Psoriasis is a known skin disease of a chronic nature that is accompanied by the appearance of raised red spots on which there are silvery white scales. According to statistics, about 3 percent of people from the entire population of the planet suffer from the disease.
The main symptoms of psoriasis are characterized by the appearance on the skin of a monomorphic rash: nodules of bright pink color, covered with silver scales. Elements of the rash can merge into different configurations reminiscent of the geographical map. It is accompanied by a mild skin itch.
As a rule, the disease affects the skin on the head, elbows and knee joints, in the lower back. Also known is psoriasis of the nails, external genital organs and joints, however, these forms are much less common than skin lesions.
The disease can develop at any age, but most often psoriasis affects people of young age. In this article we will tell you everything about psoriasis - symptoms, treatment, diet and folk remedies that will help treat the disease at home.
Causes of psoriasis
The cause of psoriasis is unknown, but immunological changes in the body (autoimmune aggression), neurological disorders, metabolic disorders can provoke the disease. Promotes the emergence of psoriasis, heredity, reduced immunity after disease, stress.
One of the main theories of the origin of psoriasis is the hypothesis about the so-called genetic factor. As a rule, psoriasis in children under 10 years is the hereditary form of the disease - in the genus of crumbs, it is almost always possible to find a relative suffering from a similar disease. But if psoriasis manifests itself in a more mature age, doctors assume that the disease has a different nature of origin - bacterial or viral.
Factors thatcontribute to the developmentpsoriasis:
- hereditary predisposition;
- thin dry skin;
- external irritant factors;
- excessive hygiene;
- bad habits;
- taking certain medications can trigger a disease (beta blockers, antidepressants, anticonvulsants and antimalarials);
- infections (fungi and staphylococcus);
International Psoriasis Day (World Psoriasis Day) is celebrated annually on October 29th under the patronage of the International Federation of Psoriasis Associations (IFPA). For the first time this day was celebrated in 2004.
Is psoriasis contagious?
Numerous studies have confirmed that psoriasis is not contagious. The presence of several family members suffering from psoriasis is due to a possible hereditary (genetic) transmission of the disease.
Stages of development
There are three stages of development of psoriasis:
- Progressive- there are new rashes, the patient is worried about intense itching.
- Stationary- the appearance of new rashes stops, the already existing ones begin to heal.
- Regressing- around the outbreaks pseudoatrophic rims are formed, in the center of large plaques are visible areas of healthy skin; true, about the disease resembles hyperpigmentation - in place of the affected areas, the skin has a darker, than healthy, color.
Also, psoriasis is usually classified according to the severity of the lung (with a lesion of less than 3% of the skin surface), medium severity (with a lesion of 3 to 10 percent of the skin surface) and heavy (involving more than 10 percent of the skin surface). The defeat of the joints is regarded as a severe form of psoriasis, regardless of the area of skin lesions.
It is recommended to consult a doctor if the following symptoms appear:
- Red convex spots (plaques), covered with dry white or silver scales. The spots most often appear on the elbows and knees, however, rashes can be on any part of the body: scalp, hands, nails and face. In some cases the spots itch;
- Deformed, layered nails;
- Strong exfoliation of dead skin cells (resembles dandruff);
- Blisters on the palms and feet, painful cracks in the skin.
Symptoms of psoriasis
Psoriasis is a systemic disease that affects not only the skin and nails. He suffers from joints, tendons and spine, immune, nervous and endocrine systems. Often affected are the kidneys, liver, thyroid gland. The patient feels strong weakness, suffers from chronic fatigue and depression. In connection with such a complex action on the body, the disease in recent years is commonly called psoriatic disease.
Psoriasis and its symptoms are characterized by the presence of a uniform rash in the form of plaques with a diameter from 1-3 mm to 2-3 cm, pink-red, covered with loose silver-white scales. As a result of the marginal growth, the elements can merge into plaques of various sizes and shapes, sometimes occupying vast areas of the skin. Plaques are usually located on the skin of the extensor surface of the extremities, especially in the area of the elbow and knee joints, the trunk and the scalp.
- Plaque-shaped psoriasis, or ordinary psoriasis, vulgar psoriasis, psoriasis vulgaris (L40.0) is the most common form of psoriasis. It is observed in 80% - 90% of all patients with psoriasis. Plaque-like vulgar psoriasis is most often manifested in the form of typical elevated above the surface of healthy skin areas of inflamed, red, hot skin, covered with gray or silvery-white, easily peeling, scaly, dry and thickened skin. Red skin under easily removable gray or silvery layer easily injures and bleeds, as it contains a large number of small vessels. These areas of a typical psoriatic lesion are called psoriatic plaques. Psoriatic plaques tend to increase in size, merge with adjacent plaques, forming whole plates of plaques ("paraffin lakes").
- Psoriasis of flexor surfaces(flexural psoriasis), or "inverse psoriasis" (L40.83-4) usually looks as smooth, not flaking or with minimal peeling, not particularly prominent over the surface of the skin red inflamed spots, located exclusively in the folds of the skin, with or without a minimal lesion of other skin areas. Most often this form of psoriasis affects the folds in the region of the external genitalia, in the groin, on the inner surface of the thigh, axillary cavities, folds under the abdomen enlarged with obesity (psoriatic pannus), and on folds of the skin under the mammary glands of women. This form of psoriasis is especially prone to deterioration due to friction, skin trauma and sweat secretion, and is often accompanied or complicated by a secondary fungal infection or streptococcal pyoderma.
- Teardrop psoriasis(guttate psoriasis) (L40.4) is characterized by the presence of a large number of small, raised healthy skin over the surface, dry, red or purple (up to purple), similar in form to drops, tears or small dots, circles of the elements of the lesion. These psoriatic elements usually cover large surfaces of the skin, most often the hips, but can also be seen on the shins, forearms, shoulders, scalp, back, neck. Guttate psoriasis often first develops or worsens after a strep infection, in typical cases - after streptococcal angina or streptococcal pharyngitis.
- Pustular psoriasis(L40.1-3, L40.82) or exudative psoriasis is the most severe of cutaneous forms of psoriasis and looks like it is raised above the surface healthy skin with vesicles or blisters filled with uninfected, transparent inflammatory exudates (pustules). The skin under and above the surface of the pustules and around them red, hot, edematous, inflamed and thickened, easily exfoliates. There may be a secondary infection of pustules, in which case the exudate becomes purulent. Pustular psoriasis can be limited, localized, with its most frequent localization being the distal ends limbs (arms and legs), that is, the lower leg and forearm, this is called palmoplantar pustulosis. In other, more severe cases, pustular psoriasis can be generalized, with widespread pustules all over the body surface and a tendency to merge into larger pustules.
- Psoriasis of the nails, or psoriatic onychodystrophy (L40.86) leads to a variety of changes in the appearance of the nails on the fingers or toes. These changes can include any combination of discoloration of the nails and the nail bed (yellowing, whitening or graying), the appearance of dots, spots, transverse striation of the nails with lines, thickening of the skin under the nails and around the nail bed, stratification and thickening of the nail, complete loss of nails (onycholysis) or development of increased brittleness of the nails.
- Psoriatic arthritis(L40.5), or psoriatic arthropathy, arthropathic psoriasis is accompanied by inflammation of the joints and connective tissue. Psoriatic arthritis can affect any joints, but most often small joints of the distal phalanx of the fingers and / or legs. This in typical cases causes sausage-like swelling of the fingers and toes, known as psoriatic dactylitis. Psoriatic arthritis can also affect hip, knee joints, brachial joint, vertebral joints (psoriatic spondylitis). Sometimes psoriatic arthritis of the knee or hip joints and especially psoriatic spondylitis is so pronounced that it leads to the severe disability of the patient, the inability to move without special adaptations and even to bed rest. The lethality with these most severe forms of psoriatic arthritis is increased, as immobilization of the patient in bed contributes to the development of bedsores and pneumonia. Approximately 10 to 15 percent of patients with psoriasis also suffer from psoriatic arthritis.
- Psoriatic Erythroderma(L40.85), or erythrodermal psoriasis manifests itself as a common, often generalized inflammation and flaking, a detachment of the skin on all or a large part of the skin surface. Psoriatic erythroderma may be accompanied by intense skin itching, swelling of the skin and subcutaneous tissue, soreness of the skin. Psoriatic erythrodermia is often the result of exacerbation of vulgar psoriasis with its unstable flow, especially with sudden abrupt reversal of systemic treatment or local glucocorticoids. It can also be observed as a result of provocation by alcohol, neuropsychic stress, intercurrent infections (in particular, colds). This form of psoriasis can be lethal, as extremely severe inflammation and peeling or skin detachment disrupt the ability the body to regulate body temperature and the barrier function of the skin, which can be complicated by generalized pyoderma or sepsis. However, limited, localized psoriatic erythroderma may even be the first symptom of psoriasis, subsequently transforming into vulgar plaque-like psoriasis.
Symptoms of psoriasis vary depending on the season and stage. Many patients have a "winter" type of disease, in which periods of exacerbation occur at the end of autumn or in winter.
What does psoriasis look like in the initial and other stages in the photo:
Course of the disease
Psoriasis is a chronic disease characterized by a generally undulating course, with periods of spontaneous or remission-induced remissions, or improvements and periods spontaneous or provoked by adverse external influences (alcohol use, intercurrent infections, stresses) relapses or exacerbations.
- The severity of the disease can vary in different patients and even in the same patient during periods of remission and exacerbation in a very wide range, from small local lesions to complete coverage of the whole body with psoriatic plaques.
Often there is a tendency to progression of the disease over time (especially in the absence of treatment), to heavier and more frequent exacerbations, an increase in the area of the lesion and the involvement of new skin areas. Individual patients experience a continuous course of the disease without spontaneous remissions, or even continuous progression. Often the nails on hands and / or feet are also affected (psoriatic onychodystrophy). The defeat of the nails can be isolated and observed in the absence of skin lesions.
Psoriasis can also cause inflammatory joint damage, the so-called psoriatic arthropathy or psoriatic arthritis. From 10 to 15% of patients with psoriasis also suffer from psoriatic arthritis.
Treatment of psoriasis
For successful treatment it is necessary to take into account the stage of the disease at present - depending on this, the intensity of therapy changes. In addition, the treatment of psoriasis always consists of a whole complex of remedies: external ointments, physiotherapy procedures, general regimen. It is also necessary to take into account other existing diseases, age, sex, the influence of professional factors and the general state of human health.
In the case of psoriasis, softening agents, keratoplastic preparations, local preparations (ointments, lotions, creams) with glucocorticoid content are used for treatment (hydrocortisone, prednisolone, dexamethasone), preparations containing zinc pyrithionate, ointments with the content of vitamin D3 analogs, tar, naphthalan, hydroxyantrone.
In severe forms of psoriasis, ineffectiveness of external therapy or the defeat of more than 20% of the skin surface, prescribe systemic medication, which includes cytotoxic drugs (methotrexate), synthetic retinoids (retinol acetate, retinol palmitate, tretinoin), glucocorticoids.
How to treat psoriasis without the use of medications - the essence lies in the use of cryotherapy, plasmapheresis, and the appointment of systemic photochemotherapy:
- Photochemotherapy- is the combined use of ultraviolet radiation (wavelength from 320 to 420 nm) with ingestion of drugs that increase sensitivity to light. The use of photosensitizers is based on their ability to increase the sensitivity of the skin to ultraviolet rays and to stimulate the formation of skin pigment - melanin. The dose of drugs is selected individually, taking into account the weight of the patient. The procedures are carried out 3-4 times a week, 20-25 sessions are prescribed for the course. PUVA-therapy is contraindicated in acute infectious diseases, with exacerbation of chronic diseases, cardiovascular decompensation, oncology, severe diabetes, severe liver and kidney damage.
On the question of how to treat psoriasis, modern medicine is not able to give a clear answer, so in addition to traditional treatment patients with psoriasis are recommended to adhere to a special diet, as well as to try folk remedies for the treatment of psoriasis.
Ointment for psoriasis
With mild forms of psoriasis, sometimes external treatment of psoriasis with the help of masks is sufficient. There are many medicines used in the external treatment of psoriasis, here are some of them:
- Salicylic ointment promotes softening of horny skin scales and their rapid removal, which helps to be absorbed better by other medicines. , -5% salicylic ointment is applied in a thin layer in the affected area of the skin (the more inflammation of the skin, the less the ointments are applied) 1-2 times a day. Salicylic acid is also found in ointments from psoriasis Diprosalik, Acriderm SK and others.
- Naftalan OintmentIt is used in the stationary and regressive stage of psoriasis (never with exacerbation, progression of psoriasis). Naphthalan Ointment reduces skin inflammation and itching. In the treatment of psoriasis apply 5-10% naphthalan ointment.
- Sulfur-ointment 5-10%helps reduce inflammation of the skin, but it is contraindicated in the exudative form of psoriasis (with soaking scales and crusts). Serno-tar can not be applied to the face. With psoriasis of the scalp, shampoos with tar content are used (Friederm tar, etc.)
- Anthralin- ointment that inhibits the division of cells of the surface layers of the skin and reduces peeling. Antralin is applied to the skin for 1 hour and then washed off.
- Ointments for psoriasiswith vitamin D(Calcipotriol) have anti-inflammatory effect, contribute to the improvement of psoriasis. Calcipotriol is applied to the inflamed skin 2 times a day.
- Skin-cap is a cream, aerosol and shampoo that is used to treat psoriasis of the scalp. Shampoos are used in psoriasis of the scalp three times a week, aerosols and cream are applied to the skin surface 2 times a day.
In the event that the treatment did not give the expected effect, then prescribe ointments on a hormonal basis. Treatment starts with lighter drugs that have minimal side effects. If the improvement was not achieved, then prescribe a stronger ointment with glucocorticosteroids.
- Flumethasone Ointment. Has anti-inflammatory, anti-allergic, anti-edematous, antipruritic effect. Suitable for patients with exudative forms of psoriasis, reduces bleeding. Apply a thin layer to the restricted areas 2-3 times a day. Treatment lasts 10-14 days.
- Triamcinolone acetonide ointment. Local anti-inflammatory, antipruritic and antiallergic. Reduces the wetting of the skin. Apply to the affected area 2-3 times a day for up to two weeks. Used in the period of exacerbation.
- Hydrocortisone. Suppresses the increased activity of leukocytes, prevents their movement into the skin, eliminates the feeling of tightness and itching.
What kind of sanatoriums are there?
For the rehabilitation of patients with psoriasis at the resorts use: mud treatment, mineral waters, treatment with fish, light oil fractions and physiotherapy procedures. Sea water, warm climate also have a powerful influence.
Russian resorts that specialize in the treatment of psoriasis patients: Sochi, Anapa, Gelendzhik. A mild subtropical climate, plenty of sun and long sea bathing have a beneficial effect on the condition of the skin, nails and joints. Sanatorium Elton near Volgograd (mud cure), sanatorium Assy near Ufa offers a complex of physiotherapy procedures and clean air.
What can be done at home?
It is important to understand that the success of therapy largely depends on the actions of the patient himself. That is why people suffering from psoriasis are recommended to completely change their lifestyle and make every effort to create favorable conditions for recovery.
In particular, patients are recommended:
- to observe the regime of rest and work;
- avoid emotional and physical exertion;
- resort to the use of folk remedies (in agreement with the dermatologist);
- observe a hypoallergenic diet.
How to treat psoriasis with folk remedies
At home, you can use many recipes of traditional medicine that will help to treat psoriasis. Let's consider some of them.
- In dishes made of clay, you need to grind fresh St. John's wort flowers (20 g), root celandine, propolis, flowers of calendula (10 g). In the resulting mixture is added vegetable oil. Store in a cool place, protected from sunlight. Method of application - 3 times a day carefully lubricate psoriatic rashes.
- Tar is applied to the affected places with a cotton swab. In the early days, start with 10 minutes, then rinse tar with tar soap. And gradually increase the time to 30-40 minutes (this can be done in 10-12 days). The procedure is done once a day, preferably in the evening, because the smell of tar remains even after a long rinse. And overnight, the smell, as a rule, completely passes.
- Purity is torn out with a root, grind, squeeze the juice and plentifully grease them every spot. Do the whole season. If necessary, repeat the next summer.
- In the early stages of the disease, you can use an ointment that can be obtained from a mixture of two eggs and one st. tablespoons vegetable oil. All this must be shaken, and then add half the st. spoon of acetic acid. The container with this product should be kept tightly closed and in a place where no light enters. Apply, spreading on specks, should be at night.
- Folk treatment of psoriasis involves the use of certain medicinal herbs. With the disease, the infusion of the recipe is good. In particular, this folk method should be tried by those who suffer not only psoriasis, but also diseases of the gastrointestinal tract, liver or gall bladder. Infusion helps normalize the work of affected areas and improve metabolism. One tablespoon of dry cake should be poured in enameled dishes with a glass of boiling water, cover and insist for an hour, after which drain, squeeze, bring the amount of liquid boiled to the original volume and drink a quarter cup four times a day before meals.
Psoriasis can not be cured. Modern medicine does not offer a single medicine that can cure psoriasis once and for all. However, if it is treated with medications and other methods, then a rather unstable remission can be achieved.
Diet for psoriasis
To say clearly which diet for psoriasis will be most effective is difficult. The fact is that in addition to foods that are undesirable for consumption or useful, individual tolerance of the same food products correlates in different patients.
In this regard, for each person suffering from psoriasis, specific recommendations are given. The recommended form of nutrition provides for the rejection of certain products, but provides a balanced diet that supplies the body with all the necessary substances.
What you can not eat with psoriasis:
- sharp, smoked and salty foods;
- a peel of citrus;
- fat meat;
- blue cheese;
Food for psoriasis should be rich in fatty acids, which are abundant in fish. The essence of the disease is this: a failure in the activity of the immune system provokes the body to produce more and more skin cells without having to get rid of the old ones. As a result, skin cells are layered and glued, there is itching, irritation, peeling.
Why the immune system behaves in a similar way is unknown. Doctors say one thing - psoriasis is incurable, so it is not the illness itself that is to be fought, but its manifestations.
Quality of life of patients
It has been shown that psoriasis can worsen the quality of life of patients to the same extent as other serious chronic diseases: depression, a previous myocardial infarction, hypertension, heart failure or type 2 diabetes mellitus. Depending on the severity and localization of psoriatic lesions, patients with psoriasis may experience significant physical and / or psychological discomfort, difficulties with social and professional adaptation and even need disabilities.
In a survey of the American National Fund for Psoriasis, which was held in 2008 and covered 426 psoriasis patients, 71% of patients reported that the disease is a serious problem of their daily life. More than half of patients noted a significant fixation in their appearance (63%), fear of looking bad or being rejected by others because of the presence of psoriasis, a sense of embarrassment, shame or embarrassment when communicating (58%). More than one-third of patients reported that with the onset or progression of the disease, social activity and communication with people or limited the search for partners and intimate relationships because of illness.
Strong skin itching or pain can interfere with basic life functions: taking care of oneself, walking, sleeping. Psoriatic plaques on open parts of the hands or feet may prevent the patient from working on certain work, engage in some sports, take care of family members, pets or home. Psoriatic plaques on the scalp often present a special psychological problem for patients and cause significant stress and even social phobia, since pale plaques on the scalp can be mistaken for those who surround themselves for dandruff or the result of having lice.
An even greater psychological problem is the presence of psoriatic eruptions on the skin of the face, ear lobes. Treatment of psoriasis can be expensive and take a lot of time and energy for the patient, interfering with work, study, socialization of the patient, the device of personal life.
The prognosis for life in psoriasis is conditionally unfavorable, the disease is chronic, slowly progressive, timely and adequate treatment only increases the quality of life, but does not eliminate the disease itself.
During periods of exacerbation, disability is observed. In the absence of adequate medical care, disability can result.
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