After psoriasis appears in most patients, it does not go away on its own, it just progresses and becomes more widespread and spreads over the skin.
However, with timely diagnosis, it becomes easier to treat them and recovery is much faster.
The most important thing is to watch out for the first signs of psoriasis in good time and to make an appointment with a dermatologist immediately.
Signs that are characteristic of psoriasis
Early psoriasis can present as small, reddish, scaly patches.
The place of appearance of such rashes directly depends on the form in which the disease progresses.
In most cases you can see them:
- on elbows and knees;
- on the head (in the hairy area);
- on the palms and feet;
- in the wrinkle area (buttocks, armpits, areas under the breast in women).
Primary eruptions (papules) are very small: their diameter does not exceed 4 millimeters.
However, as the disease progresses, they enlarge and fuse together, forming obscure plaques.
Most often the appearance of papules is not accompanied by pain or itching. The feeling of discomfort increases with the development of psoriasis and the enlargement of the affected areas of the skin.
The affected area starts to hurt and itch, and there is a severe burning sensation.
These signs of psoriasis are complemented by emotional discomfort, which can greatly increase the rate of spread of the disease.
If such rashes are detected, it is inappropriate to start self-treatment because psoriasis has similarities with other skin conditions in the early stages of development.
Accordingly, the wrong choice of medication does not lead to positive results, but only worsens the situation.
Cumulative symptoms
Scaly lichens belong to the category of systemic pathologies.
This means that it not only manifests itself on the skin and nails, but can affect the spine, joints and tendons, as well as some body systems (e. g. , endocrine, immune, and nervous).
There are known cases of diseases that affect the digestive system (liver) and the urinary system (kidney).
The first symptoms of psoriasis
- constant feeling of tiredness;
- weakness;
- a state of depression (up to depression).
Because of the complex effects of the disease on the body, experts consider it appropriate to refer to it as psoriasis.
Even so, the main aspects of the disease are based on damage to the skin.
As mentioned above, small papules in the color range between pale pink and red are the first call to begin the development of pathology.
They differ in a symmetrical position on the surface of the skin (folds, lower back, head area covered with hair), sometimes on the mucous membrane of the external genital organs.
The size of the papules in the further course of the disease can exceed 10 centimeters.
Psoriasis eruptions are divided into:
depending on their characteristics- dotted (their size is no larger than the head of a pen);
- teardrop-shaped (similar to a crack, the size of a lentil grain);
- coin-shaped (badges with a diameter of 5 mm, rounded edges);
- Rarely arched, ring-shaped or map-like.
Above the papules there are plaques with scales that are formed from keratinized cells of the epidermis and are removed without great effort. They first appear in the center of the plaque and gradually spread further and further.
Keratinous cells have air gaps, which leads to visual friability and light shadows.
Sometimes items are surrounded by a pink ring, which acts as an area for plaque growth and inflammation. In this case, the state of the surrounding skin does not change.
Removing plaque reveals a shiny, deep red surface based on capillaries, which in turn have very thin walls.
The presence of such small-diameter vessels is due to damage to the structure of the upper layers of the skin, the structure of which is disturbed by the incomplete maturation process of the epidermal cells (keratinocytes), which makes their correct differentiation impossible.
Symptoms of different forms of psoriasis
Common psoriasis has very specific symptoms so diagnosis is not difficult.
It appears as scaly, rounded areas that protrude above normal skin and are pink or red.
Sometimes in the early stages of the disease there are no typical plaques: before they appear on the scalp and in the area of the joints (ankles, elbows and knees), small papules can be observed.
They can persist for a long enough period and not cause discomfort to the patient: nothing itchy and painful, or no pain at all, or they are practically not felt, the papules themselves are almost impossible to notice.
They don't peel off, but if they are lightly scraped off, the scales appear immediately. Such pink seals can disappear or lose their size significantly in summer as the sun's rays affect the skin.
The acute form of frequent psoriasis is manifested in the form of several constantly itchy rashes of brightly colored papules and is the result of the influence of factors that activate the disease.
In order not to confuse it with an allergic reaction, you need to scrape the surface of the plaque a little before the characteristic phenomena appear.
Seborrheic psoriasis starts on the scalp (hairy area) and then spreads to the face and shoulders.
It is characterized by profuse peeling of the skin of the relevant area, most often viewed by patients as flakes, so they do not rush to a dermatologist.
This fact allows the disease to quietly reach the developmental stage when the forehead and the areas behind the ears are peeled off. And only then do plaques form.
The lesion of the skin folds with psoriatic disease (armpits, genitals, and groin under the breasts in women) is often confused with ordinary irritation from friction or sweat.
This type of disease is characterized by smooth plaques that look like spots. Peeling is not observed, but they often get wet. The rashes themselves are bright red, they are even and shiny.
If the genitals are affected, the characteristic signs of psoriasis can be mistakenly interpreted as balanoposthitis (lesions on the head of the penis and the foreskin on its inner part) in men and vulvitis (rashes on the labia minora) in women.
The palmar-plantar form of the disease manifests itself in the form of densified areas, similar to calluses, the surface of which is covered with yellow scales that are difficult to remove.
The affected areas are cracked and sore. With this form of the disease, it is difficult to induce the appearance of a terminal film and bloody dew by scraping.
Psoriasis of the nails begins with psoriatic onychodystrophy, which is one of the main symptoms of this form of the disease and manifests itself as rashes much earlier.
In the early stages, the edge of the nail is covered with grooves and small recessed areas.
As the disease develops, they spread and reach the root, after which changes in their color are observed. The nail becomes dull and thick. Due to circulatory disorders, the manifestation of the disease increases.
Epidermal cells accumulate under the nail plate and are bordered on all sides by reddened tissue, after which they can peel off after a while.
This type of psoriasis is dangerous because it makes tissues more sensitive, which in turn increases the likelihood of infection. Very often this disease is confused with a fungus.
Movable joints of bones (joints) are often affected. They are deformed, the joint capsule undergoes modifications of the dystrophic type.
Psoriatic arthritis begins with an increase in joint volume, which is accompanied by pain.
The fingers of the hands and feet are the most susceptible to this type of psoriasis.
In severe forms, shoulder and elbow, hip and knee joints, and some parts of the spine are exposed to the disease.
Effect on the manifestation of symptoms of psoriasis stages
The symptoms of psoriasis are directly related to the time of year and the stage the disease is in.
Most often in the spring and summer periods there is a noticeable decrease in the activity of the disease, which is facilitated by ultraviolet rays.
Accordingly, the disease quickly gains momentum in the autumn-winter period due to lack of sun. There are practically no patients with summer exacerbations.
There are three stages of psoriasis:
- progressive- characterized by the continuous appearance of new rashes, an increase in the size of previously appeared plaques and their surroundings with pink edges, the affected area is very itchy and scaly;
- stationary- new rashes no longer appear and old ones do not grow; The top layer of skin in the plaque area becomes wrinkled.
- regressive- The skin does not peel off, plaques disappear and leave highly pigmented areas.
Psoriasis diagnostics
Diagnosis of psoriasis is made on the basis of information obtained from a medical examination by questioning a patient, as well as the symptoms that are inherent in one form or another of the disease.
The earlier a disease is detected, the faster the treatment process begins. Accordingly, more tangible results are obtained.
Due to the fact that the picture of the disease is extremely specific, the diagnosis of psoriasis can be limited to a simple examination by a dermatologist.
However, in some cases, due to the implicit or absent symptoms, difficulties may arise that arise when the disease does not manifest itself or looks uncharacteristic. This situation requires further research.
For diagnosis, a certain method is used, which consists in scraping the papules gradually along the layer.
As a result of such manipulation, it is possible to identify characteristic signs (psoriasis triad) in order to distinguish psoriasis with other diseases and make a definitive diagnosis:
- stearin coloring;
- terminal film (pink epidermal cells);
- Blood thaw (drops of blood appear on the surface of the plaque due to a broken capillary).
If necessary, the patient is tested in the form of samples of affected tissues.
If psoriasis-related arthritis is suspected, x-rays are taken.
If psoriasis is in its early stages, its diagnosis is not difficult: the picture of osteoporosis is clearly visible.
In later periods there is a narrowing of the joint space, erosion of bone-forming tissues, osteosclerosis and periostitis.
If the disease is severe, the joints of the wrist and metatarsus are destroyed, as a result of which the joint completely loses its range of motion.
It should be remembered that all the tests performed are necessary not only for the final diagnosis, but also for differentiation with other diseases that, at first glance, are identical.
These diseases include: parapsoriasis, seborrheic eczema, lichen rosacea, atopic dermatitis, lupus erythematosus, rheumatoid arthritis, and others.