Psoriasis (its more understandable and close to reality name - squamous scaly) is a chronic, with frequent relapses, a skin disease capable of damaging the periarticular tissues. Its distinctive feature is red, merging together nodules, covered with silvery scales. These irregularly shaped spots appear, as usual, on the elbows, knees, scalp and lower back, although at the same time, they can occur almost everywhere.Psoriasis can develop at any age, but most often it occurs after 35 years, and equally, both in men and in women. The severity of the course of the disease varies from person to person: for some, this is only a slight inconvenience, for others - the factor that most seriously affects the quality of life.
- Symptoms and types of psoriasis
- Plaque psoriasis
- Psoriasis of the scalp (psoriasis on the head)
- Psoriasis of the nails
- Teardrop psoriasis
- Psoriasis of flexor surfaces
- Pustular psoriasis
- Erythrodermal psoriasis
- Causes of psoriasis
- Treatment of psoriasis
- Local (topical) treatment
- Systemic treatment
- Video on the topic: "Psoriasis"
Symptoms and types of psoriasis
Psoriasis is characterized by a cyclic course with alternating periods of exacerbation and relief of symptoms. There are several types of this disease, which can be present in the patient both in the singular, and simultaneously, and even alternating.
The most common form of the disease, occurring in 90% of cases. The skin forms dry, red, silvery scales plaques that can itch and / or cause pain. The traditional place of their dislocation can be elbows, knees, head or lower back.
Psoriasis of the scalp (psoriasis on the head)
Appears exclusively on the scalp in the form of red areas, covered with a thin silver film. In severe cases, psoriasis on the head causes temporary alopecia.
Psoriasis of the nails
Approximately half of those suffering from psoriasis are affected by nail disease, which can become pitted, discolored, or tend to abnormal growth. There may be a loss of nails due to their separation from the nail bed. In severe cases, the nails under the influence of the disease literally fall apart.
It appears small (less than 1 cm) drop-shaped sores on the chest, limbs and head, which, by the way, can disappear in a few weeks by themselves. In some cases, it develops following strep throat infection. It is more common in children and adolescents.
Psoriasis of flexor surfaces
It affects the skin in the groin, underarms, under the buttocks and mammary glands. It is an extensive, smooth, red spots, the condition of which deteriorates with friction and sweating, so this kind of psoriasis is especially difficult to tolerate in hot weather.
A rare form of psoriasis, causing the formation of pus-filled vesicles (pustules) on the skin. Pustular psoriasis can be generalized, palmar-plantar, acropustulous (it affects the fingers and nails).
Another rare form of psoriasis, affecting almost all skin integument. It causes loss of fluid and proteins, which causes dehydration, hypothermia, exhaustion and increases the risk of developing infectious diseases and heart failure.
Causes of psoriasis
Psoriasis occurs when young and dying skin cells change each other too quickly. The cause of this phenomenon is still unsolved.
The nucleation of new cells occurs in the deep layers of the skin. Over time, they rise upward, forming the outer layer of the skin. Then the cells naturally die and exfoliate. Normally the entire process takes 3 to 4 weeks. In psoriasis, the picture is completely different, and for these cell metamorphoses it takes only 3-7 days. As a result, a whole conglomerate of immature cells accumulates on the surface of the skin, which forms the most unpleasant picture, called clinical manifestations of psoriasis.
According to some experts, accelerated renewal of the outer layer of skin cells can be associated with immune disorders. Although, again, exactly what causes such immune disorders is not known for certain: it can be any genetic reasons (because it was observed that psoriasis can be transmitted by inheritance) or the negative impact of certain factors environment.
Symptoms of psoriasis can worsen under the action of so-called trigger factors, which for this disease can be:
- skin damage, such as a cut, scratch or sunburn;
- alcohol abuse;
- psychological stress;
- hormonal "swings in particular - in women (for example, in the puberty period or during menopause);
- some drugs, including angiotensin-converting enzyme inhibitors, NSAIDs and beta-blockers;
- infection of the throat (in particular, it is important for teardrop-shaped psoriasis);
- other immune disorders, such as HIV.
Treatment of psoriasis
Treatment of psoriasis is directed, first of all, not to get rid of the disease (unfortunately, this is not yet possible for modern medicine), but to suppress its symptoms.
The therapeutic process can develop in three directions:
- local treatment (creams and ointments from psoriasis, applied to the skin);
- phototherapy (UV irradiation);
- systemic treatment with the use of oral and injectable dosage forms, acting on the whole organism.
Local (topical) treatment
Since it, as a rule, begin with mild and moderate psoriasis. These are creams and ointments from psoriasis, applied to damaged areas of the skin. And, in the first place, in this context means glucocorticosteroids. These drugs are potent, so their use is only permissible according to the doctor's prescription and only in limited areas of the skin. Otherwise, the abuse of SCS can lead to thinning of the skin.
Vitamin D analogues are used in place of or together with SCS with mild and moderate psoriasis, affecting the skin of the limbs, trunk and scalp. They slow down the reproduction of skin cells and have an anti-inflammatory effect.
Calcineurin inhibitors, such as tacrolimus and pimecrolimus, reduce the hyperreactivity of the immune system, which helps to arrest inflammation. These drugs are used in psoriasis, affecting sensitive areas of the skin (scalp, genital area), in case of ineffectiveness of GCS.
Coal tar is a heavy, thick substance, possibly the most ancient treatment for psoriasis. The principle of its work in this direction is for certain unknown, nevertheless, this substance can inhibit the formation of psoriatic scales, reduce itching and inflammation.
For 50 years now, dithranol has been used to treat psoriasis. It suppresses the process of cellular reproduction and has practically no side effects. Dithranol usually applies a limited amount of time on the skin of the extremities or trunk under medical supervision, since it paints everything that it contacts, be it leather, clothing or sanitation equipment.
Phototherapy involves the use of natural or artificial irradiation. Ultraviolet irradiation slows down the reproduction of skin cells and proves to be quite effective for some types of psoriasis, which local means can not cope with. Each irradiation session lasts several minutes 2-3 times a week for 6-8 weeks. PUVA-therapy (Psoralen + UltraViolet A) provides for the preliminary reception of psoralen, which makes the skin more sensitive to irradiation. Then it is exposed to ultraviolet-A (unlike ultraviolet-B, it penetrates the skin more deeply). This method is used for severe forms of psoriasis, which do not respond to other treatment methods. Phototherapy can successfully be combined with other anti-psoriasis medications. So, coal tar makes the skin more susceptible to irradiation. Well combined with UV irradiation and with dithranol.
If psoriasis is very severe and / or does not respond to other therapy options, then in this case resort to systemic treatment. It affects the body in greater than the previous methods, degrees, but it is fraught with a greater likelihood of developing side effects. Systemic treatment can be non-biological (used, as a rule, oral dosage forms - methotrexate, cyclosporine and acitretin) and biological (injection forms - etanercept, adalimumab, infiximab and ustekinumab).
For a patient suffering from psoriasis, it is of particular importance that all medical recommendations and prescriptions are followed, even if it seems to him that his condition is improving. Long-term treatment will help prevent possible outbreaks of the disease.
Video on the topic: "Psoriasis"