Psoriasis - what is this disease?

16 September 2020

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

What is this disease?

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

Of course, almost everyone has heard of a disease such as psoriasis. And this is not surprising, as scaly lichen is quite prevalent. This disease is diagnosed in 4-10% of the world's population. Moreover, statisticians who gather information about the prevalence of psoriasis, argue that the number of patients is constantly increasing.

Scaly lichen has been known to people since ancient times, and even healers in ancient Greece tried to treat this disease. The modern history of the study of psoriasis is about 150 years old. But during this considerable period of time, researchers managed to learn insufficiently 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 as a complex systemic disease associated with disorders in the immune system, with a dysfunction of metabolic processes and the emergence 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 these are disorders of trophism and metabolic processes in the skin caused by a malfunction in the functioning of the body systems. Today, two theories about the etiology of psoriasis are considered the most likely: genetic and viral.

Genetic theory has many supporters, as psoriasis often acts as an inherited 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 hereditary origin of psoriasis. This circumstance is the reason for dividing these cases into a separate group, in which the main reason is not genetic failures, but phenotypic.

There are other theories that explain psoriasis. For example, endocrine, neurogenic, metabolic, etc. Of course, all of these theories are not unfounded, and studying them allows you to get more important information about psoriasis. However, today it is known for sure that the condition of the endocrine and nervous system, as well as the work of the gastrointestinal tract, do not cause psoriasis, but have a significant effect on the course of this disease.

For example, pathologies affecting the liver lead to the fact that the quality of blood cleansing performed by this organ is greatly reduced. And this, in turn, can provoke the appearance of various skin manifestations, including psoriasis.

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc. ), leads to the fact that the tissues of this organ regenerate, ie 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 oblique relationship, psoriasis is often associated with fatty degeneration, affecting the liver. Therefore, in treating this skin disease, it is important to follow a diet so as not to unnecessarily burden the liver. Patients are advised to limit fatty foods, to completely eliminate alcohol.

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

International Classification

Psoriasis manifests itself in various forms. To make navigation easier by 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, hence the abbreviation ICD 10. Work began on 10 revisions of the International Classification of Diseases in 1983 and ended in 1987.

Basically, ICD 10 is a standard assessment tool used in medicine and health management. The manual in Review 10 is used to monitor the prevalence of various diseases and other health problems.

Using version 10 of the ICD, it is possible to compare morbidity and mortality data across countries, which makes it possible to obtain statistical data and systematize diagnostic information. By agreement of WHO members, ICD 10 is used to set codes for various diseases. In the 10th version of the classifier, alphanumeric codes are adopted, with the help of which it is convenient to store information in electronic form.

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

Common psoriasis(synonyms: vulgar, simple, plaque-like). The disease is assigned a code according to ICD 10 - L-40. 0. This is the most common form, observed in 80-90% of patients. The main symptoms are the formation of plaques raised on the surface of the unaltered skin, covered with scales of grayish-white skin. This shape is characterized by light scaly skin. After removing them, the inflamed red skin opens, which is very easily damaged and begins to bleed. As the inflammatory process progresses, the plaques may increase significantly in size.
Reverse psoriasis. It is a disease that affects the folds of the skin (flexion 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 light spots. Deterioration is observed when the skin is damaged by friction. The disease is often complicated by an accompanying streptococcal or fungal infection.
Psoriasis Guttate. This form of psoriasis is characterized by the formation of a large number of small red or purple spots on the skin, resembling water droplets in shape. According to version 10 of the international classifier, such a disease received the code L4. Most often, guttate psoriasis affects the skin of the feet, but rashes can occur on other parts of the body. At the same time, it is known about tear psoriasis that it develops as a complication after streptococcal infections - pharyngitis, tonsillitis, etc.
Pustular or exudative psoriasisis a severe cutaneous form, according to ICD 10 assigned codes L1-3 and L 40. 82. Characterized by the formation of blisters or pustules. The skin in the lesions is swollen, red, inflamed, easily peeled off. If fungi or bacteria penetrate the pustules, the contents of the pustules become purulent. Pustular psoriasis often affects the extremities, but in more severe cases, a generalized process can develop with the spread of rash throughout the body.
Psoriatic arthritis psoriatic or arthropathic. According to version 10 of the ICD pathology, the L5 code was assigned. Manifested by inflammation of the joints. Arthropathic psoriasis can affect all types of joints, but in most cases the joints in the phalanges of the fingers and hands become inflamed. Knee, hip, or shoulder joints can be affected. Lesions can be so severe that they will lead to disability of the patient. Therefore, you should not think of psoriasis as it is an exclusively skin disease. Severe types of psoriasis can lead to systemic damage, disability or even death of the patient.

Erythrodermic psoriasis. A rare but severe type of psoriasis, according to ICD 10, this disease got the code L85. Erythrodermic psoriasis often manifests in a generalized way, all or almost the entire surface of the skin can enter the affected area. The disease is accompanied by severe itching, swelling, soreness.
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 nails on the fingers and hands. Nails can change color, become thicker, and begin to deteriorate. Complete loss of nails 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;
widespread 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, then common psoriasis is more common than other forms.

Flow phases

Psoriasis limited or widespread during its course goes through three stages: progressive, persistent and regressive.

The following is a characteristic of the progressive stage of psoriasis:

the appearance of new rashes;
increase already existing tiles;
appearance of new redness elements at the site of skin lesions (scratches, abrasions);
Abundant scaling of existing tiles.

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

no new items appear;

moderate peeling of elements;
shows no signs of increasing elements.

The appearance of folds in the corneal layer around the elements is a sign of a transition from a stationary phase to a regressive one.

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

reduction of peeling intensity;
resolution of elements.

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

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

winter (aggravated in autumn and winter);
summer (with deteriorations during the warm period);

Diagnostic Features

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

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

A layman can mistake psoriasis and fungus like mushrooms. Since skin fungi (skin fungi) are manifested by similar symptoms - the formation of scaly plaques. Therefore, if you notice suspicious symptoms on the body or nails, you do not need to diagnose yourself and read to treat the fungus using pharmacy or folk remedies.

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

When you contact a dermatologist, a fungal test will be done, a scratch will be taken from the nail or skin. The resulting material is then placed in nutrient media. If fungi are 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 what type of fungus provoked 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. ) Diagnosis of psoriasis by a dermatologist , patients will need to be tested periodically for fungi and other infectious agents.

In the diagnostic process, a certain role is assigned to a series of phenomena called psoriatic triads. The phenomena appear sequentially, when you clean the blush element.

The psoriatic trio appears as follows:

when you clean the blush element, the scales are removed in the form of "shavings";
After removing the chips, a thin transparent film similar to polyethylene opens;
when the film is damaged, the correct bleeding opens.

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

Interesting facts about psoriasis

People have known about psoriasis for a long time. Even the name of the disease itself came to our language from ancient Greek. At the time of the prosperity of Ancient Hellas, the word "psora" meant all skin diseases manifested by itching 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 an extensive chapter on this disease.

They knew about psoriasis, but this disease was not unequivocally evaluated, as it was called, sometimes "imperial" disease, then "devilish".

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

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

Modern understanding of disease

It must be said that modern science does not know much about this mysterious disease. There are various theories about the origin as well as the 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 unclear, it was possible to discover the nature of psoriasis. This disease is autoimmune, i. e. it is caused by a malfunction of the immune system;
another proven 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 their relatives are ill;
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 redness are formed at the sites of skin lesions - scratches, burns, frostbite. Sometimes psoriasis appears after a while, at the site of the marks;
An important observation that allows you to get more information about psoriasis is the relationship of this disease to climatic factors. Deteriorations and relapses are often timely to coincide with the change of season;
patients have probably noticed in practice the link between exacerbations and stress. All patients should know for sure that the disease recurs or worsens its course against the background of nervous tension and experiences;
a new fact about psoriasis is that the disease can debut at any age, although it was previously believed that lichen scales occur after 30;
It is important for all people to know that psoriasis is not a contagious disease. Even with close contact with the patient, there is no risk of infection;
almost everyone has heard of the cure for psoriasis and this is true, as no cure has been found that can surely beat the disease. But patients should be aware that psoriasis can be controlled. Adequate and timely treatment allows long-term remission.

Modern methods of treatment

Speaking of the common disease of psoriasis, we can not but tell about the treatment of this common disease. It must be said that it is impossible to cure psoriasis with tablets or oils alone.

To forget the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will have to make an effort. It will be necessary to organize the food properly. Some experts argue that it is possible to forget about psoriasis forever only with the help of a properly formulated diet and regular cleansing of the body.

The doctor will draw up a preliminary treatment plan. As a rule, external therapy methods (oils, creams) and systemic (tablets, injections) are used. Furthermore, physiotherapeutic methods will be used and treatment at resorts is recommended. It is recommended to treat psoriasis using healing mud, mineral water and thermal.

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

May offer other treatments for scaly lichen at resorts. For example, caterpillar therapy, healing baths and 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.

Alternative treatments for psoriasis are also widely advertised. Indeed, some of them can help in achieving forgiveness. However, when choosing a method, you need to remember about common sense so as not to harm your health. If a recipe or recommendation is in doubt, then it is best not to use it. Consult a doctor before using any treatment method.

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 to overcome this mysterious and insidious disease.