A characteristic feature of psoriasis is the most prevalent in the location of the papules symmetrically on the skin of the extender of the surface of the hands and the feet and the scalp.
Despite the fact that the leading role in the development of psoriasis is the presence of a genetic predisposition (psoriasis is a disease that is inherited), the impetus for the emergence of the disease can serve a multitude of Exo and factors endogenous (the development of psoriasis in the nervous system, endocrine disorders, after infectious diseases, etc.).
The etiological factors of the disease
The disease has no sex predisposition, therefore, the frequency of occurrence of psoriasis in men and women is no different. In 12% of patients with the disease first develops up to ten years. Twenty years before the psoriasis develops into forty-six percent of patients, and up to thirty years sixty percent.
In the development of psoriasis there are two large peaks:
- twenty-seven and fifty-four years for men;
- fifteen and fifty-four years in women.
Causes of psoriasis in adults
The exact cause of psoriasis is unknown. The role of leadership in the pathogenesis of the disease belongs to genetic predisposition. Also, an important role played by the occurrence of immune instability, lipid disorders and if the patient foci of chronic infection.
In favor of genetic theories (inherited causes of psoriasis) is evident in the fact that the disease is always to be found, not only the patient, but also their family members.
To identify a predisposition to psoriasis can be the time to do a classical analysis of the genome. These patients may be ten loci of the chromosomes responsible for the genetic predisposition to the disease (PSORS 1 to 9, as well as HLA – B27, 17, etc.).
The main gene responsible for the maximum expressed by the innate predisposition to develop the disease, think of PSORS1.
Also, in the pathogenesis of psoriasis play an important role of genetically determined disorders of metabolism of carbohydrates and lipids. In the majority of patients with psoriasis revealed severe hyperlipidemia and the metabolic syndrome. In this sense, in patients with psoriasis, there is a high risk of severe early atherosclerotic vascular lesions and cardiovascular diseases.
In addition to hyperlipidemia, highlighting the altered the metabolism of fatty acids (fatty acids), increasing the production of free radicals compounds that are involved in keratinization of the epidermis, etc.
In the study of psoriatic plaques, which had a great concentration of oxidized low-density lipoprotein.
The main markers for the evaluation of the proliferation of keratinocytes on the outbreak of psoriasis are proteins Ki67 and keratin, six, sixteen and seventeen. These markers are responsible for the pronounced the processes of hyperplasia, disorders of differentiation of cells and development of reactions of inflammation in the dermis.
Because of this, even with the onset of the clinical phase and recovery of psoriasis (the disappearance of the inflammation of the epidermis) that can persist inflammatory process in the blood vessels of the dermis.
Also, in the development of inflammation in the outbreak of psoriasis play a role of activated T-lymphocytic cells, mediators of reactions inflammatory diseases, the inflammation in the microvasculature. In the study of the microflora of the skin of patients with psoriasis reveal streptococci, provoke the development and the exacerbation of guttate psoriasis.
Immunological basis of the pathogenesis of psoriasis is the progression of immunocompetent cells, activated CD4+T-lymphocyte cells and cytokines with anti-inflammatory action. In favour of this theory is demonstrated by the fact that the monoclonal antibodies in psoriasis act against activated CD4+T-lymphocytes, the cells have a significant therapeutic effect. Also, effective remedy for psoriasis are drugs aimed to inhibit the production of factors tumor necrosis.
Contagious psoriasis on other
No. Psoriasis is a genetic disease.
If psoriasis it is transmitted from person to person
No. Catch psoriasis from another person is impossible. Despite the fact that streptococcal infection may be a factor precipitating, a person without a genetic predisposition to the disease, the psoriasis does not occur.
If the psoriasis transmitted sexually
No. Psoriasis is not contagious and is not transmitted, nor suspended in the air, no contact, either sexual or in any other way.
If passed, the psoriasis hereditary
For the development of psoriasis requires a genetic predisposition (hereditary) predisposition. Therefore, the disease is often found in close relatives. In the presence of psoriasis in the parents, there is a high risk of psoriasis and have a child.
However, some authors distinguish psoriasis the second type. It is assumed that this variant of psoriasis that develops in patients after the age of forty and affects mainly the joints and the nail plate is not associated with the inheritance.
Can you die from psoriasis
No. Psoriasis is not life threatening disease. The prognosis in these patients is favorable.
However, psoriasis is much more difficult to complete the patient's life, causing him a lot of discomfort and reduce their social activity.
Also, it should be pointed out that pustular psoriasis can occur is very difficult, accompanied by emptying and suppuration of the pustules, in addition to the fall away of the skin, the type of "purulent lakes". In this case, perhaps the development of the erythroderma, secondary bacterial complications of joint damage, etc.
Trigger factors for the development of psoriasis
Aggravating factors that contribute to the exacerbations of psoriasis are:
- lesions of the skin;
- endocrine disorders;
- pregnancy;
- the appearance of metabolic disorders;
- the use of drugs of beta-blockers, anti-malarial RS-V, etc.;
- the presence of focus of chronic infection (particularly streptococcal infection);
- the abuse of alcohol;
- Not;
- excess exposure to the sun,
- spicy food, sweet, fatty foods, etc;
- acute infectious diseases;
- exacerbation of illnesses, allergic;
- the stress, the overload of emotional (psoriasis nerves becomes aggravated more often).
The classification of psoriasis
Of the species isolated forms of psoriasis:
- vulgaris (common psoriasis);
- exudative;
- chronic Palmar-plantar;
- warty;
- follicle;
- nails;
- pustular;
The disease can lead to the progressive, stationary.
On the extent of the lesion distinguish limited, common and widespread flow.
There may also be a seasonality of the exacerbations: winter, summer, and indeterminate (non-seasonal) exacerbation of psoriasis.
Images, symptoms and treatment of psoriasis in adults
For psoriasis is characterized by the appearance of a pinkish red or bright red papules, covered with silvery, white scales, loose consistency. Itchy skin may be missing. Many patients noted the appearance of a feeling of tightness of the skin.
Intense itching characteristic, as a general rule, to psoriatic lesions of the scalp and the perineum.
The appearance of pain in the joints observed in the development of the psoriatic arthritis.
The most typical manifestation of psoriasis is a triad of specific symptoms :
- the emergence of the phenomenon stearin spot (strengthening of flaking in the diagnosis of psoriatic papules, which makes it similar to a drop of stearin);
- the appearance of the terminal films (the appearance of thin transparent film remaining after when poskablivanii will be separated all the peeling);
- the appearance of blood from the dew or the appearance of to establish the bleeding at the site of the terminal-rejection of the films.
Psoriatic papules may bring isolated or merged. The size can vary from small to cover a large surface of the skin. The most common of the location of the papules are the elbows, knees, head (scalp) and back.
In rare cases, the plate can affect the mucous membranes of the mouth and the oral cavity.
In children, the elderly, the sick and people with diabetes can develop this form of the disease. In this case, the affected skin behind the ears, armpits, crotch, buttocks, around the navel and under the Breasts.
Patients with this psoriasis can be any peeling. Surface psoriatic lesions may be smooth and bright red. In some cases, it may cause maceration of the folds.
In some patients the only manifestation of the disease may be plaques on the skin and the mucous genital.
Normally psoriatic skin lesions are symmetrical in nature, but some patients may experience unilateral eruption. You may also receive curly psoriatic lesions (annular, arcuate, geographical, etc.).
Patients with long course of disease, long-existing and plaques on the skin of the lumbar and gluteal region can be accompanied by an increase of warty growths.
In addition, the reasons of the appearance of verrucous psoriasis can include:
- purulent infection of the skin;
- incorrect external treatment (usually self);
- the excess body weight.
When warty forms of the disease, the scales start to stick between them, forming on the surface of the plates of yellow bark.
Some patients can be produced in isolation that occur Palmar-plantar psoriasis. In this case, the patient concerned painful cracks, pustules, papules, erythematous-squamous plaques on the palms of the hands and feet.
Frequent manifestation of psoriasis is the lesions of the nail plates. In the majority of cases, the appearance of points gaps in the surface of the nail (dystrophy). Also can appear the deformation of the nail, longitudinal and transversal grooves, thickening of the plate of the nail, is loosening and changing colors, bleeding under the nail plate.
In psoriatic erythroderma, emerging usually against a background of excessive sun exposure or improper treatment topical, there is a large swelling of the skin, redness, intense itching and flaking, fever, weakness and loss of appetite. To severe, can cause anemia, heart failure, and disorders of the kidney and liver, there is dehydration and alopecia areata.
Psoriasis and pregnancy is a threat to the child, especially
Psoriasis does not violate the reproductive function and are not contraindications to pregnancy. It should be noted that many of the women during pregnancy, the disease is easier than normal. However, a twenty percent of women can be expressed exacerbation of the disease.
In General, psoriasis does not interfere with the course of pregnancy and threatens the life of a child. However, in patients with arthritis, for the increase of the load on the joints, it could be significant deterioration. In generalized forms of pustular psoriasis, the possible appearance of secondary complications bacterial infections.
It should be noted that since the psoriasis is not true for infectious diseases, the mother is allowed contact with the child and the chest. The likelihood of developing psoriasis in the future is equal to about 15-20% if evil only a parent and approximately 50% when both parents are sick.
The main difficulty in the treatment of psoriasis in pregnant women is that they are contraindicated in most assigned medications. Therefore, in the planning of the pregnancy, you should inform your doctor so he adjust the treatment.
Self-medication is strictly prohibited and can cause significant damage both to the mother and the baby (some drugs have toxic effects on the fetus).
The diagnosis of the disease
The diagnosis put on the basis of specific symptoms (psoriatic triad). And also, if necessary, the data of histological, immunological, and radiological studies.