Psoriasis is a common non-contagious skin disease associated with inflammatory lesions. It is chronic - the acute period is followed by periods of relief or disappearance of symptoms - and is caused by a combination of various factors.
The disease is widespread and occurs somewhat more frequently in women than in men. It is not completely cured, but it is possible to relieve symptoms and improve the patient's quality of life.
Psoriasis can lead to arthritis, an inflammation of the joints.
Russian Synonyms
Scaly lichen.
English synonyms
Psoriasis.
Symptoms
The symptoms and signs of psoriasis depend on the type of psoriasis.
- Plaque psoriasis. It is accompanied by specific inflammatory skin formations: raised red lesions, oval, sharply delineated, flaky and covered with silvery scales. Most often, the formations appear on the outer surface of the elbows, knees, scalp and trunk. Elements of a rash can be painful and itchy. In severe cases, the skin near the joints of the affected areas cracks and bleeds.
- Guttate psoriasis. This type is associated with the appearance on the body of numerous papules (nodules) of pink-orange color, 1-10 mm in size. The rash usually appears on the torso, shoulders, and thighs but can be found all over the body. As a rule, it affects people under the age of 30, as well as 2-3 weeks after suffering from infectious diseases of the upper respiratory tract, after superficial bacterial infections in the anus.
- Nail psoriasis. It is characterized by compaction, exfoliation, discoloration of the nail plates, discoloration, yellowing of the nails, the presence of spots on them, the formation of pits, cracks, damage to the nails. Nails are destroyed, nail growth is disturbed, they can be separated from the nail bed. It occurs in 30-50% of patients with psoriasis.
- Large fold psoriasis. In this case, skin lesions in the form of red inflammatory spots appear in the area of the armpit folds, under the mammary glands, in the cervical folds, in the genital area, on the foreskin. Cracks may appear along the edges and in the center of the lesions. Most often, wide-fold psoriasis occurs in overweight and obese people. Sweating and friction worsen the disease.
- Head psoriasis. It is accompanied by redness of the scalp, itching, peeling of the scalp with the appearance of white flakes on the hair and shoulders - dead skin particles.
- Psoriatic arthritis. Skin lesions are accompanied by joint pain, swelling, curvature and deformation of the joints. Joints of the fingers, wrists, feet, knee joints may be involved.
- Pustular psoriasis. This type is characterized by reddening of the skin and the formation of a large number of pustules - small blisters filled with pus. The formations can appear on the palms and feet or all over the body. As more pustules appear on the body, fever and weakness combine.
- Psoriatic erythroderma. Reddened areas of the skin, plaques may appear. The lesions are usually accompanied by severe itching. Most often, psoriatic erythroderma is associated with sunburn or drug abuse.
Usually, with different types of psoriasis, the disease manifests itself gradually, skin lesions spread and are observed for several weeks. Then the symptoms disappear. After exposure to a factor that contributes to the development of psoriasis (or spontaneously), the symptoms reappear after some time.
General information about the disease
Psoriasis is a common non-contagious skin disease associated with inflammatory lesions.
It is chronic and often recurs: the acute period is followed by periods of weakening or disappearance of symptoms, then after a while the symptoms reappear.
Psoriasis is common, especially among people aged 16-22, 57-60 years old. Women are more susceptible to it than men. People with fair skin are at greater risk of developing the disease.
Despite the fact that psoriasis is synonymous with scaly lichen, it is absolutely not contagious to others.
The causes of psoriasis have not yet been fully established. Its appearance is associated with a genetic predisposition, with dysfunctions of the immune system and with environmental factors that affect the organism.
The development of psoriasis is associated with one of the types of cells of the immune system (with T lymphocytes), while hyperactivity of T cells is observed. Normally, they travel with blood throughout the body, detecting foreign agents - viruses and bacteria. In psoriasis, for unknown reasons, T cells begin to accumulate in the skin. Their hyperactivity provokes the expansion of blood vessels in the affected area, disrupts the cycle of formation of new skin cells - they are formed much faster than usual. Dead skin cells, meanwhile, don't have time to exfoliate and build up on the skin's surface, forming plaques.
Psoriasis can be triggered by one of the following factors:
- infections (tonsillitis, thrush, HIV);
- damage to the skin - cutting, scratching, biting or burning;
- hypothermia;
- sunburn;
- emotional stress;
- smoking, alcohol abuse;
- the use of drugs (antimalarials, etc. ).
At the same time, in some patients with psoriasis, rashes appear without an obvious influence of environmental factors.
There are the following main types of psoriasis.
- Plaque psoriasis. It is the most common.
- Guttate psoriasis. It usually affects people under the age of 30. It occurs 2-3 weeks after the transferred infectious diseases of the upper respiratory tract, as well as after superficial bacterial infections in the area around the anus.
- Nail psoriasis.
- Psoriatic arthritis. In this type of psoriasis, skin lesions are accompanied by arthritis - inflammation of the joints.
- Psoriatic erythroderma. Most often associated with sunburn and drug abuse.
- Pustular psoriasis. It is quite rare, in severe cases, it threatens the patient's life.
- Head psoriasis. In this case, the hair loss caused by the disease usually does not occur, as the hair roots are located much deeper than the scaly formations.
Psoriasis classification according to the severity of the course:
- soft (less than 2% of the entire skin is affected);
- moderate (skin lesions occupy no more than 3-10% of the skin surface);
- severe psoriasis (more than 10% of the skin is affected).
Depending on the type, location and extent, psoriasis can cause complications:
- thickening of the skin, addition of a secondary infection through scratches and scrapes that appeared due to itching with psoriasis;
- psychological problems (stress, low self-esteem, depression, social self-isolation);
- joint damage (deformity with stiffness and reduced joint mobility);
- increased risk of developing various diseases and conditions: hypertension, inflammatory bowel disease, cardiovascular disease, skin cancer.
Psoriasis is usually relatively mild. However, for most patients, social adaptation becomes the main problem, especially in the presence of skin lesions in visible areas of the skin - the hostility of others to the type of skin lesions, their fear of being infected (many do not know that the disease is not contagious).
Who is at risk?
- People with hereditary predisposition (more than 40% of patients with psoriasis have a relative with psoriasis).
- People with viral, bacterial, fungal infections (streptococcus, thrush, HIV, etc. ).
- Emotionally stressed.
- Obese and overweight people.
- Smokers.
- Alcohol abusers.
- Taking certain medications (antimalarial drugs, etc. ).
- Burned by the sun.
Diagnostics
The diagnosis of psoriasis is usually based on the typical type of lesion, taking into account their location. In difficult cases, further tests may be needed to rule out other skin conditions.
Laboratory research
- General blood analysis. With psoriasis, leukocytosis and anemia can be detected.
- Rheumatoid factor (RF) is a protein, the level of which in the blood can increase in systemic inflammatory diseases accompanied by joint damage, especially in rheumatoid arthritis. The psoriasis test result is negative. This allows psoriasis to be distinguished from rheumatoid arthritis, in which RF is increased.
- Erythrocyte sedimentation rate (ESR) is generally normal, with the exception of pustular psoriasis and psoriatic erythroderma.
- Uric acid. Uric acid levels in psoriasis can be elevated (especially in pustular psoriasis), which leads to psoriatic arthritis being confused with gout, in which the uric acid concentration increases significantly.
- Antibodies to HIV (human immunodeficiency virus). The sudden onset of psoriasis can be due to HIV infection.
Other research methods
- X-ray of the joints. Allows you to assess the severity of joint damage in psoriatic arthritis.
- Skin biopsy. The examination involves taking a small sample of skin for subsequent examination under the microscope. It is performed in difficult cases to distinguish psoriasis from other skin diseases.
Treatment
Therapy for psoriasis includes local treatment of skin lesions, medications, phototherapy, prevention of exposure to factors that provoke the appearance of rashes. It depends on the type and severity of the psoriasis.
To get rid of skin lesions, you can use emollients (creams, petroleum jelly, paraffin, vegetable oils). They are most effective when used twice a day after a shower. Salicylic acid, anthralin, tar preparations, ointments, solutions, shampoos containing coal tar are also used. These agents are anti-inflammatory and slow the formation of new skin cells.
Using corticosteroid ointments makes the treatment more effective. They are indicated for mild to moderate psoriasis. However, their long-term use is not recommended (skin atrophy, drug addiction are possible).
Light therapy - exposure of the skin to ultraviolet radiation - can be helpful. In this case, burns should be avoided.
Local treatment of lesions in severe cases is combined with taking medications: retinoids, vitamin D preparations, methotrexate, etc.
Treatment of psoriasis can be difficult, as the disease is chronic and recurs after the symptoms disappear. The effectiveness of a particular treatment method depends on the patient's susceptibility to it.
Daily baths (bath oil, oatmeal, or sea salt recommended; avoid hot water and scrubs) and hydration after bathing can help soften the skin and reduce psoriasis inflammation.
Prevention
- Avoid hypothermia, sunburn.
- Avoid emotional stress whenever possible.
- Stop smoking and alcohol abuse.
- Take some medications (antimalarials, etc. ) with caution.
Recommended analyzes
- General blood analysis
- Erythrocyte sedimentation rate (ESR)
- Rheumatoid factor
- Serum uric acid
- HIV 1, 2 Ag / Ab Combo (determination of HIV type 1 and 2 antibodies and p24 antigen)