Psoriasis: what is this disease?

Despite the fact that psoriasis is a common and well known disease, it is still not fully understood. And patients very often do not know at all that psoriasis is not a bacterial infection or a fungus, but a non-standard reaction of the immune system, provoked by unknown reasons. Information about the causes and symptoms of psoriasis will be very useful for patients, as it will help overcome the disease.

What is this disease?

Squamous lichen is another name for psoriasis and this name perfectly describes this disease. Psoriasis is manifested by the formation of inflamed plaques of various sizes on the skin, they are densely covered with thick skin scales.

Surely, almost everyone has heard of a disease like psoriasis. And this is not surprising, since scaly lichen is quite widespread. This disease is diagnosed in 4-10% of the world population. In addition, statisticians who collect information on the prevalence of psoriasis claim that the number of patients is constantly growing.

Scaly lichen has been known to people since ancient times, even healers in ancient Greece tried to cure this disease. The modern history of the study of psoriasis is about 150 years old. But during this rather considerable period of time, the researchers managed to not learn enough about the causes and treatment of psoriasis.

Wide prevalence, uncertainty of etiology (causes of occurrence), insufficiently effective treatment - all this characterizes psoriasis as one of the most difficult problems in dermatology.

Today, dermatologists consider psoriasis a complex systemic disease associated with disorders of the immune system, with a malfunction of metabolic processes and the appearance of trophic disorders. These failures result in specific skin changes.

Therefore, when answering the question of what psoriasis is, a modern dermatologist will answer that it is trophism and metabolic disorders in the skin caused by a malfunction in the functioning of body systems. Today, two theories about the etiology of psoriasis are considered more likely: genetic and viral.

• The genetic theory has many supporters, as psoriasis often acts as a hereditary or familial dermatosis. A careful study of the patient's family history in 60-80% confirms the presence of psoriasis in one form or another in the patient's relatives. However, in some patients it is not possible to confirm the fact of the hereditary origin of psoriasis. This circumstance is the reason for assigning these cases to a special group, in which the main reason is not genetic, but phenotypic failures.
• The viral theory, according to which psoriasis develops as a result of an infection, has its proponents. Confirmation of information about the viral origin of psoriasis is the detection of antibodies in the blood of patients, as well as the "elementary bodies" in the cells of the epidermis. According to this theory, psoriasis develops not only when infected with a virus, but also under certain conditions.

There are other theories that explain psoriasis. For example, endocrine, neurogenic, metabolic, etc. Of course all these theories are not without foundation and their study allows to obtain more important information on psoriasis disease. However, today it is already known for sure that the state of the endocrine and nervous systems, as well as the work of the gastrointestinal tract, do not cause psoriasis, but have a significant impact on the course of this disease.

For example, pathologies affecting the liver lead to the fact that the quality of blood purification carried out by this organ is significantly reduced. And this, in turn, can provoke the appearance of various aspects of the skin, including psoriasis.

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc. ) lead to the fact that the tissues of this organ are reborn, that is, the liver is gradually replaced by connective tissue. As a result, the liver ceases to cope with its cleansing functions. Externally, this is manifested by yellowing of the mucous membranes and skin, and the development of skin diseases, including psoriasis, is possible.

There is also an inverse relationship, psoriasis is often accompanied by fatty degeneration, which affects the liver. Therefore, in the treatment of this skin disease, it is important to follow a diet in order not to unnecessarily burden the liver. Patients are advised to limit fatty foods, completely eliminate alcohol.

Therefore, despite numerous studies, it was not possible to get an exact answer to the question of what psoriasis is. However, the work continues, so there is a chance that the mystery of this mysterious disease will be solved and we will learn a lot about skin disease psoriasis.

International classification

The disease of psoriasis manifests itself in various forms. To make navigation easier for specialists, a generally accepted classification of psoriasis is used.

Added psoriasis to the International Classification of Diseases (ICD). To date, 10 revisions of the International Disease Register are already in use, therefore the abbreviation ICD 10 is used. Work began on 10 revisions of the International Disease Classifier in 1983 and completed in 1987.

In essence, the ICD 10 is a standard assessment tool used in medicine and health management. The Handbook in Revision 10 is used to monitor the prevalence of various diseases and other health problems in the population.

Using version 10 of the ICD, it is possible to compare data on morbidity and mortality in different countries, which makes it possible to obtain statistical data and systematize diagnostic information. With the agreement of WHO members, ICD 10 is used to assign codes to various diseases. In the tenth version of the classifier, alphanumeric codes are adopted, with the help of which it is convenient to store information in electronic format.

All types of psoriasis are included in ICD 10 and each is assigned a specific code. In dermatology, the following forms and types of psoriasis are distinguished:

• Ordinary psoriasis(synonyms: vulgar, simple, plaque-like). The disease was assigned a code according to ICD 10 - L-40. 0. This is the most common form, it is observed in 80-90% of patients. The main symptoms are the formation of raised plaques above the surface of the unaffected skin, covered with white-gray scales. This form is characterized by a slight peeling of the scales. After their removal, inflamed red skin opens, which is very easily injured and begins to bleed. As the inflammatory process progresses, the plaques can significantly increase in size.
• Inverse psoriasis. It is a disease that affects the folds of the skin (flexor surfaces). For this form of the disease, code L83-4 is adopted in ICD 10. Dermatosis appears with the formation of folds on the skin of smooth or minimally scaly patches. The deterioration of the condition is observed when the skin is injured by friction. The disease is often complicated by a strep infection or an associated fungus.
• Guttate psoriasis. This form of psoriasis is characterized by the formation on the skin of a large number of small specks of red or purple color, shaped like water droplets. According to version 10 of the international classifier, such a disease received the L4 code. Most often, guttate psoriasis affects the skin of the legs, but rashes can occur on other parts of the body. At the same time, teardrop psoriasis is known to develop as a complication after streptococcal infections - pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasisis ​​a severe cutaneous form, according to ICD 10 it has been assigned codes L1-3 and L 40. 82. It is characterized by the formation of blisters or pustules. The skin of the lesions is swollen, red, inflamed, easily peels off. If fungi or bacteria enter the pustules, the contents of the pustules become purulent. Pustular psoriasis often affects the distal extremities, but in severe cases, a generalized process can develop with the spread of rashes throughout the body.
• Psoriatic arthritis or arthropathic psoriasis. According to version 10 of the ICD pathology, the code L5 was assigned. It manifests itself with inflammation of the joints. Arthropathic psoriasis can affect all types of joints, but in most cases the joints in the phalanges of the toes and hands become inflamed. The knee, hip or shoulder joints may be affected. The injuries can be so severe that they lead to patient disability. Therefore, you shouldn't think about psoriasis which is exclusively a skin disease. Severe types of psoriasis can lead to systemic damage, disability or even death of the patient.

• Erythrodermal psoriasis. A rare but severe type of psoriasis, according to ICD 10, this disease has received the L85 code. Erythrodermal psoriasis often manifests itself in a generalized way, the entire or almost the entire surface of the skin can enter the affected area. The disease is accompanied by severe itching, swelling, pain.
• Psoriatic onychodystrophy or nail psoriasis. According to version 10 of the ICD, the disease was assigned the code L86. The pathology is manifested by changes in the appearance of the nails of the toes and hands. Nails can change color, become thicker and begin to deteriorate. Complete nail loss is possible.

In psoriasis, the classification of the disease takes into account not only the types of disease, but also the severity of the symptoms:

• localized psoriasis is a disease in which less than 20% of the skin is affected;
• diffuse psoriasis affects more than 20% of the body surface;
• if almost the entire surface of the skin is affected, we are talking about universal psoriasis.

If we consider all types of disease, common psoriasis is more common than other forms.

Flow phases

Limited or diffuse psoriasis goes through three stages in its course: progressive, stable and regressive.

The following is characteristic of the progressive stage of psoriasis:

• the appearance of new skin rashes;
• growth of existing plaques;
• the appearance of new elements of the rash at the site of skin lesions (scratches, abrasions);
• Abundant scaling of existing plates.

The following symptoms are characteristic of the stationary stage of psoriasis:

• no new items are displayed;

• moderate peeling of the elements;
• no signs of growth of elements.

The appearance of folds in the stratum corneum around the elements is a sign of a transition from a stationary to a regressive stage.

The regression phase is characterized by the following types of symptoms:

• decrease in peeling intensity;
• element resolution.

After the psoriatic plaques have resolved, the hypo or hyperpigmented spots remain in place.

Squamous lichen is characterized by a long course with periodic exacerbations. The following types of psoriasis are distinguished:

• winter (with aggravation in autumn and winter);
• summer (with exacerbations during the hot period);
• out of season psoriasis is the most severe type, since there is no clear connection between relapses and seasons of the year, periods of remission can be virtually absent.

Diagnostic functions

If psoriasis has a typical clinical picture, the diagnosis will not be so difficult. However, this disease is often masked by other pathologies.

For example, nail psoriasis is often mistaken for nail fungus, since the external manifestations at an early stage of these diseases are very similar. However, nail fungus and psoriasis are completely different in nature, so treatment should be different.

A layman can mistake psoriasis and mushrooms for mushrooms. Since mycoses of the skin (skin fungus) are manifested by similar symptoms - the formation of scaly plaques. Therefore, having noticed suspicious symptoms on the body or nails, it is not necessary to diagnose yourself and read on to treat the fungus using drugs or folk remedies.

If the diagnosis is wrong, and in fact the cause of the onset of symptoms is not the fungus, but psoriasis, the treatment will not benefit, but, on the contrary, will aggravate the symptoms.

When contacting a dermatologist, an analysis will be performed for fungi, a scraping from the nail or skin will be taken. Then the resulting material is placed in a nutrient medium. If the fungus is present in the material, a large colony will grow in the test sample after a few days. From the appearance of the material, it will be possible to understand which type of fungus caused the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, it can be a bacterial infection or a fungus. Therefore, when the clinical picture changes (appearance of purulent discharge, discoloration of plaques, etc. ), patients will need to be periodically tested for fungi and other infectious agents.

In the diagnostic process, a certain role is assigned to a set of phenomena which are called the psoriatic triad. The phenomena appear sequentially, when scraping the element of the rash.

The psoriatic triad looks like this:

• when scraping the rash element, the scales are removed in the form of "chips";
• After removing the chips, a thin transparent film similar to polyethylene opens;
• when the film is damaged, punctual bleeding opens.

A dermatologist diagnoses psoriasis, but if necessary, the doctor can refer the patient for consultations to other specialists: a rheumatologist, a gastroenterologist, a surgeon, etc.

Interesting Facts About Psoriasis

People have known psoriasis for a long time. The very name of the disease also entered our language from ancient Greek. At the time of the prosperity of ancient Greece, the word "psora" indicated all skin diseases that manifest themselves with flaking and itching.

The first person to write a detailed treatise on psoriasis was a Roman named Cornelius Celz. In the fifth volume of his work "De Medicina" there is a large chapter on this disease.

They knew about psoriasis, but this disease was not unequivocally assessed, as it was called, sometimes "imperial", sometimes "diabolical".

Of course, the ancient healers knew very little about psoriasis. Until the 19th century, this disease was often mixed with other skin disorders. For the first time psoriasis was identified as an independent nosological form in 1799. This was done by the English dermatologist Robert Villan, who identified psoriasis from a large group of skin diseases manifested by itching and flaking.

Not only ordinary people, but also prominent political figures knew psoriasis firsthand. For example, Winston Churchill, who suffered from this disease, has promised to erect a pure gold monument to a person who can learn all about psoriasis and offer effective treatment for this disease.

Modern understanding of the disease

It must be said that modern science doesn't know much about this mysterious disease. There are various theories on the origin, course and treatment of psoriasis.

Here are some facts about psoriasis that are beyond doubt:

• despite the fact that the causes of the disease are not clear, it was possible to know the nature of psoriasis. This disease is autoimmune, that is, it is caused by a malfunction of the immune system;
• another established fact about psoriasis: the disease can be inherited. However, this is not always the case, even if both parents are ill, the risk of developing the disease in their child is 65%. At the same time, some patients develop psoriasis, although none of his relatives are sick;
• An interesting fact about psoriasis is that this disease is characterized by the Kebner phenomenon. This phenomenon is manifested in the fact that the elements of the rash are formed at the sites of skin lesions: scratches, burns, frostbite. Sometimes psoriasis appears after a while, at the site of the scars;
• An important observation that allows us to obtain more information about psoriasis is the relationship of this disease with climatic factors. Exacerbations and relapses are often scheduled to coincide with the change of season;
• patients have probably noticed the connection between exacerbations and stress in practice. All patients should know for certain that the disease recurs or worsens its course against the background of tension and nervous experiences;
• a new fact about psoriasis is that the disease can debut at any age, even though it was previously thought that scaly lichen occurs after age 30;
• It is important for all people to know that psoriasis is not a contagious disease. Even in close contact with the patient, there is no risk of infection;
• almost everyone has heard of the incurability of psoriasis, and this is true, as no treatment has been found that can guarantee the victory of the disease. But patients need to be aware that psoriasis can be controlled. Adequate and timely treatment allows for long-term remission.

Modern treatment methods

Speaking of the common disease of psoriasis, one cannot fail to mention the treatment of this common disease. It must be said that it is impossible to cure psoriasis with just tablets or ointments.

To forget about the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will have to make an effort. Food will need to be properly organized. Some experts argue that you can forget about psoriasis forever only with the help of a properly composed diet and regular cleansing of the body.

The doctor will draw up a preliminary treatment scheme. As a rule, methods of external (ointments, creams) and systemic (tablets, injections) therapy are used. In addition, physiotherapy methods will be used and treatment at the resorts will be recommended. It is recommended to treat psoriasis using healing mud, mineral and thermal water.

Resorts may also offer non-traditional treatment methods. For example, with the help of fish that live in hot springs. These little healers effectively remove dead skin scales and disinfect the skin, promoting faster healing.

Spas may offer other treatments for scaly lichen. For example, leech therapy, baths and healing applications, sun therapy, etc.

You will need to be prepared for the fact that the treatment regimen will change periodically. Since not all methods are suitable for a specific patient. If the selected treatments do not work, they will need to be replaced.

Popular treatments for psoriasis are also widely advertised. Indeed, some of them can help in achieving remission. However, when choosing a method, common sense should be remembered in order not to harm health. If a recipe or recommendation is in doubt, it is best not to use it. Consult a physician before using any treatment.

It should be understood that it will be possible to forget about psoriasis forever only if the patient himself and his immediate environment are positively tuned. Only faith in success and an optimistic attitude will help overcome this mysterious and insidious disease.