Psoriasis - what is this disease?

Psoriasis on the elbows

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

What is this disease?

Lichen scaly is another name for psoriasis, and this name perfectly describes this disease. Psoriasis is manifested by the formation of inflamed plaques of various 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 argue that the number of patients is growing steadily.

Scaly lichen has been known to people since ancient times, even healers in Ancient Greece tried to treat this disease. The modern history of the study of psoriasis is about 150 years old. But during this rather substantial period of time, the researchers managed to learn not enough about the causes and treatment of psoriasis.

Wide prevalence, uncertainty of etiology (causes of occurrence), insufficiently effective treatment - all this characterizes psoriasis as one of the most difficult problems in dermatology.

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

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

  • The genetic theory has many supporters, since psoriasis often acts as a hereditary or familial dermatosis. A careful study of the patient's family history in 60-80% confirms the presence of psoriasis in one form or another in the patient's relatives. However, in some patients it is not possible to confirm the fact of the hereditary origin of psoriasis. This circumstance is the reason for the allocation of these cases into a special group, in which the main reason 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 when infected with a virus, but also under certain conditions.

There are other theories that explain psoriasis. For example, endocrine, neurogenic, metabolic, etc. Naturally, all these theories are not without foundation, and their study allows you to get 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 gastrointestinal tract, do not cause psoriasis, but have a significant effect on the course of this disease.

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

Girl with psoriasis

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc. ) lead 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 the development of skin diseases, including psoriasis, is possible.

There is also an inverse relationship, psoriasis is often accompanied by fatty degeneration, affecting 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 get an exact answer to the question of what is psoriasis. 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.

International Classification

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

Added psoriasis to the International Classification of Diseases (ICD). To date, 10 revisions of the International Register of Diseases are already in use, therefore the abbreviation ICD 10 is used. Work began on 10 revisions of the International Classifier of Diseases in 1983 and completed in 1987.

In essence, ICD 10 is a standard assessment tool used in medicine and health administration. The Handbook in Revision 10 is used to monitor the prevalence of various diseases and other health problems.

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

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

  • Ordinary psoriasis(synonyms: vulgar, simple, plaque-like). The disease has been assigned a code according to ICD 10 - L-40. 0. This is the most common form, it is observed in 80-90% of patients. The main symptoms are the formation of plaques raised above the surface of unchanged skin, covered with white-gray skin scales. This form is characterized by slight flaking of the scales. After their removal, the inflamed red skin opens, which is very easily injured and begins to bleed. As the inflammatory process progresses, the plaques can increase significantly in size.
  • Inverse psoriasis. It is a disease that affects the folds of the skin (flexor surfaces). For this form of the disease, the code L83-4 is adopted in ICD 10. Dermatosis appears with the formation of folds on the skin of smooth or minimally flaky spots. The deterioration of the condition is observed when the skin is injured through friction. The disease is often complicated by an associated streptococcal infection or fungus.
  • Guttate psoriasis. This form of psoriasis is characterized by the formation of a large number of small specks of red or purple on the skin, resembling water droplets in shape. According to version 10 of the international classifier, such a disease received the L4 code. 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 psoriasisis ​​a severe cutaneous form, according to ICD 10 it was assigned codes L1-3 and L 40. 82. It is characterized by the formation of blisters or pustules. The skin in the lesions is swollen, red, inflamed, easily peels off. If fungus or bacteria enter the pustules, the contents of the pustules become purulent. Pustular psoriasis often affects the distal extremities, but in the most severe cases, a generalized process may develop 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. It is manifested by inflammation of the joints. Arthropathic psoriasis can affect all types of joints, but in most cases the joints in the phalanges of the toes and hands become inflamed. Knee, hip, or shoulder joints may be affected. The lesions can be so severe that they will lead to the patient's disability. Therefore, you should not think about psoriasis that it is an exclusively skin disease. Severe types of psoriasis can lead to systemic damage, disability or even death of the patient.
  • Healthy skin and psoriasis
  • Erythrodermic psoriasis. A rare but severe type 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 the entire surface of the skin may enter the affected area. The disease is accompanied by severe itching, swelling, soreness.
  • Onychodystrophy psoriatic or psoriasis of nails. 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, and begin to deteriorate. Complete loss of nails is possible.

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

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

If we consider all types of 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 regressive.

The following is characteristic of the progressive stage of psoriasis:

  • the appearance of new rashes;
  • growth of already existing plaques;
  • the appearance of new elements of the rash at the site of skin injuries (scratches, abrasions);
  • profuse scaling of existing plaques.

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

  • no new elements appear;
  • Psoriasis on the face
  • moderate peeling of elements;
  • no signs of growth of elements.

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

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

  • decrease in peeling intensity;
  • resolution of elements.

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

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

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

Diagnostic Features

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

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

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

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

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

In the diagnostic process, a certain role is assigned to a set of phenomena that are called the psoriatic triad. The phenomena appear sequentially, when scraping the element of the rash.

The psoriatic triad appears like this:

  • when scraping the rash element, the scales are removed in the form of "shavings";
  • After removing the chips, a thin transparent film similar to polyethylene opens;
  • when the film is damaged, pinpoint 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.

Interesting facts about psoriasis

People have known about psoriasis for a long time. Even the very name of the disease came into our language from ancient Greek. At the time of the prosperity of Ancient Hellas, the word "psora" meant 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 Celz. In the fifth volume of his work "De medicina" there is an extensive chapter on this disease.

They knew about psoriasis, but this disease was not assessed unambiguously, as it was called, sometimes "imperial", sometimes "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 identified as an independent nosological form in 1799. This was done by the English dermatologist Robert Villan, who singled out psoriasis from an extensive group of skin diseases, 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 monument of pure gold to a person who can learn everything about psoriasis and offer effective treatment for this disease.

Modern understanding of the disease

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

Here are some facts about psoriasis that are beyond doubt:

  • despite the fact that the causes of the disease are unclear, it was possible to find out 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: 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 his relatives are sick;
  • An interesting fact about psoriasis is that this disease is characterized by the Kebner phenomenon. This phenomenon manifests itself in the fact that the elements of the rash are formed at the sites of skin lesions - scratches, burns, frostbite. Sometimes psoriasis appears after a while, at the site of the 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 have probably noticed the connection between exacerbations and stress in practice. All patients should know for sure that the disease recurs or worsens its course against the background of nervous tension and experiences;
  • a new fact about psoriasis is that the disease can debut at any age, although it was previously believed that lichen scaly occurs 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 cure has been found that could surely defeat the disease. But patients should be aware that psoriasis can be controlled. Adequate and timely treatment allows for long-term remission.

Modern methods of treatment

Speaking about the common disease of psoriasis, one cannot but tell about the treatment of this common disease. It must be said that it is impossible to cure psoriasis only with tablets or ointments.

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 properly organize food. Some experts argue that it is possible to forget about psoriasis forever only with the help of a properly formulated diet and regular cleansing of the body.

The doctor will draw up a preliminary scheme for the treatment. As a rule, methods of external (ointments, creams) and systemic (tablets, injections) therapy are used. Additionally, physiotherapeutic methods will be used, and treatment at resorts will be recommended. It is recommended to treat psoriasis using 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 scales and disinfect the skin, promoting its quickest healing.

May offer other treatments for scaly lichen in resorts. For example, leech therapy, healing baths and applications, sun therapy, etc.

You will need to be prepared for the fact that the treatment regimen will periodically change. Since not all methods are suitable for a specific patient. If the selected treatments do not work, they will need to be replaced.

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

It should be understood that it will be possible to forget about psoriasis forever only if the patient himself and his immediate environment are positively tuned. Only faith in success and an optimistic attitude will help to overcome this mysterious and insidious disease.