Psoriasis is a common non-communicable skin disease associated with inflammatory lesions. Chronic chronic - the acute period is followed by periods of relief or disappearance of symptoms - and is caused by a combination of different factors.
The disease is widespread and occurs somewhat more often in women than in men. It does not completely cure, 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
Liken me scales.
English synonyms
Psoriasis.
Symptoms
The symptoms and signs of psoriasis depend on the type of psoriasis.
- Plaque psoriasis. It is accompanied by specific inflammatory formations of the skin - raised lesions, oval, pronounced scabs, scaly and covered with silvery scales. Most often, the formations appear on the outer surface of the elbows, knees, scalp and trunk. Elements of skin rash can be painful and itchy. In severe cases, the skin near the joints of the affected areas crack and bleed.
- Guttate psoriasis. This type is associated with the appearance on the body of numerous papules (nodes) orange-pink, 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.
- Psoriasis of the nails. It is characterized by compaction, exfoliation, staining of nail plates, staining, yellowing of nails, the presence of stains on them, the formation of holes, cracks, damage to nails. Nail plates are destroyed, nail growth is disturbed, they can separate from the nail bed. Occurs in 30-50% of patients with psoriasis.
- Psoriasis of large folds. In this case, skin lesions in the form of inflammatory red spots appear in the area of the armpit folds, under the mammary glands, in the folds of the cervix, in the genital area, in the foreskin. Cracks may appear along the edges and in the center of the lesions. Most often, severe psoriasis folds in overweight and obese people. Sweating and rubbing make the disease worse.
- Psoriasis of the scalp. It is accompanied by redness of the scalp, itching, fragmentation of the scalp with the appearance of white scales on the hair and shoulders - particles of dead skin.
- Psoriatic arthritis. Skin lesions are associated with joint pain, swelling, curvature and deformity of the joints. Toe joints, wrists, feet, knee joints may be involved.
- Pustular psoriasis. This type is characterized by redness of the skin and the formation of a large number of pustules - small bubbles filled with pus. Formations can appear on the palms and soles of the feet or all over the body. When multiple pustules appear on the body, fever and weakness come together.
- Psoriatic erythroderma. Areas of skin redden, plaques may appear. Lesions are usually accompanied by severe itching. Most often, psoriatic erythroderma is associated with sunburn or misuse of medication.
Usually, with different types of psoriasis, the disease appears gradually, skin lesions spread and are noticed over 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-communicable skin disease associated with inflammatory lesions.
Chronically chronic and often recurrent - the acute period is followed by periods of weakening or disappearance of symptoms, then after a while the symptoms reappear.
Psoriasis is prevalent, especially among people aged 16-22 years, 57-60 years. Women are more sensitive to it than men. People with pale skin are at increased 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. His appearance is associated with a genetic predisposition, with malfunctions of the immune system and with environmental factors affecting the body.
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 through the 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 causes dilation of blood vessels in the affected area, disrupts the cycle of formation of new skin cells - they form much faster than usual. Dead skin cells, meanwhile, do not have time to exfoliate and accumulate on the surface of the skin, forming plaques.
Psoriasis can be caused by one of the following factors:
- infections (tonsils, mosquitoes, HIV);
- skin damage - cutting, scratching, biting or burning;
- hypothermia;
- sunburn;
- emotional stress;
- smoking, alcohol abuse;
- use of drugs (antimalarial, etc. ).
At the same time, in some patients with psoriasis, rashes appear without noticeable influence of environmental factors.
There are the following main types of psoriasis.
- Plaque psoriasis. It is more common.
- Guttate psoriasis. It usually affects people under the age of 30. Occurs 2-3 weeks after infectious diseases of the upper respiratory tract, as well as after superficial bacterial infections in the area around the anus.
- Psoriasis of the nails.
- Psoriatic arthritis. In this type of psoriasis, skin lesions are associated with arthritis - inflammation of the joints.
- Psoriatic erythroderma. It is most often associated with sunburn and misuse of medication.
- Pustular psoriasis. It is quite rare, in severe cases, life-threatening to the patient.
- Psoriasis of the scalp. 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.
Classification of psoriasis according to the severity of the course:
- soft (less than 2% of all 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, the addition of a secondary infection through scratches and abrasions that appeared due to itching with psoriasis;
- psychological problems (stress, low self-esteem, depression, social isolation);
- joint damage (stiff deformation and decreased joint mobility);
- Increased risk of developing various diseases and conditions: high blood pressure, inflammatory bowel disease, cardiovascular disease, skin cancer.
Psoriasis is usually relatively mild. However, for most patients, social adjustment 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 becoming infected (many do notknow that the disease is not contagious).
Who is at risk?
- People with a hereditary predisposition (more than 40% of psoriasis patients have a relative with psoriasis).
- People with viral, bacterial, fungal infections (streptococcus, mosquitoes, HIV, etc. ).
- Emotionally stressed.
- Obese and overweight people.
- Smokers.
- Alcohol abusers.
- Taking certain medications (antimalarial medications, etc. ).
- Sunburned.
diagnostic
The diagnosis of psoriasis is usually based on the typical type of lesion, taking into account their location. In severe cases, additional tests may be required to rule out other skin conditions.
Laboratory research
- General blood test. 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 associated with joint damage, especially in rheumatoid arthritis. The test result for psoriasis is negative. This allows you to distinguish psoriasis from rheumatoid arthritis, in which RF is increased.
- The erythrocyte sedimentation rate (ESR) is generally normal, with the exception of pustular psoriasis and psoriatic erythroderma.
- Uric acid. Uric acid levels in psoriasis may increase (especially in pustular psoriasis), leading to confusion of psoriatic arthritis with gout, in which the uric acid concentration increases significantly.
- Antibodies to HIV (Human Immunodeficiency Virus). The sudden onset of psoriasis may 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. Examination involves taking a small sample of skin for later examination under a microscope. It is performed in difficult cases to distinguish psoriasis from other skin diseases.
Treatment
Therapy for psoriasis includes local treatment of skin lesions, medication, phototherapy, prevention of exposure to factors that provoke the appearance of rashes. It depends on the type and severity of psoriasis.
Emollients (creams, Vaseline, paraffin, vegetable oils) can be used to get rid of skin lesions. They are most effective when used twice a day after a shower. Also used salicylic acid, antralina, tar preparations, ointments, solutions, shampoos containing coal tar. These agents are anti-inflammatory and slow down the formation of new skin cells.
The use of 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 dependence are possible).
Light therapy - exposing the skin to ultraviolet radiation - can be helpful. In this case, burns should be avoided.
Local treatment of lesions in more severe cases is combined with medication - retinoids, vitamin D preparations, methotrexate, etc.
Treating psoriasis can be difficult, as the disease is chronic and recurrs once the symptoms disappear. The effectiveness of a particular method of treatment depends on the patient's sensitivity to it.
Daily baths (bath oil, oatmeal or sea salt are recommended; hot water and cleansers should be avoided) and hydration after washing can help soothe the skin and reduce the inflammation of psoriasis.
prevention
- Avoid hypothermia, sunburn.
- Avoid emotional stress whenever possible.
- Quit smoking and alcohol abuse.
- Take certain medications (antimalarial, etc. ) carefully.
Recommended tests
- General blood test
- Erythrocyte sedimentation rate (ESR)
- Rheumatoid factor
- Serum uric acid
- HIV 1, 2 Ag / Ab Combo (determination of antibodies to HIV type 1 and 2 antigen and p24)