still not fully understood. And most often, patients do not know at all that psoriasis is not a bacterial infection or fungus, but a non-standard reaction of the immune system, which is caused by unknown reasons. Information about the causes and symptoms of psoriasis will be very helpful for patients as it will help overcome the disease.

What is this disease?

Squamous lichen is another name for psoriasis, and this name describes this disease perfectly. Psoriasis is manifested by the formation of inflamed plaques of various sizes on the skin, they are densely covered with thick scales.

Certainly, almost everyone has heard of a disease like psoriasis. And this is not surprising, because scaly lichen is quite widespread. This disease is diagnosed in 4-10% of the world's population. Additionally, statisticians who collect information on the prevalence of psoriasis claim that the number of patients is steadily increasing.

Scaly lichen has been known to people since ancient times, even healers in ancient Greece tried to treat this disease. The modern history of the study of psoriasis dates back to about 150 years. But during this rather important period, researchers managed to not know enough about the causes and treatment of psoriasis.

Large prevalence, uncertainty of etiology (causes of occurrence), insufficiently effective treatment - all of this characterizes psoriasis as one of the most difficult problems in dermatology.

Today, dermatologists regard psoriasis as a complex systemic disease associated with disorders of the immune system, with dysfunction of metabolic processes and the appearance of trophic disorders. These failures lead to specific skin changes.

Therefore, answering the question of what psoriasis is, a modern dermatologist will answer that these are disorders of trophism and metabolic processes of the skin caused by dysfunction of body systems. Today, two theories about the etiology of psoriasis are considered the most likely: genetic and viral.

• The genetic theory has many supporters, as psoriasis often acts as a hereditary or familial dermatosis. Careful study of the patient's family history in 60-80% confirms the presence of psoriasis in one form or another in relatives of the patient. However, in some patients it is not possible to confirm the fact of the hereditary origin of psoriasis. This circumstance is the reason for the distribution of these cases in a special group, in which the main reason is not genetic, but phenotypic failures.
• The viral theory that psoriasis develops as a result of 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 under certain conditions.

There are other theories that explain psoriasis. For example, endocrine, neurogenic, metabolic, etc. Of course, all of these theories are not without merit, and their study provides more important information about the disease of psoriasis. However, today it is already known for sure that the state of the endocrine and nervous systems, as well as the work of the gastrointestinal tract, do not cause psoriasis, but have a significant impact on the course of this disease.

For example, pathologies affecting the liver lead to the fact that the quality of blood purification performed by this organ is greatly reduced. And this, in turn, can provoke the appearance of various skin appearances, including psoriasis.

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc. ) lead to the fact that the tissues of this organ are reborn, that is, the liver is gradually replaced by connective tissue. As a result, the liver ceases to cope 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 possible.

There is also an inverse 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 so as not to overload the liver. Patients are advised to limit fatty foods, completely eliminate alcohol.

So, despite numerous studies, it has not been 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.

International classification

Psoriasis disease manifests itself in various forms. To facilitate specialist navigation, a generally accepted classification of psoriasis is used.

Addition of psoriasis to the International Classification of Diseases (ICD). To date, 10 revisions of the International Disease Registry are already in use, which is why the abbreviation ICD 10. Work began on 10 revisions of the International Disease Classifier in 1983 and was completed in 1987.

In essence, the ICD 10 is a standard assessment tool used in medicine and health administration. The Manual in Revision 10 is used to monitor the prevalence of various diseases and other health problems in the population.

Using version 10 of the ICD, it is possible to compare morbidity and mortality data in different countries, thus obtaining statistical data and systematizing diagnostic information. With the agreement of WHO members, ICD 10 is used to assign codes to various diseases. In the 10th version of the classifier, alphanumeric codes are adopted, with the help of which it is convenient to store information in electronic form.

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

• Ordinary psoriasis(synonyms: vulgar, simple, plaque-shaped). The disease was coded according to ICD 10 - L-40. 0. This is the most common form, it is observed in 80 to 90% of patients. The main symptoms are the formation of raised plaques above the surface of the unchanged skin, covered with white-gray skin scales. This form is characterized by a slight flaking of the scales. After their removal, the inflamed red skin opens, which is very easily injured and begins to bleed. As the inflammatory process progresses, the size of the plaques can increase significantly.
• Reverse psoriasis. It is a disease that affects the folds of the skin (the surfaces of the flexors). For this form of disease, the code L83-4 is adopted in ICD 10. Dermatosis appears with the formation of folds on the skin of smooth or slightly scaly spots. Deterioration is observed when the skin is injured by friction. The disease is often complicated by an associated strep infection or fungus.
• Guttate psoriasis. This form of psoriasis is characterized by the formation on the skin of a large number of small red or purple spots, in the form of water droplets. According to version 10 of the international classifier, such a disease was assigned the code L4. Most often, guttate psoriasis affects the skin of the legs, but rashes can occur on other parts of the body. At the same time, it is known that guttate psoriasis develops as a complication after streptococcal infections - pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasisis ​​a severe cutaneous form, according to ICD 10, the codes L1-3 and L 40. 82 have been assigned to it. It is characterized by the formation of blisters or pustules. The skin of the lesions is edematous, red, inflamed, peels off easily. If fungi or bacteria enter the pustules, the contents of the pustules become purulent. Pustular psoriasis often affects the distal extremities, but in more severe cases a generalized process can develop with the rash spreading throughout the body.
• Psoriatic arthritis or arthropathic psoriasis. According to version 10 of the ICD pathology, the code L5 was assigned. It manifests as inflammation of the joints. Arthropathic psoriasis can affect all types of joints, but in most cases the joints of the phalanges of the toes and hands become inflamed. The knee, hip, or shoulder joints can be affected. The lesions can be so severe that they will result in disability of the patient. Therefore, you should not think of psoriasis as an exclusively skin disease. Severe types of psoriasis can lead to systemic damage, disability or even death to the patient.

• Erythrodermic psoriasis. A rare but severe type of psoriasis, according to ICD 10, this disease was assigned the code L85. Erythrodermic psoriasis often manifests itself in a generalized way, all or most of the skin surface can penetrate the affected area. The disease is accompanied by severe itching, swelling, pain.
• Psoriatic onychodystrophy or nail psoriasis. According to version 10 of the ICD, the disease was assigned the code L86. The pathology is manifested by changes in the appearance of the nails on the toes and hands. The nails can change color, get thicker, and start to deteriorate. Complete nail loss is possible.

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

• Localized psoriasis is a disease in which less than 20% of the skin is affected;
• widespread psoriasis affects more than 20% of body surface area;
• if almost the entire surface of the skin is affected, it is called universal psoriasis.

If we consider all types of disease, common psoriasis is more common than other forms.

Flow steps

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

The following is characteristic of the progressive stage of psoriasis:

• the appearance of new skin rashes;
• growth of already existing plaques;
• the appearance of new elements of the rash at the site of the skin lesions (scratches, abrasions);
• Extensive scaling of existing plates.

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

• no new element appears;

• moderate peeling of the elements;
• no signs of growing elements.

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

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

• decrease in coat intensity;
• element resolution.

After the psoriatic plaques resolve, the hypo- or hyperpigmented spots remain in their place.

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

• winter (worse in autumn and winter);
• summer (with exacerbations during the hot period);
• Out-of-season psoriasis is the most serious type, as there is no clear link between relapses and the seasons of the year, periods of remission may be virtually absent.

Diagnostic functions

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

For example, psoriasis of the nails is often confused with nail fungus, because the external manifestations at an early stage of these diseases are very similar. However, nail fungus and psoriasis are completely different in nature, so treatment should be different.

A layman may confuse psoriasis and fungus with fungus. Since yeast infection of the skin (skin fungus) is manifested by similar symptoms - the formation of scaly patches. Therefore, having noticed any suspicious symptoms on the body or the nails, you do not need to diagnose yourself and read more to treat the fungus with the help of drugs or folk remedies.

If the diagnosis is wrong, and in fact the cause of the onset of symptoms is not fungus, but psoriasis, treatment will not be beneficial, but will make symptoms worse.

By contacting a dermatologist, an analysis will be made for fungi, a scraping will be taken from the nail or skin. Then the resulting material is placed in a nutrient medium. If the fungus is present in the material, a large colony will develop in the test sample after a few days. By the appearance of the material, it will be possible to understand what type of fungus caused the infection.

Sometimes psoriasis is complicated by adding secondary infections, it could be a bacterial infection or a fungus. Therefore, when the clinical picture changes (appearance of purulent discharge, discoloration of plaques, etc. ), patients should periodically be tested for fungi and other infectious agents.

In the diagnostic process, a certain role is attributed to a set of phenomena called the psoriatic triad. The phenomena appear sequentially, when scratching the element of the rash.

The psoriatic triad appears like this:

• when scratching the rash element, the scales are removed as "chips";
• After removing the chips, a thin transparent film similar to polyethylene opens;
• when the film is damaged, a point bleed opens.

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

Interesting facts about psoriasis

People have known about psoriasis for a long time. Even the very name of the disease has come in our language from ancient Greek. In the days of the prosperity of ancient Hellas, the word "psora" referred to all skin diseases that manifested as flaking and itching.

The first person to write a comprehensive treatise on psoriasis was a Roman named Cornelius Celz. In the fifth volume of his work "De medicina", there is a long chapter on this disease.

They knew about psoriasis, but it has not been unambiguously evaluated, as it was called, sometimes "imperial" disease, sometimes "evil".

Of course, the ancient healers knew very little about psoriasis. Until the 19th century, this disease was often associated with other skin conditions. For the first time, psoriasis was identified as an independent nosological form in 1799. This was done by the English dermatologist Robert Villan, who distinguished psoriasis from a large group of skin diseases, manifested by itchingand peeling.

Not only ordinary people, but also prominent politicians knew about psoriasis firsthand. For example, Winston Churchill, who suffered from this disease, promised to erect a monument of pure gold to a person who can learn all about psoriasis and provide effective treatment for this disease.

Modern understanding of the disease

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

Here are some facts about psoriasis that are beyond doubt:

• Despite the fact that the causes of the disease are not clear, it was possible to find out the nature of psoriasis. This disease is autoimmune, that is, it is caused by a dysfunction of the immune system;
• Another established fact about psoriasis: the disease can be inherited. 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 his relatives is sick;
• An interesting fact about psoriasis is that this disease is characterized by Kebner's phenomenon. This phenomenon is manifested by the fact that the elements of the rash are formed at the sites of skin damage - scratches, burns, frostbite. Sometimes psoriasis appears after a while at the site of the scars;
• An important observation that allows you to get more information about psoriasis is the relationship of this disease with climatic factors. Exacerbations and relapses are often timed to coincide with the change of season;
Patients
• have probably noticed the link between exacerbations and stress in practice. All patients should know for sure that the disease returns or worsens its course amidst nervous tension and experiences;
• a new fact about psoriasis is that the disease can begin at any age, although it was previously thought that scaly lichen occurs after 30 years;
• it is important for everyone to know that psoriasis is not a contagious disease. Even with close contact with the patient, there is no risk of infection;
• almost everyone has heard of the incurability of psoriasis, and it is true, because no treatment has been found that can guarantee the victory of the disease. But patients should know that psoriasis can be controlled. Adequate and prompt treatment allows for long-term remission.

Modern methods of treatment

Speaking of the common disease of psoriasis, one can only talk about the treatment of this common disease. It must be said that it is impossible to cure psoriasis only with tablets or ointments.

To forget about the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will have to make an effort. It will be necessary to properly organize the food. Some experts claim that it is possible to forget about psoriasis forever only with the help of a properly formulated diet and regular cleansing of the body.

The doctor will draw up a preliminary schedule for the treatment. As a rule, both external (ointments, creams) and systemic (tablets, injections) therapy methods are used. In addition, physiotherapeutic methods will be used and treatment in resorts is recommended. Psoriasis is recommended to be treated with healing mud, mineral and thermal water.

Stations may also offer non-traditional treatment methods. For example, with the help of fish that live in hot springs. These little healers effectively remove dead dander and disinfect the skin, promoting its fastest healing.

May offer other scaly lichen treatments at resorts. For example, leech therapy, baths and healing applications, solar therapy, etc.

You should be prepared that the regimen will change periodically. Since not all methods are suitable for a specific patient. If the selected treatments do not work, they will need to be replaced.

Alternative treatments for psoriasis are also widely advertised. Indeed, some of them can help to achieve remission. However, when choosing a method, you need to remember common sense so as not to harm your health. If a recipe or recommendation is in doubt, it is best not to use it. Consult a physician before using any method of treatment.

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