Psoriasis - symptoms and treatment

PsoriasisIs a chronic disease that affects the skin, sometimes the nails, joints and internal organs. It is manifested by itching and the appearance of pink-red rashes - papules, which may merge into larger patches. These papules rise above the surface of the skin. They are covered with silvery scales that peel off easily when peeling.

psoriasis on the skin

Quite often, the disease is associated with impotence, accelerated ejaculation and Reiter's syndrome. With extensive psoriasis, psoriatic arthritis can occur.

Risk factors

Causes of psoriasishave not yet been fully identified. Risk factors for the development of the disease include:

  • microbial factor - various types of fungi, mycoplasmas;
  • neuropsychic trauma, stress;
  • endocrine diseases - diabetes mellitus, thyroid disease;
  • foci of chronic infection, especially streptococcal;
  • immunodeficiency states;
  • lipid and protein metabolism disorders;
  • injuries to the skin and joints.

Is psoriasis transmitted?

Psoriasis is not contagious. Many researchers pay attention to the familial nature of psoriasis and recognize its genetic nature. In addition, it is not the disease itself that is inherited, but a predisposition to it.

If you notice similar symptoms, see your doctor. Don't self-medicate - it's dangerous for your health!

Symptoms of psoriasis

The first symptoms of psoriasis:rashes in the form of bright pink patches with a scaly surface. The plaques are unique, rise above the level of healthy skin, are located on the elbows and in the popliteal fossa.

Most often, psoriatic plaques appear on the skin of the knees, elbows, chest, abdomen, back and scalp, but with the progression of the disease they can appear in any othermost unexpected place of the seed coat.

where is psoriasis located

Initially, the papules are small - 3-5 mm, the color is bright pink. Growing larger, they become covered with silvery scales and merge into larger formations called plaques.

overgrowth of psoriatic papules

As a rule, the fresh elements of the papules are brightly colored, up to red, the "old" ones are more faded. At the initial stage of psoriasis, the edges of the papules do not peel off. They represent a hyperemic frontier -growth corolla. . .

the initial stage of psoriasis

The hallmark of psoriasis is the Auspitz triad. This triad can be observed by scratching the surface of the papule with a sharp object. It includes three phenomena:

  • stearin stain phenomenon- superimposition of a large number of silvery white scales, which easily separate when scratched;
  • symptom of psoriatic film- exuded surface, consisting of a thorny layer, which opens after having peeled off the lower layers of the stratum corneum;
  • blood dew phenomenon- exposure of the superficial capillaries in the form of small blood spots after detachment of the psoriatic film.
detachment of the psoriatic film

Signs of different types of psoriasis

Clinical types of psoriasis:

  • Spotted psoriasis- represented by weakly infiltrated pale pink spots. It looks like drug eruption.spotted psoriasis
  • Irritated psoriasis- occurs due to exposure of the skin to aggressive environmental factors (sun, cold, heat) and irritant drugs. The color of the plaque becomes more intense, it increases in size, rises more above the surface of the skin, a belt forms at the edges in the form of redness.irritated psoriasis on the body
  • Seborrheic psoriasis- often develops in patients with seborrhea. The clinical picture is very similar to seborrheic eczema. seborrheic psoriasis on the head
  • Exudative psoriasis- occurs quite often. This happens due to the excessive secretion of an inflammatory fluid - exudate. It permeates accumulations of scales, turning them into scabs of scales.exudative psoriasis on the body
  • Psoriasis of the palms and soles- is represented either by common plaques and papules, or by hyperkeratotic formations, similar to calluses and calluses.psoriasis of the palms and underside
  • Follicular psoriasis- a rare form of the disease. The rash consists of white miliary nodules with a funnel-shaped depression in the center.follicular psoriasis
  • Psoriasis of the mucous membranes- a rare form of the disease. It occurs on the mucous membrane of the mouth and bladder. It manifests itself in the form of areas of gray-white color with a red border.
mucosal psoriasis

Frequency of psoriatic manifestations

Cyclic exacerbations are characteristic of psoriasis. Most often they occur in autumn and spring.

Pathogenesis of psoriasis

cross section of skin in psoriasis

Dermatosis is an inflammatory process associated with the work of immune T cells. As a result of this inflammation, the proliferation of keratinocytes, the main cells of the epidermis, is accelerated.

mechanism of development of psoriasis

Psoriasis, a type of dermatosis, is a chronic inflammatory disease. It proceeds with the participation of microbial pathogens that can bind to the surface of the skin.

Everything that happens in the skin under the influence of the pathogen is a classic inflammatory reaction according to the principle of RTCDF:

  • Rubor - redness;
  • Tumor - tubercle, edema;
  • Calor - fever, fever;
  • Pain - pain;
  • Functia laesa - dysfunction.

Redness and thickening of the skin at the sites of injury, itching, increased keratinization followed by the formation of scales - all manifestations of the inflammatory process, a protective reaction of the body aimed at combating the microbial pathogen. Without timely outside help, the body is often defeated.

keratinization of cells in psoriasis

Some scientists adhere to the theory of a genetic predisposition to a violation of the process of cell division. With such a violation, there is an increased death and keratinization of cells, followed by their growth and the appearance of a large number of incompletely keratinized epithelial cells. But this theory does not contradict the above microbiology in any way.

Classification and stages of development of psoriasis

There is no generally accepted classification of psoriasis.

Traditionallythere are four types of disease:

  • vulgar psoriasis - seborrheic, follicular, verrucous, exudative, bullous, psoriasis of the palms and soles, psoriasis of the mucous membranes;
  • pustular psoriasis;
  • psoriatic erythroderma;
  • psoriatic arthritis.

According to ICD-10, there are:

  • L40. 0 Psoriasis vulgaris (patchy and plaque psoriasis);
  • L40. 1 Generalized pustular psoriasis (impetigo herpetiformis, Tsumbusch's disease);
  • L40. 2 Persistent acrodermatitis;
  • L40. 3 Palmar and plantar pustulosis;
  • L40. 4 Psoriasis tear;
  • L40. 5 Arthropathic psoriasis;
  • L40. 8 Other psoriasis;
  • L40. 9 Psoriasis, unspecified

Complications of psoriasis

Without timely and competent treatment, psoriasis begins to negatively affect vital organs and systems: joints, heart, kidneys and nervous system. These conditions can lead to disability and even death.

What is Psoriatic Arthritis

Psoriatic arthritis is the most serious form of psoriasis because it often leads to disability.

Doctors are most often faced with this complication. It occurs as a result of inflammatory changes in the joints.

psoriatic arthritistypes of psoriatic arthritis

The joints of the hands, wrists, feet and knees are the most affected. Over time, the disease can spread to the hip, shoulder, and spine joints. With progression, the muscles start to ache near the affected joints. Patients complain of stiffness in movement, especially in the morning. Their body temperature is often elevated throughout the day.

The clinical picture of psoriatic arthritis develops like ordinary arthritis: first there is pain, then swelling, stiffness and limited mobility. A characteristic symptom of this complication is a sausage finger. It appears due to the defeat of all interphalangeal surfaces.

pathogenic syndrome in psoriasis

Other complications of psoriasis

A little less frequentpsoriatic erythroderma. . .This condition occurs when the skin is completely affected. Patients fear itching and burning, profuse peeling of dead tissue, a strong reaction of the skin to a change in temperature.

psoriatic erythroderma

The next most common occurrence ispustular psoriasis. . .This complication is associated with the addition of a secondary infection - staphylococci and streptococci. Clinically, pustular psoriasis is accompanied by the appearance of pustules - pustules the size of a buckwheat grain. Pustules appear in different places. They rise above the surface of the skin, are characterized by rapid growth and a tendency to merge. In addition to existing symptoms, there is a high fever and signs of severe poisoning.

pustular psoriasis

Internal organ damagewith psoriasis are now extremely rare. As a rule, people who lead an antisocial life are sensitive to it. The genitourinary system is more often affected: the kidneys, the lining of the bladder and the urethra. This leads to the development of pyelonephritis, glomerulonephritis, cystitis and urethritis.

On the side of the heart, psoriasis can cause damage to the mitral valves, inflammation of the heart muscle and the outer wall of the heart - myocarditis and pericarditis. With damage to the nervous system, patients complain of a crawling sensation, increased irritability or depression, constant fatigue, drowsiness and listlessness.

Diagnosis of psoriasis

When to consult a doctor

It is necessary to consult a doctor at the first symptoms of psoriasis: the appearance on the skin of bright pink patches with a scaly surface.

Preparing to see a doctor

Three days before seeing a doctor, you should stop applying medicinal ointments to the skin. No other special training is required.

Psoriasis is such a recognizable disease that it won't be difficult to diagnose it based on outward signs. Often a diagnosis can be made to patients, as we say, "out of the box". If necessary, the doctor scratches the surface of the skin to detect the Auspitz triad.

OV Terletskiy, candidate for medical sciences, in collaboration with the coauthors, proposed a diagnostic scheme developed on the basis of data from the American Rheumatological Association. It includes the following exams:

  • complete blood count (with platelets);
  • general urinalysis;
  • blood chemistry;
  • acute phase reactions of the body - C-reactive protein and rheumatoid factor;
  • immunoglobulins - IgA, IgG, IgM, IgE)
  • complement binding reaction with gonococcal antigen and chlamydia;
  • the reactions of Wright and Heddelson;
  • coagulogram - assessment of blood coagulation;
  • blood test for borreliosis and toxoplasmosis (according to indications);
  • blood test for HLA.

However, there are many diseases under the guise of psoriasis. In this regard, it becomes necessary to conductdifferential diagnosis, especially between papular syphilis, Reiter's syndrome, neurodermatitis, rosaceous lichen, systemic lupus erythematosus and seborrheic eczema. To do this, use:

  • biopsy - pinching of a piece of skin with subsequent histological examination;
  • laboratory diagnostics - often used to distinguish psoriasis from papular syphilis;
  • blood tests for other hidden infections for better selection of antibiotics.
psoriasis diagnosis

Instrumental diagnostic methodsmainly used for complicated forms of psoriasis associated with damage to joints and internal organs. These include: x-rays of the joints, ultrasound of the heart, kidneys and bladder.

Psoriasis treatment

Is there an effective treatment for psoriasis

Despite the fact that psoriasis is a persistently recurring disease, it can be completely eliminated if you consult a dermatologist quickly, who can identify the true causes of psoriasis. Over the past decade, many drugs of systemic and local action have appeared, aimed at eliminating the cause and suppressing the mechanism of the development of the disease. Drugs that interact with each other using chemical signals (cytokines) have been proven to work. They eliminate the increased proliferation of skin creatinocytes.

Phototherapy

In 1994, the team of the dermatovenereology service of MAPO SPb introduced a method of treating psoriasis usingUFO blood- photomodification of blood with ultraviolet light.

The ability of sunlight to have a beneficial effect on the skin for many diseases, including psoriasis, has been known since time immemorial. At the start of the twentieth century, a group of German scientists suggested that since ultraviolet light has a healing effect on exposed skin, this effect is likely to occur when ultraviolet radiation is applied to blood. After all, it is also a kind of fabric. This hypothesis was confirmed by the first UV exposure session on blood, which was held in Germany in 1924.

The therapeutic effect of ultraviolet rays on the blood is associated with profound structural changes at the molecular-atomic level, which are captured by the immunocompetent organs - the liver, spleen, bone marrow and lymphoid tissue. These changes are seen by the organs as a warning signal and therefore produce tens of times more immune complexes. In this case, ultraviolet light is a kind of "whip" that forces the body to dramatically increase its defenses to fight disease.

ufo blood for psoriasis

It is also worth noting the PT effect -ultraviolet therapy. . . This method of treatment is important, given the chronic nature of psoriasis, associated with many complications of internal organs caused by a variety of microbial pathogens. The longer the microbes are in the body, the more their habitat expands. These microscopic creatures are capturing more and more anatomical areas through the blood and lymph flow. Once in the tissues, they strive to penetrate as deeply as possible into the intercellular spaces. There they form microcolonies, protected by the remains of dead and destroyed cells and a well of leukocytes. Because of this, microorganisms can be out of the reach of antibiotics for years. They easily make up for the lack of nutrients by entering a state of suspended animation - something between life and death.

The ability of ultraviolet rays helps destroy microbial "shelters". They create favorable conditions for the penetration of antibiotics and other drugs that affect the cause of psoriasis.

The cutaneous application of ultraviolet radiation is also relevant. The most well-known treatment method using this principle isPUVAtherapy. . . Although it is less effective than ultraviolet irradiation of blood. The therapeutic effect does not last long, a relapse may occur two weeks after the end of treatment.

puva therapy for psoriasis

Medical treatment

Among the drugs, the following worked well:

  • vitamin A derivatives, which reduce the rate of maturation of keratinocytes and normalize cell differentiation;
  • immunosuppressants that reduce the activity of T lymphocytes, which contribute to increased division of epidermal cells;
  • drugs for the treatment of malignant tumors which inhibit the reproduction and growth of atypical skin cells.

What ointments and creams are effective in the treatment of psoriasis

Ointments and creams with anti-inflammatory components will help alleviate the patient's condition.

How to treat scalp psoriasis

Ointments are not effective in treating scalp psoriasis. In addition to drugs and ultraviolet treatment, a special shampoo can be used.

How to treat psoriasis on the elbows and arms

Psoriasis of the elbows and arms is treated with the same methods as the rest of the body. The peculiarity of the course of psoriasis in this area is that the skin of the hands is subject to physical, mechanical and chemical influences, which is considered an aggravating factor in the course of the disease.

Is Psoriasis Monoclonal Antibody Treatment Effective?

Monoclonal antibody therapy for psoriasis is very effective. Monoclonal antibody drugs are antibodies produced in the laboratory similar to those produced by human immune cells. Monoclonal antibodies selectively target targets responsible for disease development.

How to recognize and treat psoriasis in children

In children, psoriasis often progresses more violently and disguises itself as other diseases (eczema, erysipelas, herpes), which complicates the diagnosis. The therapeutic methods are similar to those for adults: phototherapy, medication and topical treatment.

What baths to take with psoriasis

Aloe baths can help reduce inflammation and itching.

How to treat psoriasis according to Pegano

The Pegano method of treating psoriasis involves cleansing the intestines, diet, and herbal teas. The effectiveness of this method has not been proven by clinical studies.

Role of nutrition in treatment

Nutrition greatly affects the course of psoriasis. When processing it is necessary to exclude alcohol, salty, spicy, pickled, nuts, citrus fruits, honey, chocolate and smoked meats.

What sanatoriums show rest for the treatment of psoriasis

For psoriasis, the spa treatment is best to take place on the sea in an area with a hot, dry climate and many sunny days. The most suitable for this are the resorts of Crimea.

Folk ways

Some folk remedies can help reduce itching and flaking of the skin in patients with mild to moderate psoriasis. These methods include:

  • cream with aloe extract;
  • fish oil applied to the skin with a smeared bandage for six hours a day for four weeks;
  • Oregon grape extract cream.

Forecast. Prevention

Psoriasis is not a phrase. If the patient in time sought qualified help from a specialist who was able to establish the real causes of the disease and prescribe effective treatment, the disease will be conquered.

The simple form of psoriasis manifests itself only as a skin defect. Therefore, the patient does not need special conditions for work. The exception is work in a chemical plant: in this case, stay in the workplace should be excluded.

It should be remembered that psoriasis can lead to complications. Most often, psoriatic arthritis develops. Its severe forms can limit the performance of tasks at work and lead to total disability in the future.

Prevention of psoriasis is an integral part of therapeutic measures aimed at eliminating one of the most serious skin diseases. After recovery, the patient should completely review his lifestyle, eliminate bad habits, pay attention to the treatment of chronic diseases of other organs, adjust nutrition, include outdoor walks and sports in the daily routine.

Do they take psoriasis in the military?

Severe forms of psoriasis are sufficient grounds for declaring a conscript unfit for military service, mild forms - of limited ability.