Psoriasis is a non-communicable chronic disease that until recently was viewed as a mere skin disease. The peculiarity of the inflammatory process in certain areas of the skin in patients with psoriasis is that the life cycle of normal skin cells is about 30-40 days, if, as in psoriasis, it is 4-5 days, that is, after 4 days, the skin cells gradually die and formPlaques, dryness, peeling of the skin and so on.
The problem of treating this complex and now difficult to treat disease is not only urgent for dermatologists, many doctors in other specialties are often involved in determining the causes of psoriasis in a patient and are also directly involved in the complex treatment of this disease. Today, medicine regards psoriasis as a systemic failure of the body, rather than just an inflammatory process of the skin.
The name has also changed, now it is a psoriasis disease. Why is psoriasis a systemic pathology? Because patients have various disorders in the work of the whole body - in the nervous, endocrine, immune areas. In medicine there are different types of psoriasis, there are also a variety of reasons for the appearance of this disease, mainly these are theories, since there is no convincing evidence of these alleged causes, we will consider them in more detail.
Some facts:Psoriasis is not contagious as it is believed to be caused by a malfunction of the human immune system, namely the overactive T-lymphocytes on the skin. Psoriasis is classified as a hereditary disease, with psoriasis in one of the parents, the risk of developing psoriasis in a child is 25% if both parents have 65%. In addition to the hereditary factor, the trigger mechanism for the occurrence of psoriasis or relapse is the intake of antibiotics, NSAIDs, B vitamins, as well as stress, alcohol and skin injuries.
Viral theory of the cause of psoriasis
A number of studies done in patients with psoriasis have identified various changes in the peripheral lymph nodes that may indicate the viral nature of the development of this disease. It is thought that retroviruses, which are genetically transmitted through heredity, may be one of the causes of psoriasis. However, in order to demonstrate the viral nature of the origin of psoriasis, the virus must be identified, isolated and the habitat selected. Nobody can do this yet.
The fact is that retroviruses can change the host's genetic code, synthesize DNA with the help of the reverse transcriptase enzyme and create a “wrong program” in the cells that change the human genome. However, it has been found that even blood transfusions from psoriasis patients to healthy individuals have never been found to be infected or transmitted. Therefore, the version about the viral cause of psoriasis has not yet been proven.
The immune cause of psoriasis
This is one of the widely accepted theories about the causes of psoriasis, as cellular immunity disorders are believed to be the main trigger mechanism of the disease. It was found long ago that in people with a genetic predisposition to psoriasis diseases, at chronic foci of infection - tonsillitis, sinusitis, indicating impaired immunity - provoke factors in the appearance of psoriasis.
When a primary focus of psoriasis occurs, medicine also suggests that damage to the epidermis is caused by autoimmune aggression. Numerous studies in patients with psoriasis have identified abnormalities in immune complexes, antibodies, and immunoglobulins that cause Munro micro abscesses.
When the inflammation of psoriasis is activated, the hypersensitivity of the skin increases sharply, which is why rashes characteristic of psoriasis appear in places with physical or chemical irritation. When examining dander, antigen components and autoantibodies were found in the blood that are not found either on the skin or in the blood in healthy people.
This fact gives rise to the assumption that the autoimmune process plays an important role in the cause of psoriasis. However, since all processes, including immune reactions, take place in the body as in an integral system, a combination of other factors such as endocrine influence, hereditary factors and metabolic disorders should be taken into account.
Infectious theory of psoriasis development
A hundred years ago, many researchers persistently searched for an infectious agent for psoriasis, and streptococci, spirochetes, and epidermophytos were found guilty. However, it has not been established that none of these pathogenic microorganisms, fungi, are the cause of psoriasis according to research.
Infectious diseases, tonsillitis, and ARVI influenza, however, affect the exacerbation or trigger the primary onset of psoriasis, especially during the cold season when the immune system is weakened and patients with psoriasis are often hospitalized.
Some authors believe that the development of psoriasis against the background of acute and chronic infection is explained by the influx of pulses from the focus of infection into the endocrine system and vegetative area, which leads to a restructuring of the reactivity of the body. Very often, namely in 90% of cases, chronic tonsillitis is accompanied by psoriasis, which confirms the influence of infectious processes and impaired immunity on the development of psoriasis.
According to many experts, there is also an infectious-allergic cause of psoriasis. Its proponents believe that psoriasis is an allergic tissue reaction to viruses, streptococci, and their waste products. However, neither the viral nor the infectious theory has been confirmed so far.
Genetic cause
This cause is based on a familial manifestation of psoriasis in close and distant relatives. However, psoriasis should not be viewed as a purely hereditary disease, as should diabetes, cancer and ischemic heart disease, as psoriasis itself is not inherited, only a genetic predisposition to it. Yes, 60% of people with psoriasis have ancestors or close relatives with the disease. If one of the parents is sick, the child's risk of developing psoriasis increases theoretically by 25%, and if both parents are sick, by up to 75%.
Not always with psoriasis, however, the cause is only a genetic factor. This disease has recently become very common in clinical practice and is not always directly related to predisposition. In psoriasis, the causes of occurrence are so varied that it is impossible to clearly point to a specific cause. Since the pathogenic factors are violations of protein or carbohydrate metabolism and changes in lipid, enzyme metabolism, a combination with foci of streptococcal infections or a viral nature.
Metabolic disorders as factors in the development of psoriasis
If we take into account metabolic disorders in psoriasis, there is a slight decrease in body temperature in many patients, and this is one of the symptoms of a slowed metabolism. Elevated cholesterol levels are also noted, indicating changes in lipid metabolism. Given the high level of cholesterol, many researchers consider psoriasis a cholesterol diathesis and consider its increase as the first manifestation of dermatosis, since a violation of lipid metabolism stimulates the formation of keratinization of the skin.
Even with psoriasis, the metabolism of vitamins is disturbed, especially vitamins C, A, B12, B6, while the content of vitamin C in the skin is increased. Shifts in the levels of iron, copper and zinc have also been noted, which significantly reduces the adaptive properties of the human body. Almost 25% of psoriasis patients also have diabetes mellitus. However, some researchers consider this fact not as a cause of psoriasis, but, on the contrary, as a manifestation of psoriasis disease.
As the disease progresses, the basic metabolism is most often increased in patients with psoriasis, and symptoms of hypothyroidism, endocrine glands and gonads are common in patients with decreased metabolism, and in 60% of patients with psoriasis, general carbohydrate metabolism is disturbed. A low-calorie diet or even moderate fasting will reduce the body's self-intoxication, so diet used to treat psoriasis improves the patient's condition.
Provoking factors for psoriasis
At the present moment of medical research in the field of determining the cause of psoriasis, we can say that it is a recurrent systemic disease that occurs in genetically predisposed people and at the same time disrupts various types of metabolism of the central nervous system.
Stress
Both for the onset of psoriasis and for the worsening of the existing chronic psoriasis, the main triggers are usually stress, psychological trauma, persistent fatigue and nervous tension.
Stress triggers immunological and biochemical reactions that contribute to the development of psoriasis. However, sometimes negative emotions, on the contrary, serve to complete the clinical symptoms of psoriasis. According to a survey of patients with psoriasis, this provoking factor leads to the onset of the disease in 49% of patients and a relapse of psoriasis in 41%.
Infectious diseases, vaccinations, chronic sources of infection
Tonsillitis, sinusitis, STIs, otitis media etc. , highly virulent streptococci are particularly common. For worsening of the disease, this factor is relevant in 21% of patients, and for the onset of the development of psoriasis, infection is a triggering mechanism in 15% of patients.
Hormonal changes in women
During pregnancy, breastfeeding, menopause or adolescence - in 6% of the patients surveyed, this was also a provocative factor in the development of psoriasis.
Injuries, bites, burns
Any skin trauma - in 12-14% of patients, the occurrence of psoriasis is caused by physical trauma.
Prolonged hypothermia
Is the cause of psoriasis or its exacerbation in 5% of patients.
Medicines
Like any type of antibiotic, NSAID. Vitamin therapy - especially vitamin C, B, beta blockers, cytostatics, vaccinations, the use of herbal medicines in treatment - leads to psoriasis in 6% of patients.
Food poisoning, abuse of certain foods
Chocolate, citrus fruits and other products - according to a survey of patients, this is the cause of psoriasis in 4% of patients.
Drink alcohol
Also a provocative factor that causes a generalization of the inflammatory process, shortens the duration of remission and increases the risk of complications. This is stated by 3% of the respondents.
Climate change
High humidity, prolonged exposure to intense ultraviolet radiation, sudden changes in temperature and humidity - cause exacerbation in 2% of patients.
The first symptoms of the onset of psoriasis can appear regardless of age. They are equally common in infants, and people between the ages of 20 and 40 can develop psoriasis even as they age. Of course, the sooner it occurs, the more severe the consequences for the patient. When psoriasis starts in a person after 30 years of age, it is usually associated with gastritis, liver disease, obesity, various neuroses, diabetes, arthritis, and other diseases.