What is skin psoriasis. Psoriasis: types and forms by classification

A person can develop one of more than ten forms of psoriasis at any age. Most often, areas of the skin tissue are affected, which are constantly subjected to pressure and friction: the buttocks, near the joints, on the folds of the limbs. But the appearance and / or spread of psoriatic plaques or pustules in the later stages in any area of \u200b\u200bthe body is not excluded: on the soles of the feet, palms, hairy areas, including the head, armpits and external genitalia, on the back, chest and.

Usually, with psoriasis, excessively dry, reddish patches-plaques protruding above the skin surface are formed due to chronic inflammation and excessive proliferation of dermal keratinocides, macrophages and lymphocytes within it. Their formation is also facilitated by excessive angiogenesis - the growth of new tiny capillaries. At the same time, the diseased skin thickens, rises above the healthy one, forming characteristic pale, gray or silver spots in the form of hardened wax or paraffin.

Psoriasis proceeds for a long time and in waves. Spontaneous short or long remission can occur, up to self-healing, which is very rare. Relapses can also be spontaneous and last for life, but more often they are provoked by external influences if the patient:

often uses alcohol;
suffers from intercurrent infections (diseases that join, accompany and complicate psoriasis);
subjected to stress.

The classification assigns code L40 to psoriasis, it combines papulosquamous disorders. By type it happens:

Ordinary or plaque-shaped (L0). The structure of papules is scaly. Pathology is characterized by plaques of gray, silvery-white or pink color. They tend to grow and join with neighboring ones, capturing large areas. skin.
Generalized pustular (L1). It is often referred to as Zumbusch disease or impetigo. The form of the disease is the most severe due to vesicles or blisters filled with exudate. When opening the bubbles against the background of inflamed skin and penetration into the infection, the rashes become purulent and often affect the arms and legs, less often the body.
Persistent acrodermatitis (L2). It is called Setton's or Crocker's dermatitis. In pustules (pustules) there is no infection, but if there are plaques on the hands and fingers, peeling of the nails is possible.
(L3) or pustular bactericide. Large and small pustular formations spread over the feet and palms. Despite the sterility of the pustules, this type is considered severe, because when walking, abrasion and opening of the pustules occurs. This fact complicates the treatment of the disease.
Teardrop (L4). Small purple dots may appear on the thighs, shins, forearms, shoulders, back, neck and head. Streptococcal tonsillitis or pharyngitis causes teardrop-shaped pathology.
Arthropathic (L5-7 - M07.0-M07.3, M09.0) or psoriatic arthropathy, psoriatic arthritis. With damage to the joints and connective tissue, the phalanges on the fingers of the extremities swell. Less common is the defeat of the knee, humeroscapular, hip joints and spine. In this case, the motor function is disturbed, which gives rise to the registration of disability.
Other species (L8). This includes inverse psoriasis with smooth, inflamed patches without scaling. The spots cover the skin in the folds, under the breast, in the groin, on the folds, the skin and mucous membranes of the external genitalia. Due to the fact that sweat is released in the folds, and the affected areas constantly rub, a fungal infection can occur, which makes treatment difficult.
Unspecified (L9), that is, all other forms.

Types of psoriasis by clinical classification

By clinical classification determine the localization of psoriatic plaques. They are distributed in the following areas:

palms and soles, this species is called pustular bacterid (code L3);
nails, the pathology is called psoriatic onychodystrophy: point, atrophic and hypertrophic. Manifested by depressions and grooves on the nails, dull color of the nail plate, peeling, crumbling, itching near the cuticle and translucence of capillaries;

With punctate psoriasis of the nails, many indentations appear in the form of dots on the nail bed. It is surrounded by an inflammatory border, and the dull edges become brittle. With atrophic - the nail plates become thinner and disappear, and the inflammatory process does not develop. With hypertrophic - under the nail plate, cornea appears from the epithelium due to the accumulation of dying cells, which also thickens the nails and changes their shape.

on the limbs (legs, forearms) a palmoplantar form of pustulosis, vulgar plaque pathology, inverse psoriasis covering the flexion surfaces are diagnosed;
on the joints, this type is called - psoriatic arthritis (by code L5-7);
on the mucous membranes, pustules affect the mucous membranes of the mouth, genitals,. Inflamed elements have a different shape with clear boundaries and slight swelling;
on the face, which is typical for some forms of the disease;
scalp, this is a type of psoriasis in which the scalp is flaky, cracking near the shells of the ears. Rashes capture the skin of the neck, cause severe itching. Tearing off the scabs leads to the formation of bruises;
on large folds of the skin, which is called intertriginous psoriasis. The location of the plaques is the groin, armpits, the area between the fingers, in women - under the breasts;
on the surface of the body, which is called erythroderma. It leads to a violation of the basic functions of the skin: barrier protection, temperature regulation and lethal outcome. In this case, several types of scaly rash can be combined. The generalized form is very difficult.

Types of psoriasis

What is psoriasis - one of the most common types of skin diseases? Pathology occurs pustular and non-pustular type.

Pustular psoriasis

If small inflamed vesicles appear on the skin, and they are filled with exudate that does not spread the infection to other people, then the rash is considered pustular (exudative).

The pustular type of pathology can be of several types:

Generalized. Severe von Zumbusch disease occurs suddenly and spreads in the form of pustules (erythema) throughout the body, it is difficult to treat.
Generalized acrodermatitis Allopo with pustular rash involving the hands and feet. It opens and forms erosions up to 5 mm in diameter, on which purulent crusts appear.
Localized Allopo acrodermatitis with lesions on the pubis.
Herpetiform impetigo with localization of pustules under the armpits and in the groin, on the inner surface of the thighs in pregnant women.
Palmoplantar or palmoplantar or Barber's psoriasis. It flows in waves, affecting the feet and hands with pustules. After drying, the pustules form hard, dense crusts. Foci spread in the absence or belated treatment.

Psoriasis of the non-pustular type

This type of scaly rash is the most common and comes in two forms

vulgar plaque-like (ordinary). It manifests itself in the form of whitish scales on inflamed and red areas of the skin. Plaques merge, which leads to the formation of huge foci;
erythrodermic or psoriatic erythroderma. It can take a generalized form due to the inflammatory process, peeling and flaking of large areas of the skin.

Stages of psoriasis

The scaly type of pathology, as a systemic process, occurs with serious immune, morphological or functional disorders of the organs and systems of the body. The severity of the disease is interrelated with remissions and exacerbations and their spontaneity, adequate treatment. Psoriasis can cause inflammation of the joints - psoriatic arthropathy or psoriatic arthritis.

All types of psoriasis are divided into three stages.

First stage

With progression, new papules form on the skin and / or the size of existing conglomerates increases. An erythematous border forms around the peripherally growing zone. There is no flaking at the edges as the psoriatic mass continues to grow faster than the flaking process can begin.

In the acute phase, psoriatic papules appear even in places where there is a minor skin injury due to a sunburn, scratch, or prick. With irrational methods of therapy, psoriasis is aggravated, significant areas of the skin are affected, especially with frequent stress, psoriatic erythroderma develops.

Second stage

Later, new papules cease to appear, the growth of papules or plaques and conglomerates stops. Then the growth of other papules begins:

After the papule stops growing, a stratum corneum forms around it in the form of folds 2-7 mm wide. After the psoriatic foci resolve, the process of hypopigmentation begins: the formation of a light patch of skin. V rare cases completes the resorption of foci, the process of hyperpigmentation: the formation of dark areas of the skin. However, both of these processes are not permanent.

In the second stage, lenticular formations are often found due to the presence of infection in the tonsils, which is why psoriasis is called tonsillogenic.

Third stage

At this stage, regression begins and it manifests itself:

gradual disappearance of rashes;
the formation of a whitish pseudosclerotic border around the focus (Voronov's rim) with mild itching;
resolution of psoriasis formations, starting from the center, which can be seen from the semicircular figures, similar to those that were with progressive psoriasis in the first stage. In this case, "garlands" of psoriatic formations are formed.

The third stage is also characterized by rashes mainly on the folds of the limbs, the sacrum, on the head under the hair without changing their structure and without loss, in the inguinal-femoral folds, under the armpits, on the nipples of the chest. The rashes are highly infiltrated, there is no corneal corolla on the plaques, therefore, after the release of the infiltrate, a psoriatic film appears with the presence of bloody dew.

Some cases in the third stage are characterized by marked progression and no regression. Therefore, the skin is affected in large areas, which is called diffuse psoriasis. An exception is the concentration of the rash on limited areas of the skin: the penis, the head under the hair, on one half of the body in the form of a strip.

Why does psoriasis occur?

Scientists have not yet figured out the true cause. According to the versions, the reasons are:

genetic inheritance;
exacerbation of influenza, tonsillitis, acute respiratory infections, chronic tonsillitis;
violations of metabolic processes;
changes in the composition of the blood, an increase in the level of lymphocytes, which leads to skin hyperemia and rashes;
decreased immunity against the background of existing foci of infection;
disturbed hormonal background, affecting the regeneration in cells.

Therapy for all types of psoriasis

External and systemic therapy is applied to all types of psoriasis, and their treatment is reduced to the elimination of the inflammatory process, the suppression of the proliferation of epithelial cells, and the normalization of their differentiation. In the course of external treatment with local preparations, inflammation, peeling and infiltration of the skin are reduced. For example, ointments:

The medicinal properties of Kartalin ointment are based on extracts of chamomile, string, lavender and eucalyptus oil, salicylic acid, bee honey, lysozyme and vitamins A and D.

Ointments are in demand:

based on herbal extracts and mineral components - Magnispor;
with crab chitin, mineral components and extracts of Far Eastern plants - Antipsoriasis.

Solid oil-based ointment can be prepared with your own hands. To do this, mix the purified grease (1 tbsp.) With honey (2 tbsp.), Baby cream (1/4 tube). Sulfur is added to the mixture at the tip of a spoon, egg white and wood ash (a pinch). After application, the ointment is kept for 20 minutes, gradually increasing the time to 60 minutes. For rinsing, you need foam from tar soap and warm water.

Effective universal cream for psoriasis "Sophora" based on yellowish sophora with the addition of mint, ash roots, Amur cork tree, fruits of Monnier root, azure splayed, glycerin, monostearic acid, aliphatic alcohol, liquid paraffin, dried scorpion and other components. It can be used when psoriasis and dermatitis, neurodermatitis, mycoses of the extremities (alimentary polyneuritis, purulent inflammations) and dermatomycosis, eczema, lichen and scabies.

Daily care for sore skin will be provided by a line consisting of Losterin cream and shampoos. The products consist of deresined naphthalan, urea, salicylic acid, extracts medicinal herbs, natural oils. Losterin is included in complex therapy for the treatment of many types of psoriasis, as well as eczema, neurodermatitis, atopic dermatitis.

Natural oils have a beneficial effect on the skin: avocado, olive, moisturizers and shampoos with tar and Dead Sea microcomponents.

Systemic therapy is carried out according to the doctor's prescription. Aromatic retinoids are used to inhibit the proliferation of epithelial cells, normalize keratinization processes and stabilize membrane cell structures and liposomes. Apply an analogue of retinoic acid - Acetritin, which is part of the drug Neotigazon. It has less side effects than aromatic retinoids, and the elimination process from the body lasts 50 hours.

Cyclosporine is used to treat severe forms of the disease and achieve an immunosuppressive effect. Therapy for severe refractory psoriasis: erythroderma, pustular and arthropathic is carried out with the cytostatic Methotrexate, a folic acid antagonist.

As alternative methods to increase immunity and have a beneficial effect on the skin in the cold season, PUVA therapy is prescribed using long-wave ultraviolet radiation and chemical photosensitizers.

Gara Rufa fish are used in salons and spas to treat all types of psoriasis. They do not have teeth in their mouths and use horny plates to remove and eat the psoriatic layer of the skin without causing pain or discomfort.

At the same time, healthy areas of the skin remain intact. The saliva of fish contains enzymes that normalize the regeneration of skin tissues. After the procedure, the skin is cleansed, moisturized and more elastic.

What is this disease?

Lichen scaly is another name for psoriasis, and this name perfectly characterizes this disease. Psoriasis is manifested by the formation of inflamed plaques of different sizes on the skin, they are densely covered with thick skin scales.

Surely, almost everyone has heard about such a disease as psoriasis. And this is not surprising, since scaly lichen is quite widespread. This disease is diagnosed in 4-10% of the world's population. Moreover, statisticians who collect information about the prevalence of psoriasis claim that the number of patients is steadily growing.

Known scaly deprive people since ancient times, even doctors in ancient Greece tried to treat this disease. The modern history of the study of psoriasis has about 150 years. But over this fairly solid period, researchers have not been able to learn much about the causes and treatment of psoriasis.

Widespread, uncertainty of etiology (causes of appearance), not enough effective treatment- all this characterizes psoriasis as one of the most difficult problems of dermatology.

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

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

The genetic theory has many supporters, since psoriasis often acts as a hereditary or familial dermatosis. A thorough 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 the allocation of these cases to a special group, in which the main cause is not genetic, but phenotypic failures.
The viral theory, according to which psoriasis develops as a result of infection, has its supporters. Confirmation of information about the viral origin of psoriasis is the detection of antibodies in the blood of patients, as well as "elementary bodies" in the cells of the epidermis. According to this theory, psoriasis develops not only in case of infection with a virus, but also in the presence of certain conditions.

There are other theories that explain the appearance of psoriasis. For example, endocrine, neurogenic, metabolic, etc. Naturally, all these theories are not without foundation, and their study allows us to obtain more important information about the disease psoriasis. However, today it is already known for sure that the state of the endocrine and nervous systems, as well as the work of the digestive 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 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 are reborn, that is, the liver is gradually replaced by connective tissue. As a result, the liver ceases to cope with its cleansing functions. Outwardly, this is manifested by yellowing of the mucous membranes and skin, and possibly more developed skin diseases, including psoriasis.

There is also an inverse relationship, psoriasis is often accompanied by fatty degeneration that affects the liver. Therefore, in the treatment of 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, completely eliminate alcohol.

Thus, despite numerous studies, it was not possible to obtain an exact answer to the question of what psoriasis is. However, work continues, 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.

Classification according to the international system

The disease psoriasis manifests itself in various forms. To make it easier for specialists to navigate, the generally accepted classification of psoriasis is used.

Psoriasis has also been included in the International Classification of Diseases (ICD). To date, the 10th revision of the international registry of diseases is already in use, therefore the abbreviation ICD 10 is used. Work began on the 10th revision of the international classifier of diseases in 1983, and completed in 1987.

In fact, ICD 10 is a standard assessment tool used in medicine and the field of health management. The 10th revision of the handbook 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 morbidity and mortality data in different countries, which allows you to get statistical data and systematize diagnostic information. By agreement of WHO members, ICD 10 is used to assign codes various diseases. In version 10 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 the ICD 10, and each of them is assigned a specific code. In dermatology, the following forms and types of psoriasis are distinguished:

Common psoriasis(synonyms: vulgar, simple, plaque-like). The disease was assigned an ICD 10 code - L-40.0. This is the most common form, it occurs in 80-90% of patients. The main symptoms are the formation of plaques raised above the surface of the unchanged skin, covered with white-gray scales of the skin. This form is characterized by slight flaking of scales. After their removal, inflamed red skin opens, which is very easily injured and begins to bleed. As the inflammatory process progresses, plaques can increase significantly in size.
Reverse psoriasis. This is a disease that affects the skin folds (flexion surfaces). For this form of the disease, ICD 10 adopted the code L83-4. Dermatosis appears with the formation of folds of smooth or minimally flaky spots on the skin. The condition worsens when the skin is injured by friction. The disease is often complicated by an associated streptococcal infection or fungus.
Guttate psoriasis. This form of psoriasis is characterized by the formation on the skin of a large number of small spots of red or purple, shaped like water droplets. According to the 10th version of the international classifier, such a disease received the code L4. Most often, guttate psoriasis affects the skin of the legs, but rashes can occur on other parts of the body. At the same time, it is known about guttate psoriasis that it develops as a complication after streptococcal infections - pharyngitis, tonsillitis, etc.
Pustular or exudative psoriasis- this is a severe cutaneous form, according to ICD 10 it is assigned the code L1-3 and L 40.82. It is characterized by the formation of blisters or pustules. The skin in the foci is edematous, red, inflamed, easily exfoliates. If a fungus or bacteria penetrates into the pustules, the contents of the pustules become purulent. Pustular psoriasis often affects the distal extremities, but in the most severe cases, it is possible to develop a generalized process with the spread of rashes throughout the body.
Arthritis psoriatic or arthropathic psoriasis. According to version 10 of the ICD pathology, the code L5 was assigned. Manifested by inflammation of the joints. Arthropathic psoriasis can affect all types of joints, but in most cases, the joints on the phalanges of the toes and hands become inflamed. The knee, hip, or shoulder joints may be affected. Lesions can be so severe that they lead to disability of the patient. Therefore, you should not think about psoriasis that this disease is exclusively skin. Severe varieties of psoriasis can lead to systemic lesions, disability or even death of the patient.
Erythrodermic psoriasis. A rare but severe variety of psoriasis, according to ICD 10, this disease received the code L85. Erythrodermic psoriasis often manifests itself in a generalized manner, the entire or almost entire surface of the skin can enter the affected area. The disease is accompanied by severe itching, swelling, soreness.
Onychodystrophy psoriatica or nail psoriasis. According to version 10 of the ICD, the disease was assigned the code L86. Pathology is manifested by changes in the appearance of the nails on the toes and hands. Nails can change color, become thicker, begin to break down. Perhaps the complete loss of nails.

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

limited psoriasis is a disease in which less than 20% of the skin is affected;
widespread psoriasis affects more than 20% of the body surface;
with the defeat of almost the entire surface of the skin, we are talking about universal psoriasis.

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

Flow stages

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

For the progressive stage of psoriasis is characterized by the following:

the appearance of new rashes;
growth of pre-existing plaques;
the appearance of new elements of the rash at the site of skin injuries (scratches, abrasions);
profuse desquamation of existing plaques.

For the stationary stage of psoriasis, the following symptoms are characteristic:

lack of appearance of new elements;
moderate peeling of elements;
no signs of element growth.

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

The following types of symptoms are characteristic of the regression stage:

reduction in the intensity of peeling;
element resolution.

After the resolution of psoriatic plaques, hypo- or hyperpigmented spots remain in their place.

For scaly lichen is characterized by a long course with periodic exacerbations. There are the following types of psoriasis:

winter (with exacerbation in autumn and winter);
summer (with exacerbations in the warm period);
off-season psoriasis is the most severe variety, since there is no clear relationship between relapses and seasons of the year, periods of remission may be practically absent.

Features of diagnostics

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, psoriasis of the nails is often mistaken for nail fungus, since the external manifestations on early stage these diseases are very similar. However, the fungus and nail psoriasis have a completely different nature, so the treatment should be different.

A layman can mistake for a fungus and skin psoriasis. Since skin mycoses (skin fungus) are manifested by similar symptoms - the formation of scaly plaques. Therefore, having noticed suspicious symptoms on the body or nails, you do not need to self-diagnose yourself and read to treat the fungus using pharmacy or folk remedies.

If the diagnosis is erroneous, and in fact, the cause of the symptoms is not a fungus, but psoriasis, then the treatment will not bring benefits, but, on the contrary, will aggravate the symptoms.

When contacting a dermatologist, an analysis will be made for the fungus, a scraping from the nail or skin will be taken. Then the resulting material is placed in nutrient media. If the fungus is present in the material, then a large colony will grow in the test sample in a few days. By 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, patients with a change in the clinical picture (appearance of purulent discharge, discoloration of plaques, etc.) will have to be periodically tested for fungus and other infectious agents.

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

The psoriatic triad manifests itself as follows:

when scraping the element of the rash, 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, spot bleeding opens.

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

People have known about the disease psoriasis since ancient times. Even the very name of the disease came into our language from ancient Greek. During the prosperity of Ancient Hellas, the word "psora" denoted all skin diseases that are manifested by peeling and itching.

The first person to write a detailed treatise on psoriasis was a Roman named Cornelius Celsus. In the fifth volume of his work "De medicina" there is an extensive chapter devoted to this disease.

In Ancient Russia, they knew about psoriasis, but this disease was not unambiguously assessed, since it was called either “imperial” or “devilish” disease.

Of course, the ancient healers knew very little about psoriasis. Until the 19th century, this disease was often mixed with other skin ailments. For the first time

psoriasis was isolated as an independent nosological form in 1799. This was done by the English dermatologist Robert Willan, who singled out psoriasis from a large group of skin diseases that are manifested by itching and flaking.

Not only ordinary people, but also prominent political figures knew about psoriasis firsthand. For example, Winston Churchill, who suffered from this disease, promised to erect a solid gold monument to a man who could learn everything about psoriasis and offer an effective treatment for this disease.

Modern ideas about the disease

It must be said that modern science does not know enough about this mysterious disease. There are various theories about the origin, course and treatment of psoriasis.

Here are the facts about psoriasis that do not cause doubts among specialists:

despite the fact that the causes of the disease are unclear, it was possible to learn about 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 is that the disease can be inherited. However, this is not always the case, even if both parents are sick, 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 sick;
An interesting fact about psoriasis is that this disease is characterized by the Koebner phenomenon. This phenomenon manifests itself in the fact that the elements of the rash form at the sites of skin damage - scratches, burns, frostbite. Sometimes psoriasis appears after some time, at the site of scars;
An important observation that allows you to get more information about psoriasis is the relationship of this disease with climatic factors. Exacerbations and relapses are often timed to coincide with the change of season;
Patients probably noticed in practice the connection 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 psoriasis manifests itself 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 about the incurability of psoriasis, and this is true, since no treatment has been found that could be guaranteed to defeat the disease. But patients should know that psoriasis can be controlled. Adequate and timely treatment allows to achieve long-term remission.

Modern methods of treatment

Speaking about the common disease psoriasis, it is impossible not to talk about the treatment of this common ailment. It must be said that it is impossible to cure psoriasis only with pills or ointments.

In order to forget about the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will need to make an effort. It will be necessary to organize food properly. 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 scheme according to which the treatment will take place. As a rule, methods of external (ointments, creams) and systemic (tablets, injections) therapy are used. In addition, physiotherapeutic methods will be used, as well as treatment at resorts. It is recommended to treat psoriasis with the use of healing mud, mineral and thermal water.

The 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 flakes and disinfect the skin, helping it to heal faster.

Other methods of treating scaly lichen may be offered at resorts. For example, leech therapy, healing baths and applications, sun treatment, 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 particular patient. If the chosen methods of treatment do not work, they will need to be replaced.

widely advertised and folk ways psoriasis treatment. Indeed, some of them can help in achieving remission. However, when choosing a method, you need to remember common sense so as not to harm your health. If any recipe or recommendation is in doubt, then it is better not to use it. Before using any method of treatment, consult your doctor.

You need to understand that it will be possible to forget about psoriasis forever only if the patient himself and his inner circle are positive. Only faith in success and an optimistic attitude will help defeat this mysterious and insidious disease.

Psoriasis vulgaris (vulgaris) is chronic illness skin, which is characterized by the appearance of characteristic changes on the skin, a sharp decrease in the quality of life due to the appearance of itching and burning of the skin, but does not pose an immediate threat to life, remaining in most cases throughout its entire length.

The first signs of psoriasis in most cases are found in childhood or adolescence, after thirty years the disease, as a rule, does not manifest. About two percent of the population suffers from this disease, although according to some other figures, the figure exceeds 6%, but many cases of a mild course of the disease are simply not recorded.

Causes

Ordinary widespread psoriasis is a polyetiological disease, that is, it does not occur under the influence of a specific cause, but due to the influence of a large number of factors. It was thought so for a long time, until scientists found out that in fact the development of the disease is based on a genetic anomaly.

Disturbances in the short arm of the fifth chromosome are the cause of changes in immune tolerance, and under the influence of a number of factors, these changes can manifest as psoriasis. In other words, a genetic anomaly creates a predisposition to the disease, but does not yet guarantee its occurrence.

Factors that can contribute to the development of psoriasis include:

stress;
Alcohol and smoking;
Infectious diseases and foci of chronic infection;
Endocrine disorders are primarily diabetes;
Violations of immune tolerance under the influence of various external factors, including poor ecology.

Symptoms and first signs

Psoriasis vulgaris is the most common form of the disease, with psoriasis vulgaris accounting for 90% of all cases of psoriasis.

It can take place, but often manifestations are observed precisely on the skin. The first changes appear on the skin of the extensor surface of the elbows and knee joints. They can then spread from the primary lesions along the extensor surface of the forearm and onto the shoulder, chest, and back.

Features of the rashes are as follows:

The spot is clearly defined;
There is a white coating on the surface (similar to a wax coating);
The crusts are removed, but not easily;
After the removal of the crusts, bloody discharge appears on the surface of the rash, since the removal of the crusts injures the vessels.

Rashes in psoriasis are always accompanied by severe itching, sometimes so pronounced that it disturbs night sleep, which leads to pronounced negative emotions and disruption of work and rest. Employment opportunities are significantly reduced, and therefore psoriasis without treatment can cause disability.

Common psoriasis in children

In some cases, psoriasis vulgaris in children can manifest at a very early age, in which case characteristic clinical manifestations appear, and standard treatment is difficult due to the negative effect of drugs on other organs and systems.

Psoriasis in children photo initial stage

However, psoriasis vulgaris or any other in early childhood practically does not develop, in most cases the disease develops in adolescence, and in earlier years it can mimic a much more common one. However, if changes appear on the skin, it is still necessary to consult a doctor as soon as possible to conduct an examination and make an accurate diagnosis.

Diagnostic measures

In most cases, the diagnosis of ordinary psoriasis does not cause great difficulties. characteristic Clinical signs make it possible to suspect the presence of a disease, a positive Auspitz symptom confirms the assumptions, but to make a final diagnosis, it is precisely a biopsy of a skin area covered with rashes that is used, where histological changes characteristic of the disease are found in the dermis.

What can be confused?

Despite the presence of a characteristic clinical picture, it is not always possible to make a diagnosis only during examination, in some cases it is necessary to differentiate the disease from:

seborrheic eczema;
Neurodermatitis;
Parapsoriasis.

Most effective method holding differential diagnosis is a skin biopsy. Detection in the skin of changes characteristic of psoriasis makes it possible to verify the diagnosis.

Psoriasis treatment

If there were a single scheme for the effective treatment of psoriasis, then, probably, all patients could easily get rid of the manifestations of the disease and significantly improve the quality of life, but there are a number of problems in the treatment of this disease, among them should be mentioned:

Refusal of patients from treatment with mild and moderate course;
Difficulty coping with the situation in a severe course of the disease;
The high cost of effective treatment methods;
The need for individual selection of therapy in order to achieve the desired result.

Therapy for psoriasis should include not only treatment with systemic and local drugs, but also the use of physiotherapy techniques (PUVA therapy demonstrates good results), as well as diet and lifestyle changes (refusal to bad habits, limitation of psychological load).

Among the system and local preparations most widely used:

Cytostatics;
Monoclonal antibodies;
Inhibitors of the T-cell link of immunity;
Glucocorticoids;
Anti-inflammatory ointments based on salicylic acid.

The selection of specific drugs, the determination of their compatibility and the possibility of application (depending on the presence of concomitant pathology) is determined solely by the doctor after a comprehensive examination. In no case can be given remote recommendations to improve the effectiveness of treatment.

How to treat psoriasis at home

Involved in the development of psoriasis immune factors, a violation of tolerance due to a genetic abnormality leads to the development of those changes in the skin, which are the cause of the appearance of the corresponding symptoms.

It is not at all surprising that ethnoscience involves the use of various recipes based on herbs, leaves and roots of plants that have immunomodulatory properties. It is believed that the immunomodulatory effect can reduce the severity of manifestations.

But many herbs that are recommended for use (calendula, chamomile, and so on) have rather immunostimulating properties. Activation of immunity in psoriasis can cause an aggravation of the disease and only an increase in the severity of symptoms.

That is why in no case should one resort to self-treatment with herbs and other folk remedies for psoriasis, and if some methods can be used, then only in addition to the main therapy and only under the strict supervision of a doctor after a comprehensive examination.

If during the course of treatment, the appearance of new rashes, an increase in the severity of symptoms, aggravation of burning and itching is noticed, then such therapy should be stopped immediately, since it can pose an immediate danger to your health.

Do they take in the army with psoriasis?

Psoriasis is the disease in which a temporary deferment from military service is given or a conscript is declared unfit to carry military service. In severe forms of the disease, when large areas of the skin are affected, there are lesions of the joints, the general condition suffers significantly - they are not taken into the army.

If we talk about limited and easily treatable forms, then they can be given a temporary deferment from military service, after treatment, a medical commission is re-assembled, which recognizes the conscript fit for service or exempts him from carrying it out.

It is believed that psoriasis is a contraindication for service, however, in some cases, another decision may be made by the medical commission, so the final answer to this question is given by the medical commission after assessing the general condition, the severity of the disease and other factors. The actions of doctors are regulated by relevant instructions, according to which the conscript must be assigned to one of the categories (from A to D), in accordance with which he is given a temporary or permanent exemption from service.

Prevention of the development of psoriasis

Is it possible to carry out effective prevention of the development of psoriasis? A rhetorical question with no definitive answer. The fact is that all the factors contributing to the development of the disease can lead to the appearance of psoriasis, as it is believed today, only if there is a genetic anomaly that cannot be influenced.

Naturally, prophylaxis is not carried out in most cases, since neither the patient himself nor anyone else knows about the presence of a predisposition. The only exceptions are cases when parents suffer from psoriasis, and this fact can be assessed as a high risk of developing the disease in the patient himself.

Measures to prevent the development of the disease include:

The maximum limitation of all stressful influences and psychological stress, it is not always possible to do this, but it is recommended to limit the psycho-emotional stress;
Carrying out timely and complete treatment of infectious foci and sanitation of foci of chronic infection (recommended not only to prevent psoriasis, but also other diseases, including autoimmune ones);
Refusal of bad habits, observance of the regime of work and rest, proper nutrition;
Proper Treatment concomitant diseases, primarily endocrine pathology;
UV protection (limitation of exposure to direct sunlight, use of sunscreen).

Measures for the prevention of psoriasis vulgaris are not strictly specific, and the main difficulty in their practical use is that it is virtually impossible to carry out primary prevention due to ignorance of the potential risk, secondary prevention is important in terms of preventing the progression of the disease, but it does not help to eliminate existing changes.

Prognosis for life and recovery

With psoriasis, the prognosis for life is favorable, but for recovery it is unfavorable. This disease does not lead to the development of life-threatening complications and is not the cause of death of patients, but significantly reduces the quality of life.

The use of any approaches and methods of treatment does not make it possible to completely get rid of the disease, so the prognosis for recovery is unfavorable. Therapy should be aimed at reducing the severity of symptoms and prolonging the remission period. With proper treatment, it is possible to achieve the almost complete disappearance of rashes and significantly reduce the frequency of exacerbations.

Photo

Synonyms: psoriasis vulgaris, psoriasis vulgaris, psoriasis vulgaris, psoriasis vulgaris, chronic psoriasis

According to statistics, every 25th inhabitant of the planet suffers from psoriasis. Having no gender preference, the virus is more likely to manifest itself in young people - more than 2/3 of all patients under the age of 20 years. Skin psoriasis is a serious dermatological disease. Today we will talk about its features, methods of treatment and much more.

Description of the disease

If you have not personally encountered this disease, you can look at the photo of skin psoriasis to get an idea of what this disease looks like.

Psoriasis is an abnormal behavior of the body, in which the reaction to certain external factors changes. It manifests itself on the skin, the life of which is reduced from a month to five days.

Causes of the disease

Now scientists are sure that psoriasis is transmitted with the genetic code from parents to children. This is indicated by both studies and statistics of patients - about 4% of people.

At the same time, it is absolutely known that psoriasis is not an infection that is transmitted in traditional ways. In other words, psoriasis cannot be contracted from another person.

Since psoriasis is already in the person, its manifestation depends on some conditions. First of all - problems with the immune system.

A huge number of diseases that are in a passive state inside a person wake up immediately after the immune system ceases to suppress them. Therefore, among the causes of psoriasis on the skin, it should be highlighted first.

The emotional background also plays an important role - constant stress can cause the awakening of psoriasis. Here you can add various problems with endocrine system. Often, psoriasis manifests itself in humans along with other diseases that weaken the body.

Types of psoriasis

The stages and manifestation of psoriasis still depend on its type. There are only two types of this disease. The division is not only according to the characteristics of psoriasis, but also depending on the person who suffers from it. Thus, psoriasis of the first type is the most common.

It is transmitted from parents to a child, and awakening always follows a violation of the immune system. Most often, young people under the age of 25 suffer from this.

The second type of psoriasis is already more difficult and more dangerous. It is no longer a hereditary disease. The risk group in this case are older people - from 40 years old. This psoriasis appears in the body due to the fact that the immune system has been seriously harmed.

The signs of manifestation are also different, if in the first case the skin usually suffers, then here the damage is directed to the joints and nails of a person.

Symptoms of psoriasis

Because it serious illness, it is important to know how to identify skin psoriasis at an early stage. It all starts with inflammation of the skin.

At this stage, the patient experiences severe burning and itching in problem areas, and over time, peeling begins there. This happens due to the rapid death of the skin, after which wounds can form in the same place.

Type 1 psoriasis usually manifests itself in areas with hairline. It can be arms, legs or head. Just the latter option is observed in most cases. One out of four patients has a slightly different direction - nails. This is the second type of psoriasis.

In patients, exacerbation is observed with certain features - the season. So already after the first appearance of psoriasis, it can be assumed that the next relapse will be in the same season. Usually it is summer or winter. The third option - without belonging to the season, less than half of such patients.

Psoriasis inflammation sites are initially small, but grow over time. A huge problem in the course of the disease is itching, which haunts the patient throughout the course of the disease. The fact is that it is forbidden to scratch problem areas of the skin so that open wounds do not form.

Treatment of psoriasis

Now we will analyze how best to treat psoriasis on the skin. If you didn’t delay going to the dermatologist, then you might be able to get off more or less easily.

If the diagnosis was made at the initial stage, it is likely that simple preventive measures and drugs will be enough. On the other hand, an advanced disease requires heavy treatment and a long period of time.

In the second case, you may need cryotherapy, in which problem areas are treated liquid nitrogen. It freezes them and stops the development of the disease. In addition, doctors practice blood purification, which is aimed at removing the virus and improving the immune system.

It is important to understand that fast and effective treatment of psoriasis is possible only with timely detection. Otherwise, it can take a very long time, and the process will use both drugs in the form of tablets, and external treatment with drugs that will treat the symptoms.

Photo of skin psoriasis

Psoriasis (scaly)- common dermatosis of an autoimmune nature with an undulating course. It manifests itself in the form of itchy, scaly red plaques. It varies greatly in intensity. Most often affects the area of the knee, elbow joints, hairy part heads, skin folds, places of scratches and injuries. Superficial scales are replaced by deeper formations with a dense structure. During the next exacerbation, large areas of the skin are affected, compared to the previous time. Consider the description of psoriasis, forms, methods of treatment.

What is psoriasis and how is it treated?

The description of the disease includes more than 10 forms of scaly lichen, each of which has characteristic symptoms:

Pustular (exudative) - a severe variant, also called Zumbusch or Barber's disease, in the form of blisters that rise above the skin and are filled with transparent exudate. Around the pustules edematous, well exfoliating skin. When infected, the blisters fill with pus. The disease occurs as a reaction to stress or reception. medicines. It affects the legs and forearms.
Nail psoriasis is characterized by dots, spots, transverse striation on the nail bed, its delamination, thickening, discoloration, sometimes complete loss.
The teardrop form occurs in 10% of patients. It is characterized by dry small purple or red circles, similar to drops. Occupies large areas on the body. A provocateur may be a streptococcal infection after a sore throat or pharyngitis.
A severe form of guttate lichen is patchy psoriasis. Forms large locations of damaged skin. More common in women. The debut happens in childhood or adolescence.
Plaque cutaneous psoriasis is named for red, thickened areas of skin covered with white scales. Occurs in 80% of patients. After exfoliation of the epidermis, bleeding, easily injured red lesions remain in place of psoriatic plaques. Formed under the armpits, in the folds of the abdomen, groin, genital area. On the joints, peeling is not pronounced.
Follicular - a rare form, which is characterized by small light elements of the rash, deepened in the middle, affecting the mouth of the hair.
Psoriasis of the flexor surface in the form of smooth, shiny, rising above the skin. Place of localization: groin, folds under the breast, abdomen, inner thigh, armpits. Injury to the skin in these areas increases the likelihood of mycoses.
Palmar-plantar scaly lichen. It is more common in older people. Ordinary papules, psoriatic plaques or hyperkeratolytic formations are formed on the skin, stimulating the formation of calluses. Perhaps a continuous thickening or keratinization on the sole and palms. Plaques have clear boundaries, rarely limited to large ring-shaped peeling.
Psoriasis of the scalp with red, scaly, itchy patches. It can lead to a break in social ties, self-isolation of a patient who finds it difficult to hide from others dry crusts that give out scaly lichen.
Seborrheic form of psoriasis resembling eczema. It occurs on the head, behind the ears, between the shoulder blades, on the nasolabial folds, and on the chest. The foci have the appearance of a psoriatic crown, which is represented by separate, highly flaky areas that pass from the forehead to the scalp. On the ears, it can be red eczema, covered with purulent cracking crusts. On the face they look like spots covered with dry scales.
It is characterized by inflammation affecting the connective tissue and joints. Most often leads to psoriatic dactylitis, that is, damage to the joints of the phalanges of the fingers. As a result, it is difficult for a person to do anything with swollen fingers. It is observed in every tenth with other forms of psoriasis. Leads to disability.
In psoriatic erythroderma, a large part of the body becomes inflamed. The situation is complicated by intense itching, soreness, swelling of the skin, convergence of the skin in layers. Possible infection, injured areas and purulent skin lesions.

Severe cases may result in the death of the patient. Timely treatment allows you to translate the disease into a milder form.

Other classifications of squamous lichen

According to the degree of distribution, the following types of psoriasis are distinguished:

limited with damage to small areas of the skin;
common, when a large part of the body is covered with a rash;
generalized with damage to almost the entire skin.

There is also a dependence of the progressing stage on the season.

According to this criterion, skin psoriasis is:

Winter, aggravated in the cold months. Sharp temperature fluctuations and dry air can be provocateurs.
Summer, arising in the warm season due to solar radiation, high temperature and profuse sweating.
Uncertain, not related to seasonality.

Seasonal psoriasis can be mild or severe.

According to the severity of rashes on the skin, there are:

Mild psoriasis with mild symptoms and rapid removal of lesions on the skin. A competent responsible approach to treatment gives good results in the form of long-term remission and clear skin.
Severe, which is characterized by profuse peeling, sometimes chills. The exudative form is distinguished by the moist surface of the plaques. Psoriatic erythroderma and pustular psoriasis are also severe forms of the disease. Accompanied by nervous disorders associated with appearance sick.

In such cases, the skin is required with the use of systemic preparations that can relieve inflammation and reduce the rate of keratinization of the epidermis. Severe forms are treated in a hospital under the supervision of medical staff. In addition to systemic therapy, treatment is carried out with topical medications and with the help of physiotherapy.

The disease goes through the following stages:

Exacerbations with an increasing number of fresh plaques.
Stationary, in which the overall picture of the disease does not change.
Regressive with cleansing of the skin from rashes.

Skin with psoriasis will improve its condition if the patient follows the following recommendations of a dermatologist:

sunbathe every day, but do not abuse;
give up alcohol;
avoid stressful situations, emotional overload;
monitor body weight;
Healthy food;
take good care of your skin.

Psoriasis has a typical clinical picture; a biopsy of the affected skin helps clarify the diagnosis.

Treatment of scaly lichen

It is possible to relieve exacerbation and alleviate the patient's condition with the help of a wide range of medicines, among which:

ointments, which include: hydroxyantrons, naftalan, tar, vitamin D3 analogs;
medicines containing zinc pyrithionate;
creams, lotions containing glucocorticoids.

A special role in the treatment of scaly lichen is assigned to biologically active substances. With their help, the skin heals and performs all the functions assigned to it.

The main ones include:

Lecithin, without which it is impossible fast recovery epithelium. Medications with lecithin restore the integrity of the skin.
Omega 3 fatty acids are found in fish oils. They are essential for healthy skin.
Vitamin D. The most important mineral for the treatment of psoriasis is calcium, but its absorption without vitamin D is impossible. Vitamin-containing preparations are used during the treatment of the stationary stage of the disease.
Silicon in the composition of vitamin-mineral complexes makes a double contribution to improving the condition of the skin and, as a sorbent, absorbs antigens that provoke exacerbation.

TO non-drug methods treatments include:

photochemotherapy, which involves taking photosensitizers and ultraviolet irradiation (wavelength 320-400 nm).
plasmapheresis;
cryotherapy.

In severe form, systemic treatment is prescribed with the inclusion of cytostatics (Methotrexate), synthetic retinoids, multivitamins, glucocorticoids.

Diet for psoriasis

A prerequisite for cleansing the skin is diet, especially during an exacerbation. The diet should not contain refined foods, sweets, spicy foods. You can not starve, so as not to get the opposite effect. It is useful to organize fasting days: vegetable, kefir-curd, apple. Dishes are best stewed, boiled, steamed, grilled.

Potentially hazardous products are:

alcohol;
spices;
canned food;
pickles;
fatty foods;
red vegetables and fruits;
milk;
eggs;
chocolate;
citrus.

Useful seafood, sea fish, vegetable oils. They help regulate lipid metabolism c, restore the skin, strengthen the walls of blood vessels.

To support the functionality of the intestines, it is necessary to include foods rich in fiber in the diet. It is abundant in cereals and vegetables.

Psoriasis requires zinc and calcium. There is a lot of the first in buckwheat, beans, peanuts, cheeses, and liver. Calcium is found in soy, nuts, leafy vegetables, dairy products.

The important points are:

Maintaining a balance of vitamins A and group B (B6, B11, B12). Their antioxidant properties help support cellular processes, the synthesis of skin proteins: elastin and collagen, reduce inflammation, and ensure healthy nails.
Strengthening immunity.

As well as the prevention and timely treatment of SARS and influenza.

Consequences of psoriasis

Complications of scaly lichen most often become:

low self-esteem;
depressive states;
complicated forms of arthritis.

To reduce the number of exacerbations it is necessary:

do not overdry and do not injure the skin;
sunbathing, but limited time;
do not take medications that increase rashes (lithium, β-blockers);
to refuse from bad habits;
avoid nervous overload.

Unfortunately, at the present level of medical science there is detailed description rashes with psoriasis, but there is no treatment method. The fact is that “in the memory of the cells” of diseased skin, changes that occur at the molecular level are stored. A relapse can happen when it seems that psoriasis has receded and will never ruin a person's life again. Therefore, it is necessary not to lose hope, to be under the constant supervision of a doctor, and to follow all the recommendations of a dermatologist.