Psoriasis or scaly lichenIs a chronic disease that affects the skin and its limbs: nails and hair. It is characterized by phases of deterioration (relapses) and temporary well-being, when the manifestations of the disease decrease. This disease is not contagious and the patient is not dangerous to others. After all, the occurrence of psoriasis is not associated with microorganisms.
Psoriasis is most common between the ages of 15 and 45 years. People with fair skin are more prone to this. In developed countries, the number of patients with psoriasis reaches 2-4% of the population. Every 25th inhabitant of the world on all continents suffers from it.
A variety of medical institutions are addressing this problem. Therefore, psoriasis has been recognized as the most studied disease. But this disease is not yet fully understood. Officially, it is considered incurable and raises many questions.
Psoriasis is caused by the body's own immune cells. They rise from the lower layers of the skin to the upper layers and cause inflammation, the multiplication of epidermal cells and the formation of small capillaries.
The manifestations of psoriasis on the skin are very diverse. Most often the disease causes the appearance of red spots - psoriatic plaques. They feel dry, rise above the surface of the skin and are covered with a white coating.
Types of psoriasis
The disease is divided into two broad groups: pustular and non-pustular psoriasis.
Non-pustular psoriasis
- common (vulgar) or simple psoriasis (plaque psoriasis, chronic stable psoriasis)
- Psoriatic erythroderma or erythrodermic psoriasis
Pustular psoriasis
- Tsumbusch pustular psoriasis or generalized pustular psoriasis
- palmoplantar psoriasis (pustular psoriasis of the extremities, chronic persistent palmoplantar pustulosis)
- annular pustular psoriasis
- palmoplantar psoriasis
- Herpetiformis psoriatic impetigo
In addition, these types of psoriasis are differentiated.
- seborrheic psoriasis
- Psoriasis of the flexor surfaces and skin folds
- Psoriasis of the napkin
- drug-induced psoriasis
Depending on the severity, such forms of psoriasis are differentiated.
- Mild - less than 3% of the skin is affected.
- Moderate - 3-10% of the skin is covered with psoriatic plaques.
- Severe - joint lesions or more than 10% of the skin are affected.
Causes of Psoriasis
To date, there is no clear answer to the question, "Why does psoriasis occur? " Scientists have put forward several theories.
- Psoriasis is an autoimmune disease. It is based on a malfunction of the immune system. Immune cells from T-killers and T-helpers, whose function is to protect the body from viruses, bacteria, and tumor cells, invade the upper layers of the skin for some reason. Here they produce inflammatory mediators - substances that "trigger" the inflammatory reaction. The skin cells divide and multiply (proliferation).
- Psoriasis is a disease caused by abnormal growth, division, and maturation of epithelial cells - keratinocytes. The consequence of such skin changes is an attack by immune cells of T lymphocytes and macrophages on diseased skin cells.
Factors that contribute to the development of psoriasis
Doctors have identified a number of factors that can cause the disease to occur. Of course, psoriasis most often occurs when several of these conditions act on the body at the same time.
- Hereditary disposition.There is one version that genes that are responsible for the immune system and for the function of T lymphocytes are carriers of the disease. Therefore, parents with psoriasis are more likely to have children who develop the same symptoms.
- Thin dry skin. . . It has been found that people with such skin characteristics are more likely to get sick than people with oily and well-hydrated skin. This is likely due to the protective functions of the sebum and the structural properties of the skin.
- External irritants. . . A high proportion of patients are among those people who constantly come into contact with alcohol solutions, solvents, household chemicals, cosmetics (lotions, hand creams).
- Excessive hygiene- An excessive love of cleanliness also undermines the protective properties of the skin. Soaps, shower gels and washcloths wash away the natural protective barrier and leave microscopic injuries.
- Bad habits- Alcohol, smoking and drug addiction are bad for the skin. Your diet and blood supply deteriorate.
- HIV- AIDS patients are more prone to psoriasis. Scientists cannot explain this phenomenon. The fact is that psoriasis is caused by increased activity of lymphocytes, and in AIDS, their numbers decrease.
- Medication- The use of certain drugs can cause illness. Including: beta blockers, antidepressants, anticonvulsants and antimalarials, lithium carbonate.
- Infections (fungi and staphylococci). . . Very often psoriasis appeared immediately after fungal infections or illnesses caused by streptococci.
- To move- a change in climate or even a season, environmental degradation can be a trigger for this disease.
- Emphasize- Severe emotional shocks or physical stress (prolonged hypothermia, overheating, accidents) precede the appearance of the first symptoms of psoriasis.
- trauma- constant effects on the skin: pressure, friction, scratching. Such regular trauma can cause the first psoriatic plaques to appear at this point.
- Allergic conditions- Allergic rashes and the processes that occur in all layers of the skin also increase the risk of the disease.
What are the symptoms and signs of psoriasis?
Psoriasis is a systemic disease that affects more than just the skin and nails. It affects joints, tendons and spine, immune, nervous and endocrine systems.
Despite this, the main manifestations of the disease appear on the skin. The name squamous cellworm pretty much conveys the symptoms of psoriasis. The first manifestations are often pink or bright red papules of the correct rounded shape, covered with scales - psoriatic plaques. They are located symmetrically, mainly on the extensor sides, lower back, and scalp. However, they can affect any part of the skin and genital lining. Their size ranges from a few millimeters in the initial stage to ten centimeters or more.
Depending on the characteristics of the rash, such as:Forms of psoriasis:
- Pitting psoriasis - the size of the elements is smaller than the head of a pin.
- Guttate psoriasis - papules are teardrop-shaped and the size of a lentil grain.
- Coin psoriasis - plaques grow up to 3-5 mm in size and have rounded edges.
They also distinguish the shapes of the rash, if its elements are in the form of rings, arches and garlands, geographical maps with uneven edges.
The papules are covered with a scaly coating that is easy to remove. It consists of keratinized cells of the epidermis. Psoriatic plaques begin to be covered with scales from the center, then the plaque spreads to the edges. Its loose and light appearance is due to the fact that keratinized cells are permeated with air-filled spaces. A pink ring may form around the elements - this is an area of inflammation, a zone of plaque growth. The skin around the elements of the rash is not changed.
Psoriasis of the scalprepresents psoriasis plaques that protrude significantly above the surrounding skin. They are densely covered with scale-like scales. In this case, the hair is left untouched. Rashes can appear not only under the hair, but also on smooth skin, on the neck and behind the ears. Such changes are explained by the active division of keratinocytes in the affected areas.
Psoriasis of the feet and palmscauses a strong thickening of the stratum corneum of the skin on these parts of the body. The skin becomes thick, rough. Cracks often penetrate. This is caused by intense cell divisions that multiply 8 times faster than usual, but are not removed from the skin surface in time.
Psoriasis of the nailsdiffers in a variety of symptoms. The main ones, however, are two main types of damage to the nail plates:
- According to the "thimble" type. Small pits form on the nail plate, similar to pinprick marks.
- According to the type of onychomycosis. Lesions resemble nail fungus. Nails become thicker, discolored, peel off. A psoriasis papule surrounded by a red border is visible through the nail plate. It looks like an oil stain peeking through the nail.
Symptoms and signs of psoriasis depend on the stage of the disease, which replace each other cyclically over the course of the year. So most patients have "winter" illness if the exacerbation occurs in the autumn-winter period. An improvement in the condition in summer is due to the fact that ultraviolet light in the sun has a therapeutic effect. But some patients suffer from the "summer" type.
There are such stages in the course of psoriasis:
- progressive - the appearance of new elements, the active growth of existing plaques, the naturalness of the pink growth zone around them, intense peeling and itching.
- stationary - stopping the growth of papules, the absence of new rashes, fine folds of the upper layer of the skin around psoriatic plaques.
- Regression - the absence of peeling, the disappearance of plaques and the appearance of pigment spots in their place indicate the weakening of the process.
What do psoriasis rashes look like?
Every organism is individual and reacts differently to diseases. Therefore, the type of rash can vary widely. This explains the variety of forms and types of psoriasis.
However, in most people, the symptoms of psoriasis are similar. These are red spots - psoriatic plaques that protrude 1-3 mm above the level of healthy skin. Their appearance is caused by the fact that the cells of the surface layer of the skin - keratinocytes - divide very actively, do not have time to mature and turn into full-fledged epithelial cells. As a result of this increased pathological growth, certain areas of the skin thicken. This is because immune cells release chemicals that cause inflammation in the skin.
From above, plaques may be covered with a gray, silvery, or yellowish bloom that looks like paraffin. Hence they got the name - "paraffin lakes". These are keratinized epithelial cells whose rejection is impaired and which accumulate on the surface of the affected skin area.
The spots are scaly, hotter than the rest of the skin, and can get large. The patient often feels severe itching at this point. This is due to the fact that against the background of the inflammatory process there is a cascade of neuroreflex reactions and an allergic reaction.
Another type of element is papules. These are small elements of a rash that resemble a tubercle. The size is about 1 mm. There is no cavity filled with content in the middle. They are often located on the knee and elbow joints. They stay there even during times when the disease is receding.
During the exacerbations, the elements of the rash gradually widen and merge with neighboring plaques. In phases of improvement (remission), the spots begin to lighten from the center. They gradually take on the shape of a ring and can completely dissolve. After the plaques, a trace remains on the body - pigmentation. It can be significantly lighter or darker than the surrounding skin. After a person is tanned, the skin tone is usually evened out.
What do nail lesions look like in psoriasis?
Nail psoriasis is similar to a fungal infection of the nail plate. Laboratory analysis is required for a correct diagnosis. Changes can affect just one nail or all at once and are very different. They occur in 10-15% of patients. Damage to the nails is often associated with joint pain caused by psoriasis. In this case, there can be no rashes.
Psoriasis of the nail has several stages:
- indented points - thimble nail
- longitudinally indented grooves
- Cross compression in the center of the nail, these first signs are associated with damage to the nail root - the nail matrix
- "Oil spots" are pink spots of irregular shape that show through the nail - this is the accumulation of serous fluid under the nail
- Circulatory disorders make the nail dull, cloudy, yellow and thickened
- the nail plate takes on the appearance of a bird's claw, which is accompanied by pain. This is because the process engages the nerve endings.
Nail lesions start on the edge and gradually move towards the root, covering the entire surface. Microcirculation disorders cause the nail to become cloudy and change color from yellow to bluish.
If you experience similar symptoms in yourself, do not self-diagnose. Similar changes can be caused by other reasons: fungus, trauma, and circulatory disorders.
Is psoriasis contagious?
This question is often asked by patients who have just been diagnosed with the disease and by acquaintances of the patient. Scientists give an unequivocal answer to this. Psoriasis is not contagious, and one sick person is perfectly safe for others. Because psoriasis is not caused by viruses or bacteria, but by aggressive white blood cells. For unknown reasons, these own immune cells attack the skin cells and cause skin inflammation. The result of this process is skin rashes and swellings (psoriatic plaques) in some places.
How is psoriasis treated?
Treatment for psoriasis depends on the form and stage of the disease, as well as sensitivity to drugs. Traditional medicine focuses on the use of medicines. Treatment begins with local preparations that act on the affected skin. So they try to avoid the side effects that come with taking medication by mouth. More details on using local remedies are provided below. Now we come to pills and capsules.
There is a technique in which the patient is first offered gentler drugs with the least amount of side effects. If they are not effective, stronger ones are substituted for them, and so on. Even if the treatment is suitable for the patient, it will change over time. The fact is that the body gradually gets used to the drug and its effects wear off.
Oral systemic drugs are very effective. They are prescribed for medium and severe stages of the disease. They also help those patients for whom treatment by other means has not led to a positive result. But they have significant drawbacks: they can cause serious side effects, and after the abolition of these funds, the condition again worsens.
| Group of drugs | Dosage form and effect of the drug on the body |
| Retinoids - derivatives of vitamin A. | Affects the maturation of the top layer of the skin and eliminates the disturbances in this process caused by psoriasis. Release form - capsules. Dosage according to the scheme, depending on the stage 30-75 mg / day. Reduces the rate of division of keratinocytes, promotes normal maturation and differentiation of cells. Available in capsules. The daily dose is 25-50 mg. |
| Immunosuppressants - drugs that reduce the activity of the immune system | Reduces the activity of T lymphocytes, which cause the skin cells to divide more intensely. Sterile solution in ampoules. The starting dose when administered into a vein is 3-5 mg / kg per day, when administered orally - 10-15 mg / kg per day. |
| Medicines to treat malignant neoplasms (cytostatics) | Inhibits the overgrowth and reproduction of atypical cells of the epidermis. Available in tablet form. Assign 2, 5-5, 0 mg orally, 2-3 times a day, 1 time a week. |
Physiotherapy treatments for psoriasis are very effective. They bring significant patient relief, stop the disease from progressing, and in some cases serve as safe substitutes for medication.
| Physiotherapy method | Effects on the body |
| PUVA therapy or photochemotherapy | Combination of long-wave ultraviolet radiation and an internal photosensitizer. The course includes 20-30 procedures. The method is based on the fact that UV rays penetrate deep into the skin. The photosensitizer inhibits DNA synthesis in the skin cells and the speed at which they divide. Special installations or cabins are used for treatment. |
| Selective phototherapy (S. F. T) | Irradiation of the skin with ultraviolet rays with a wavelength of 280-320 nm. The course is 15-35 procedure. A special cabin is required for therapy. |
| Monochromatic UV treatment | Expose each focus separately with a laser or lamp source for UV radiation. It enables the irradiation of focal points even in hard-to-reach places without affecting healthy skin. It is prescribed in cases where less than 10% of the skin is affected. The course of treatment is 15-30 procedures. |
| Laser therapy | Laser radiation with different wavelengths is used to treat skin rashes. The laser promotes the rapid absorption of psoriatic plaques and protects against the appearance of scars in their place. The doctor determines the number of interventions individually for each patient. |
| Electrosleep | The procedure is performed on a device based on a mild action on the brain with weak electrical impulses. Duration 20-60 minutes. The number of procedures is 10-12. Electrosleep has a calming effect. As a result, the activity of the nervous system is normalized, plaques begin to dissolve, and a period of well-being begins faster. |
| Magnetic Therapy | Treatment with magnetic fields has a positive effect on general well-being. Itching and inflammation of the skin, swelling and pain in the joints decrease, the psycho-emotional state improves. The Betatron device is used for treatment. The duration of the procedure is 20 minutes. Number per course 10-15. |
| Ultrasound therapy | It is used as a pain reliever, antipruritic, and decongestant. Promotes resorption of scars. The procedure can be combined with medication (phonophoresis). The exposure time for an area is 15 minutes. To achieve a therapeutic effect, 7-14 sessions are required. |
| Hyperthermia | Heating fabrics to a temperature of 40 degrees with special pillows with a thermal mixture. This effect on the body normalizes the functioning of the immune system and reduces the attack on the skin. The duration of the procedure is about 2 hours. Their number is determined by the doctor. |
| Treatment with bee venom | The substance is introduced into the body using an electrophoresis or ultrasound machine. An anti-inflammatory, absorbable, antipruritic effect is achieved. The metabolism is normalized. The minimum number of procedures is 10. |
It is very important to follow a diet for people with psoriasis. Eating disorders can make the disease worse. The menu should be rich in vitamins and at the same time simple. It should give rest to the intestines and liver and also not make the body allergic.
| Approved Products | Prohibited foods |
| Vegetables (pumpkin, watermelon, beets, carrots, potatoes, radish) | Animal fat |
| Fruits (apricots, peaches, apples), juices | alcohol |
| Berries (except red berries: strawberries, raspberries, red currants) | Fatty meat (pork, duck) |
| Fresh herbs | Smoked meat |
| Lean meat (veal, beef, rabbit, turkey) no more than 200 g per day | red fish |
| Cheese, cottage cheese, dairy products | Carbonated drinks and coffee |
| nuts | Eggs |
| Low-fat fish | Ice cream and milkshakes |
| seaweed | Minimal amount of confectionery and sugar |
| Whole wheat bread | Butter and puff pastry |
In order to cleanse the body of toxins and metabolic products, it is necessary to conduct fasting days twice a week. They recommend kefir, apple, vegetables.
What ointments are effective in treating psoriasis?
The use of ointments for psoriasis brings the greatest effect, compared with other external preparations. The components of the ointment do not stay on the surface of the plaque, but rather soften the scales and penetrate the skin.
There are a large number of ointments available to treat psoriasis. Appoint in the first stagesnon-hormonal ointments.
In the event that the treatment does not give the expected effect, prescribehormonal ointments. . . Treatment begins with lighter medications that have minimal side effects. If improvement has not been achieved, stronger ointments containing glucocorticosteroids are prescribed.
| Name of the ointment | Drug action | Side effects |
| Weak ointments | Suppresses the increased activity of leukocytes, prevents their movement into the skin, eliminates the feeling of tension and itching. | Swelling of the skin, itching, redness. |
| Moderate ointments | It has anti-inflammatory, anti-allergic, anti-edematous, antipruritic effects. Suitable for patients with exudative forms of psoriasis, reduces bleeding. Apply 2-3 times a day in a thin layer to limited areas. Treatment lasts 10-14 days. | Steroid acne, skin atrophy and stretching, burning sensation, itching, hypopigmentation. |
| Strong ointments | Local anti-inflammatory, antipruritic and antiallergic agent. Reduces the moisture in the skin. Apply to the affected area 2-3 times a day for up to two weeks. Used during an exacerbation. | Skin atrophy. |
| Very strong ointments | It has a strong antipruritic and antiallergic effect. Slows down the processes of cell division and keratinization. Apply 1-2 times a day for no more than two weeks per course. | Acne, hair loss, skin atrophy. Do not use in pustular and widespread plaque psoriasis. |
Pharmaceutical companies produce many drugs in the form of ointments. The doctor selects the drug individually for the patient and, if necessary, changes it for a stronger one.
Do not forget that if you have psoriasis, you should definitely not ignore visits to the doctor. After all, this disease can hide the early stages of skin cancer.
Choosing a treatment regimen for psoriasis is a tedious process that involves lots of trial and error. Don't despair if you don't find "your" medicine right away. Remember that if the disease does not return for years, many people get permanent improvement. You can too!