Psoriasis

what psoriasis looks like on the body

Psoriasis is a common non-contagious skin disease that is associated with inflammatory lesions. It is chronic - the acute period is followed by periods of relief or resolution of symptoms - and is caused by a combination of various factors.

The disease is widespread and occurs somewhat more frequently in women than in men. It is not completely cured, but the symptoms can be relieved and the patient's quality of life improved.

Psoriasis can lead to arthritis, an inflammation of the joints.

Russian synonyms

Scaly lichen.

English synonyms

Psoriasis.

Symptoms

The symptoms and signs of psoriasis depend on the type of psoriasis.

  • Plaque psoriasis. It is accompanied by specific inflammatory skin formations - raised reddened lesions, oval, with sharp contours, scaly and covered with silvery scales. Most often, formations appear on the outer surface of the elbows, knees, scalp and trunk. The elements of a rash can be painful and itchy. In severe cases, the skin near the joints of the affected areas cracks and bleeds.
  • Guttate psoriasis. This type is associated with the appearance on the body of numerous papules (nodules) of an orange-pink color, with a size of 1-10 mm. The rash usually appears on the torso, shoulders, and thighs, but can be found all over the body. As a rule, it affects people under the age of 30, as well as 2-3 weeks after suffering from infectious diseases of the upper respiratory tract, after superficial bacterial infections of the anus.
  • Psoriasis of the nails. It is characterized by compaction, exfoliation, discoloration of the nail plates, discoloration, yellowing of the nails, the presence of spots on them, the formation of pits, cracks, damage on the nails. Nail plates are destroyed, nail growth is disturbed, they can be separated from the nail bed. It occurs in 30 to 50% of patients with psoriasis.
  • Psoriasis of the major folds. In this case, skin lesions in the form of red inflammatory spots appear in the armpit folds, under the mammary glands, in the cervical folds, in the genital area, on the foreskin. Cracks may appear along the edges and in the center of the lesions. Most often, wide-fold psoriasis occurs in overweight and obese people. Sweating and friction make the disease worse.
  • Psoriasis of the head. It is accompanied by redness of the scalp, itching, peeling of the scalp with the appearance of white scales on the hair and shoulders - particles of dead skin.
  • Psoriatic arthritis. Skin damage is accompanied by joint pain, swelling, curvature and deformity of the joints. The joints of the fingers, wrists, feet, knee joints can be affected.
  • Pustular psoriasis. This type is characterized by reddening of the skin and the formation of a large number of pustules - small blisters filled with pus. Formations can appear on the palms and feet or all over the body. When several pustules appear on the body, fever and weakness join together.
  • Psoriatic erythroderma. Areas of the skin redden, patches may appear. The lesions are usually accompanied by severe itching. Most often, psoriatic erythroderma is associated with sunburn or the misuse of medications.

Usually, with different types of psoriasis, the disease manifests itself gradually, the skin lesions spread and are observed over several weeks. Then the symptoms disappear. After exposure to a factor contributing to the development of psoriasis (or spontaneously), symptoms return after some time.

General information about the disease

Psoriasis is a common non-contagious skin disease that is associated with inflammatory lesions.

It is chronic and often recurrent - the acute period is followed by periods of weakening or disappearance of symptoms, then after a while the symptoms return.

Psoriasis is common, especially in people aged 16 to 22 and 57 to 60 years old. Women are more sensitive to it than men. People with fair skin are at an increased risk of developing the disease.

Despite the fact that psoriasis is synonymous with scaly lichen, it is absolutely not contagious to others.

The causes of psoriasis have not yet been fully established. Its appearance is associated with a genetic predisposition, dysfunctions of the immune system and environmental factors affecting the organism.

The development of psoriasis is associated with one of the cell types of the immune system (along with T lymphocytes), while overactivity of T lymphocytes is observed. Normally, they travel with blood throughout the body, detecting foreign agents - viruses and bacteria. In psoriasis, for unknown reasons, T cells start to build up in the skin. Their hyperactivity causes the expansion of blood vessels in the affected area, disrupts the cycle of formation of new skin cells - they are formed much faster than usual. Dead skin cells, on the other hand, don't have time to exfoliate and build up on the skin's surface, forming plaques.

Psoriasis can be triggered by any of the following factors:

  • infections (tonsillitis, thrush, HIV);
  • skin damage - cut, scratch, bite or burn;
  • hypothermia;
  • sunburn;
  • emotional stress;
  • smoking, alcohol abuse;
  • the use of drugs (antimalarials, etc. ).

At the same time, in some patients with psoriasis, rashes appear without the obvious influence of environmental factors.

There are the following main types of psoriasis.

  • Plaque psoriasis. This is the most common.
  • Guttate psoriasis. It usually affects people under the age of 30. It occurs 2-3 weeks after infectious diseases transferred from the upper respiratory tract, as well as after superficial bacterial infections in the area around the anus.
  • Psoriasis of the nails.
  • Psoriatic arthritis. In this type of psoriasis, the skin lesions are accompanied by arthritis - inflammation of the joints.
  • Psoriatic erythroderma. Most often associated with sunburn and misuse of medications.
  • Pustular psoriasis. It is quite rare, in severe cases it threatens the life of the patient.
  • Psoriasis of the head. In this case, the hair loss caused by the disease usually does not occur, since the roots of the hair are located much deeper than the scaly formations.

Classification of psoriasis according to the severity of the course:

  • soft (less than 2% of the entire skin is affected);
  • moderate (skin lesions occupy no more than 3-10% of the skin surface);
  • severe psoriasis (more than 10% of the skin is affected).

Depending on the type, location and extent, psoriasis can cause complications:

  • thickening of the skin, addition of secondary infection from scratching and scratching that appeared due to itching of psoriasis;
  • psychological problems (stress, low self-esteem, depression, social isolation);
  • joint damage (deformity with stiffness and reduced joint mobility);
  • increased risk of developing various diseases and conditions: high blood pressure, inflammatory bowel disease, cardiovascular disease, skin cancer.

Psoriasis is usually relatively mild. However, for most patients, social adjustment becomes the main problem, especially in the presence of skin lesions in the visible areas of the skin - the hostility of others to the type of skin lesions, their fear of being infected (manydo not know that the disease is not contagious).

Who is at risk?

  • People with a hereditary predisposition (more than 40% of patients with psoriasis have a relative with psoriasis).
  • People with viral, bacterial, fungal infections (streptococcus, thrush, HIV, etc. ).
  • Emotionally stressed.
  • Obese and overweight people.
  • Smokers.
  • Alcohol abuse.
  • Taking certain drugs (antimalarial drugs, etc. ).
  • Sunburn.

Diagnostic

The diagnosis of psoriasis is usually based on the type of typical lesion, taking into account their location. In difficult cases, additional testing may be needed to rule out other skin conditions.

Laboratory research

  • General blood test. With psoriasis, leukocytosis and anemia can be detected.
  • Rheumatoid factor (RF) is a protein that can be increased in blood levels in systemic inflammatory diseases with joint damage, especially in rheumatoid arthritis. The test result for psoriasis is negative. This allows you to distinguish psoriasis from rheumatoid arthritis, in which RF is increased.
  • The rate of erythrocyte sedimentation (ESR) is generally normal, with the exception of pustular psoriasis and psoriatic erythroderma.
  • Uric acid. Uric acid levels in psoriasis can be high (especially in pustular psoriasis), leading to confuse psoriatic arthritis with gout, in which the concentration of uric acid increases dramatically.
  • Antibodies against HIV (human immunodeficiency virus). The sudden onset of psoriasis may be due to an HIV infection.

Other research methods

  • X-ray of the joints. Allows you to assess the severity of joint damage in psoriatic arthritis.
  • Skin biopsy. The examination involves taking a small sample of the skin for further examination under a microscope. It is performed in difficult cases in order to distinguish psoriasis from other skin diseases.

Processing

Treatment of psoriasis includes local treatment of skin lesions, drugs, phototherapy, prevention of exposure to factors that provoke the appearance of rashes. It depends on the type and severity of psoriasis.

To get rid of skin lesions, emollients (creams, petroleum jelly, paraffin, vegetable oils) can be used. They are most effective when used twice a day after showering. Salicylic acid, anthralin, tar preparations, ointments, solutions, shampoos containing tar are also used. These agents are anti-inflammatory and slow the formation of new skin cells.

The use of corticosteroid ointments makes the treatment more effective. They are indicated for mild to moderate psoriasis. However, their long-term use is not recommended (skin atrophy, drug addiction are possible).

Light therapy - exposure of the skin to ultraviolet rays - can be beneficial. In this case, burns should be avoided.

Local treatment of lesions in the most severe cases is combined with the intake of drugs - retinoids, vitamin D preparations, methotrexate, etc.

Treating psoriasis can be difficult because the disease is chronic and comes back after symptoms go away. 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 scrubs should be avoided) and hydration after bathing can help soften the skin andto reduce the inflammation of psoriasis.

Prevention

  • Avoid hypothermia, sunburn.
  • Avoid emotional stress as much as possible.
  • Stop smoking and alcohol abuse.
  • Take certain medications (antimalarials, 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 anti-HIV type 1 and 2 antibodies and p24 antigen)