Psoriasis

what does psoriasis look like on the body

Psoriasis is a common non-contagious skin disease that is associated with inflammatory lesions. It is chronic - the acute period is followed by periods of weakening or disappearance of symptoms - and is caused by a combination of various factors.

The disease is widespread and occurs somewhat more frequently in women than in men. It is not completely cured, but it is possible to relieve symptoms and improve the patient's quality of life.

Psoriasis can lead to arthritis, an inflammation of the joints.

Synonyms Russian

Scaly lichen.

English synonyms

Psoriasis.

Symptoms

Symptoms and signs of psoriasis depend on the type of psoriasis.

  • Plaque psoriasis. It is accompanied by specific inflammatory skin formations - raised, oval, sharply outlined reddened lesions, flaky and covered with silvery scales. Most often, formations appear on the outer surface of the elbows, knees, on the scalp and trunk. Elements of a skin rash can be painful and itchy. In severe cases, the skin near the joints of the affected areas cracks and bleeds.
  • Guttate psoriasis. This type is associated with the appearance on the body of numerous papules (nodules) of orange-pink color, 1-10 mm in size. The rash usually appears on the torso, shoulders, and thighs, but can be found all over the body. As a rule, it affects people under the age of 30, as well as 2-3 weeks after suffering from infectious diseases of the upper respiratory tract, after superficial bacterial infections in the anus.
  • Psoriasis of the nails. It is characterized by compaction, exfoliation, discoloration of the nail plates, discoloration, yellowing of nails, the presence of spots on them, the formation of pits, cracks, damage on the nails. The nail plates are destroyed, the growth of nails is disturbed, they can be separated from the nail bed. It occurs in 30-50% of patients with psoriasis.
  • Psoriasis of large folds. In this case, skin lesions in the form of red inflammatory spots appear in the area of the folds of the armpits, under the mammary glands, in the cervical folds, in the genital area, on the foreskin. Cracks may appear along the edges and in the center of the lesions. Most often, large fold psoriasis occurs in overweight and obese people. Sweating and friction make the disease worse.
  • Psoriasis of the head. It is accompanied by redness of the scalp, itching, flaking of the scalp with the appearance of white scales on the hair and shoulders - particles of dead skin.
  • Psoriatic arthritis. Skin lesions are accompanied by joint pain, swelling, curvature, and deformation of the joints. The joints of the fingers, wrists, feet, knee joints may be involved.
  • Pustular psoriasis. This type is characterized by reddening of the skin and the formation of a large number of pustules - small blisters filled with pus. Formations can appear on the palms and feet or all over the body. When multiple pustules appear on the body, fever and weakness join.
  • Psoriatic erythroderma. Areas of the skin redden, plaques may appear. Lesions are usually accompanied by severe itching. Most often, psoriatic erythroderma is associated with sunburn or misuse of medications.

Usually, with different types of psoriasis, the disease manifests itself gradually, the skin lesions spread and are observed over several weeks. Then the symptoms disappear. After exposure to a factor contributing to the development of psoriasis (or spontaneously), symptoms reappear after some time.

General information about the disease

Psoriasis is a common non-contagious skin disease that is associated with inflammatory lesions.

It is chronic and often recurs - the acute period is followed by periods of weakening or disappearance of symptoms, then after a while the symptoms reappear.

Psoriasis is widespread, especially among people aged 16-22, 57-60 years old. Women are more susceptible to it than men. People with fair skin are at increased risk of developing the disease.

Despite the fact that psoriasis is synonymous with lichen scaly, it is absolutely not contagious to others.

The causes of psoriasis have not yet been fully established. Its appearance is associated with a genetic predisposition, with malfunctions of the immune system and with environmental factors affecting the body.

The development of psoriasis is associated with one of the types of cells of the immune system (with T-lymphocytes), while T-cell hyperactivity is observed. Normally, they travel with the blood throughout the body, detecting foreign agents - viruses and bacteria. In psoriasis, for unknown reasons, T cells begin to accumulate in the skin. Their hyperactivity causes the expansion of blood vessels in the affected area, disrupts the cycle of formation of new skin cells - they are formed much faster than usual. Dead skin cells, meanwhile, do not have time to exfoliate and accumulate on the surface of the skin, forming plaques.

Psoriasis can be triggered by one of the following factors:

  • infections (tonsillitis, thrush, HIV);
  • damage to the skin - cut, scratch, bite, or burn;
  • hypothermia;
  • sunburn;
  • emotional stress;
  • smoking, alcohol abuse;
  • the use of drugs (antimalarial, etc. ).

At the same time, in some patients with psoriasis, rashes appear without obvious influence of environmental factors.

There are the following main types of psoriasis.

  • Plaque psoriasis. It is the most common.
  • Guttate psoriasis. It usually affects people under the age of 30. It occurs 2-3 weeks after the transferred infectious diseases of the upper respiratory tract, as well as after superficial bacterial infections in the area around the anus.
  • Psoriasis of the nails.
  • Psoriatic arthritis. In this type of psoriasis, skin lesions are accompanied by arthritis - inflammation of the joints.
  • Psoriatic erythroderma. Most often associated with sunburn and misuse of medications.
  • Pustular psoriasis. It is quite rare, in severe cases, it threatens the patient's life.
  • Psoriasis of the head. In this case, hair loss caused by the disease usually does not occur, since the hair roots are located much deeper than scaly formations.

Classification of psoriasis according to the severity of the course:

  • soft (less than 2% of the entire skin is affected);
  • moderate (skin lesions occupy no more than 3-10% of the skin surface);
  • severe psoriasis (more than 10% of the skin is affected).

Depending on the type, location and extent, psoriasis can cause complications:

  • thickening of the skin, the addition of a secondary infection through scratching and scratches that appeared due to itching with psoriasis;
  • psychological problems (stress, low self-esteem, depression, social self-isolation);
  • joint damage (deformity with stiffness and decreased joint mobility);
  • increased risk of developing various diseases and conditions: high blood pressure, inflammatory bowel disease, cardiovascular disease, skin cancer.

Psoriasis is usually relatively mild. However, for most patients, social adaptation becomes the main problem, especially in the presence of skin lesions in visible areas of the skin - the hostility of others to the type of skin lesions, their fear of getting infected (many do not know that the disease is not contagious).

Who is at risk?

  • People with a hereditary predisposition (more than 40% of patients with psoriasis have a relative with psoriasis).
  • Persons with viral, bacterial, fungal infections (streptococcus, thrush, HIV, etc. ).
  • Emotionally stressed.
  • Obese and overweight persons.
  • Smokers.
  • Alcohol abusers.
  • Taking certain medications (antimalarial drugs, etc. ).
  • Sunburned.

Diagnostics

The diagnosis of psoriasis is usually based on the type of lesions and their location. In difficult cases, additional testing may be required to rule out other skin conditions.

Laboratory research

  • General blood analysis. With psoriasis, leukocytosis and anemia can be detected.
  • Rheumatoid factor (RF) is a protein, the level of which in the blood can increase in systemic inflammatory diseases accompanied by joint damage, especially in rheumatoid arthritis. The test result for psoriasis is negative. This allows you to distinguish psoriasis from rheumatoid arthritis, in which RF is increased.
  • The erythrocyte sedimentation rate (ESR) is generally normal, with the exception of pustular psoriasis and psoriatic erythroderma.
  • Uric acid. Uric acid levels in psoriasis can be elevated (especially in pustular psoriasis), which leads to psoriatic arthritis being confused with gout, in which the uric acid concentration rises significantly.
  • Antibodies to HIV (Human Immunodeficiency Virus). The sudden onset of psoriasis may be due to HIV infection.

Other research methods

  • X-ray of the joints. Allows you to assess the severity of joint damage in psoriatic arthritis.
  • Skin biopsy. The examination involves taking a small sample of the skin for later examination under a microscope. It is carried out in difficult cases in order to distinguish psoriasis from other skin diseases.

Treatment

Therapy for psoriasis includes local treatment of skin lesions, medication, phototherapy, prevention of exposure to factors that provoke the appearance of rashes. It depends on the type and severity of the psoriasis.

To get rid of skin lesions, emollients (creams, petroleum jelly, paraffin, vegetable oils) can be used. They are most effective when used twice daily after showering. Also used are salicylic acid, anthralin, tar preparations, ointments, solutions, shampoos containing coal tar. These agents are anti-inflammatory and slow down the formation of new skin cells.

The use of corticosteroid ointments makes the treatment more effective. They are indicated for mild to moderate psoriasis. However, their long-term use is not recommended (skin atrophy, addiction to the drug are possible).

Light therapy - exposure of the skin to ultraviolet radiation - may be beneficial. In this case, burns should be avoided.

Local treatment of lesions in more severe cases is combined with the intake of drugs - retinoids, vitamin D preparations, methotrexate, etc.

Treatment of psoriasis can be difficult, since the disease is chronic and recurs after the symptoms disappear. The effectiveness of a particular method of treatment depends on the patient's susceptibility to it.

Daily baths (bath oil, oatmeal, or sea salt are recommended; hot water and scrubs should be avoided) and moisturizing after bathing can help soften the skin and reduce psoriasis inflammation.

Prophylaxis

  • Avoid hypothermia, sunburn.
  • Avoid emotional stress whenever possible.
  • Quit smoking and alcohol abuse.
  • Take certain medications (antimalarial, etc. ) with caution.

Recommended tests

  • General blood analysis
  • Erythrocyte sedimentation rate (ESR)
  • Rheumatoid factor
  • Serum uric acid
  • HIV 1, 2 Ag / Ab Combo (determination of antibodies to HIV types 1 and 2 and p24 antigen)