3 stages of the cyclical development of psoriasis

Stages of psoriasis are defined time intervals in which the disease takes on its characteristic features. Many psoriasis patients mistakenly refer to the stage as severe or mild, but medical records use the term with a completely different meaning.

What are the stages of psoriasis?

Psoriasis is recognized as a recurring skin pathology that genetics are to blame when it occurs. According to dermatologists, at least 2% of the world's population suffers from this disease, which means that the problem is very urgent. Two conditions are clearly distinguished during psoriasis:

1. relapse.This term refers to the deterioration of the skin. If it relapses, the patient suffers from itching, pain, burning sensation, severe rashes, irritation and discomfort. The victim's situation is made worse by insomnia, neurosis, and anxiety.
2. remission.This word improves the appearance of the skin. In remission, the skin returns to its normal color, the redness disappears, and the area of ​​psoriatic plaques is reduced.

The stages of psoriasis partially duplicate the description of remissions and relapses, so many dermatologists use these words interchangeably. In clinical practice, 3 stages of psoriasis are described:

• progress phase;
• stationary;
• regression phase.

If you consider that it is a cyclical process, the stages flow into one another and form a continuous course of the disease.

fact!The phase of progress is considered to be the most difficult to feel.

What is the progression of psoriasis?

The progress phase is triggered by a series of triggers, e. g. B. the cold season or stress. In some cases, even an experienced dermatologist cannot clearly determine the trigger. During the progressive phase, the following happens:

1. Psoriasis nodules develop quickly, affect the skin, combine in the so-called plaques, which peel off and itch. A badge is an arbitrarily shaped place, usually round or oval, sometimes with an uneven edge.
2. Papules, ie individual nodules in a psoriasis rash, are lumps on the skin. The edges of the papules do not peel off and the central part is peeled off. When a large number of dead scales accumulate, plaques begin to rise above the surface of the skin. Puffiness gives them an even more convex and uneven appearance.
3. This stage of the pathology is characterized by an isomorphic reaction, which consists in the exacerbation of rashes on skin lesions, scratches, injections, cuts and microtraumas. This phenomenon is called Köbner.

A delayed response is characteristic of the progressive stage of psoriasis. In some cases, rashes appear around 9 days after exposure to a trigger (e. g. , a food allergen). Typically, a psoriasis rash occurs within 24 hours of exposure to adverse factors.

Interesting!95% of psoriasis patients have a food intolerance that can cause a relapse. To avoid worsening, you need to keep a food diary and observe the reaction to different types of food.

Stationary and recessive stages

The stationary stage is the period in the course of the psoriasis during which the victim's condition relatively stabilizes. In the stationary stage:

1. Psoriasis plaques have a smooth outline. The entire surface of the plaque is covered with a thick layer of scales that are easy to peel off. Itching and discomfort are moderate. There is no bright red inflamed margin around the papules.
2. With microtraumas of the skin, the Koebner phenomenon is not observed, ie scratching or cutting healthy skin no longer turns into a psoriasis plaque.

The regressive or recessive stage is characterized by massive lesions in psoriasis. First, a pseudo-atrophic margin can be seen around the papules, and then patients notice a rapid cessation of flaking with the formation of hyperpigmentation plaques on the site.

Severity of the pathology

An additional diagnostic criterion is the assessment of the area of ​​the psoriasis lesions. The term "severity" is used to describe it. Dermatologists distinguish 3 degrees of severity of skin diseases:

1. Simple.Psoriasis plaques take up 1 to 3% of the total body area. The small size of the affected areas does not mean the patient is fine. With psoriasis of the head or face, just a few plaques are enough to cause a person discomfort and anxiety.
2. medium.The volume of psoriasis eruptions is 3 to 10% of the total body area. In this case, the back, chest, and outer surfaces of the joints, scalp, palms, and feet are affected. This prevalence leads to severe poisoning and pain. The patient may lose all or part of his ability to work, the mental state and the state of the nervous system worsen.

3. Difficult.The disease covers more than 10-15% of the skin surface. According to rough estimates, the likelihood of liver or kidney failure increases significantly if psoriasis takes up more than a quarter of the total body area. Decompensated damage to internal organs can lead to psoriasis death.

A special scale called PASI is used to fully assess the severity of psoriasis. The scale takes into account:

• percentage of healthy and diseased skin;
• stage of pathology;
• Response of the patient to drug therapy;
• individual tolerance to psoriasis (mental state, complications of the nervous system and psyche);
• objective data from laboratory tests in the dynamics (e. g. the uric acid volume in a blood test).

The diagnosis takes into account all of the symptoms that affect the condition of a person with psoriasis. The intensity is reflected in the medical record:

• Itching of the skin;
• redness;
• swelling;
• hyperemia;
• skin thickening;
• peeling;
• blood flow;
• swelling;
• infections;
• pain syndrome.

On the PASI scale, the volume of the skin lesions is described by numbers from 0 to 72, where 0 is the absence of skin symptoms and 72 is the maximum possible spread of the disease over a large area.

Attention!First of all, it is important that the patient knows and monitors the signs of an exacerbation. If unfavorable symptoms appear, you should immediately consult a dermatologist, since psoriasis does not always enter the stationary stage on its own. Relapse can take decades.

Treatment of psoriasis depends on the stage

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Individual therapeutic measures have been developed for each stage of the disease. A dermatologist therefore first determines whether the psoriasis is progressing, stabilized or receding.

How is the progressive stage treated?

Everyone with psoriasis suspects that the remission comes to an end because of their own feelings. If the itching worsens, the skin looks worse, and the psoriasis is obviously spreading over the body surface, treatment should be started. Therapy for the advanced stage has the following characteristics:

1. The patient is involved in preventing further deterioration, strictly adheres to the diet and refrains from triggering the pathological process (stress, smoking, alcohol).
2. Antihistamines can be used if the itching is severe. An additional advantage of this class of active ingredients is the elimination of swellings in the area of ​​psoriatic plaques.
3. A dermatologist will prescribe a wide variety of topical treatments to heal, soften, and thin the skin. Creams, ointments, or sprays are selected by the doctor's decision. Tar soap and solid oil compresses ensure a positive dynamic. You can also apply compresses or cosmetics made with Dead Sea mud.

The main task at this stage is to stop the exacerbation before the disease enters a prolonged relapse. According to the indications, the doctor selects corticosteroids in injections or in the form of ointments.

Attention!Corticosteroids should be used in a short and intensive course under the supervision of a dermatologist. You can give yourself injections or smear antihistamine ointments.

Inpatient and regressive stage therapy

Further actions taken by the dermatologist will depend on the body's response to the selected treatment. The following scenarios are possible:

1. Medicines have a positive effect. Within 1-2 weeks the psoriasis passes the stationary stage, regresses and there is a remission.
2. Medicines have no effect. If after 2 to 4 weeks from the time of prescribing the drug course, the results are still not visible, this is a reason to change either the list of drugs or the attending physician.
3. Medicines get worse. Such a dynamic is also possible, especially if the dose or frequency of administration is insufficient. The relapse is delayed, psoriatic plaques cover a large area of ​​the body, the person needs to be hospitalized.

A more powerful therapy, such as hardware blood purification, is used in a medical facility. With a favorable response, psoriasis enters the stationary stage, which can last from several days to several months.

Interesting!More than 80% of patients notice the seasonal nature of exacerbations. This makes the disease predictable and allows you to prepare for the onset of a relapse.

The list of drugs for the stationary and regressive stage is exactly the same, but the dosage and frequency of administration are lower than for the progressive stage.

10-15 years in remission

A competent dermatologist has the following task: He selects the drugs and physiotherapeutic agents that enable psoriasis patients to get the longest possible improvement. At the same time, the patient should do his or her best to promote treatment, avoid triggers, and use medication responsibly. If the alliance between patient and doctor has developed successfully, the duration of remission is unlimited. Stable well-being can last 15 years or more.