Causes of psoriasis and its treatment. Psoriasis - what it is, symptoms, first signs, causes and treatment of psoriasis. Psoriasis is often accompanied by obesity

Psoriasis is a chronic skin disease of unknown cause that appears as red, scaly patches on the skin.

Treatment is carried out by a dermatologist.
Synonym: scaly lichen.
ICD 10 code: L40. According to the international classification, it belongs to papullosquamous skin diseases.

Psoriasis as a disease has been studied for about 200 years. Before this period, such patients were considered to have leprosy and were treated accordingly as lepers. Difference: leprosy (leprosy) is an infectious disease (caused by Mycobacterium leprae). Psoriasis is non-infectious.

Causes

The etiology (cause) of psoriasis is unknown!!!

First, I will talk about the pathogenesis (mechanism of development) of the disease, and then I will talk about the possible causes.

Pathogenesis of psoriasis:

1. Cells of the surface layer of the skin (epidermis) - keratinocytes - begin to multiply intensively. Their number increases several times. Their life cycle is shortened, meaning they become covered with scales much earlier than normal skin cells. Externally, this process is manifested by thickening and redness of the skin, the surface of which is also covered with whitish scales.
2. Immune cells - lymphocytes: T-killers and T-helpers () penetrate into the thickness of the changed skin cells. These cells secrete special substances that attract other cells of the immune system - macrophages and neutrophils.
   An inflammatory reaction develops in the skin without the involvement of infection. This reaction is called autoimmune, that is, the immune system is directed against its own body, and not against bacteria or viruses.

And now about the reasons.

Scientists are still arguing about what the triggering mechanism is – a sharp growth of keratinocytes, in response to which a mass of immune cells comes into the skin? Or is the autoimmune reaction in the skin primary, and keratinocytes subsequently begin to grow excessively and develop rapidly?

In any case, no one has yet gotten to the main reason - WHAT IS THE IMPACT for the launch of one or another mechanism at the beginning of the development of psoriasis?

And again an interesting fact. It is known that in HIV patients the immune system is suppressed, primarily T-lymphocytes. It seems that psoriasis should not develop in them. However, there is an increase in the incidence of psoriasis in HIV patients. And the course of the disease in patients with AIDS is more severe.

Provoking (trigger) factors of the disease

1. Heredity: if one parent is sick, the risk of psoriasis in children is 7%, if both parents are sick, the risk is 40%.
2. Skin injuries:
   - mechanical - scratches, cuts, abrasions,
   - chemicals - solvents, varnishes, paints, detergents, household chemicals, perfumes,
   - thermal - hypothermia, burns.
3. Endocrine diseases - diabetes, hypothyroidism, hormonal changes in the body.
4. Stress.
5. Infectious skin diseases - staphylococcal, streptococcal, fungal infections.
6. Alcohol abuse, smoking.
7. HIV infection.

Symptoms

The main symptom of psoriasis: the appearance of pink-red spots on the skin, the surface of which is covered with silvery scales of the keratinizing layer of the skin (epidermis).

1. Symptom of “stearin stain”.
   This is a pathognomonic (that is, characteristic only of this disease) sign. Scraping (grattage) of a psoriatic spot. This is done with a blunt scalpel or a glass slide (not a fingernail!!).
   When lightly scraped, the surface of the stain becomes white, as if covered with wax - this is a symptom of a “stearin stain”.
2. Symptom of “psoriatic film”.
   
   With further scraping, carefully removing the scales from the psoriatic plaque, a shiny surface is visible under the scales - the so-called symptom of psoriatic, or terminal, film.
3. Symptom of “Polotebnov’s blood dew” (Auspitz symptom).
   Another symptom pathognomonic for psoriasis.
   With further scraping (grottage) of the plaque, that is, when removing the terminal film, pinpoint bleeding appears that does not merge with each other. This is a symptom of “blood dew”.
4. Pilnov's sign. Characteristic of the initial stage and the progression stage. A round pink spot without peeling, with clear boundaries. As the disease progresses, a rim of red skin, not yet covered with scales, is noted along the periphery of the spot (plaque).
5. Koebner's sign. Psoriatic lesions appear on the skin in places of injury - in places of scratches, abrasions, in places of friction with clothing.
6. Kartamyshev's symptom. When plaques on the scalp (SC) are examined (palpated) with your fingers, a clear border of the plaques is felt with your fingers. In contrast to seborrheic dermatitis, when there is no clear boundary between the spots and healthy skin upon palpation.
7. Voronov's symptom is a symptom of a regressing (passing) spot. Along the periphery of the psoriatic spot, wrinkled skin remains for some time, lighter and shinier than healthy skin.
8. The “thimble” symptom on the nails is a sign of nail psoriasis. The nail is covered in pinpoint depressions, like a thimble.
9. Symptom of an “oil stain” on the nails: a yellow-brown spot under the nail plate is also a sign of nail psoriasis.
10. Onychogryphosis is deformation of the nail plate due to nail psoriasis. The nail takes on an ugly shape, sometimes resembling a bird's claw.
11. Beau-Reil line. A longitudinal line running through the entire nail is a sign of a malnutrition of the nail plate.

Types of psoriasis and clinic

Psoriasis vulgaris

Synonyms: simple, vulgar, coin-shaped or plaque psoriasis. ICD10 code: L40.0
This type occurs in 90% of patients.

This is what a psoriatic plaque looks like

Psoriatic plaque: a pink-red, rounded area of ​​skin, raised above the rest of the skin by 1-2 mm, clearly demarcated from healthy skin. The plaque is covered with silvery scales on top, which peel off easily, after which the plaque may bleed a little. Mild skin itching. Plaques can merge with each other, forming the so-called. "paraffin (or stearic) lakes."

In the photo: plaques with vulgar psoriasis

Localization of psoriatic plaques: knees, elbows, scalp (SC), hands, feet, lumbosacral region. These are the most favorite locations for plaques. Doctors also call them “duty” plaques (or “sentinel”), since they persist for a very long time. Only one spot in psoriasis is not an uncommon sight. This is exactly the duty plaque.

In the photo: psoriasis of the scalp

X-rays of the joints should be performed, as most patients experience changes in the joints.

Generalized pustular psoriasis (L40.1) and palmar and plantar pustulosis (L40.3)

These two forms of the disease differ only in the prevalence of the process. Their mechanisms of pathogenesis are the same.
Pustular forms occur in 1% of patients with psoriasis.

Vesicles (vesicles) and pustules (pustules) appear on the skin, which can merge with each other, forming “purulent lakes.” There may be some peeling of the skin around. Itchy skin may bother you. The skin around the pustules is red, inflamed, and hot to the touch.
Increased body temperature.
In the blood - an increase in leukocytes (leukocytosis).
These are the rare and most severe types of psoriasis. But they require immediate examination by a doctor and the prescription of comprehensive treatment. And generalized pustular psoriasis requires hospital treatment. In very rare cases, when a bacterial infection is associated, even cases of sepsis and deaths are described in the literature.

One of the types of pustular psoriasis is the exudative form. In this case, there are no ulcers or blisters on the skin, but there is weeping of the affected skin, the formation of crusts and itchy skin.

Acrodermatitis persistent Allopo

ICD 10 code: L40.2.

Pustular (pustular) psoriatic changes and peeling appear on the skin of the fingers and toes. The process involves the nail plates.
The nails are deformed, peel off in places from the nail bed, and have pinpoint depressions.

A milder form is nail psoriasis without pustular changes, that is, without ulcers on the skin.

Guttate psoriasis

ICD 10 code: L40.4

Dotted, teardrop-shaped spots 1-3 mm in size, pink in color with peeling, appear on the skin. There may be mild skin itching.
Localization: whole body - on the torso, arms and legs. Rarely - on the face.

Often the drop-shaped form appears after infectious diseases (sore throat, ARVI).

Arthropathic psoriasis

ICD 10 code: L40.5

Other names: joint psoriasis, psoriatic arthropathy, psoriatic arthritis.

Develops in 10% of patients with psoriasis.
Articular surfaces and periarticular tissues - ligaments, tendons, joint capsules - are affected.

Localization - any joints, but the small interphalangeal joints of the fingers are predominantly affected. However, there are known cases, for example, of psoriatic spondyloarthritis - damage to the intervertebral joints, or psoriatic coxarthrosis - damage to the hip joint.

Patients' complaints: pain, stiffness in the joints. Swelling and redness of the skin in the joint area appears. There are often cases when patients are not bothered by anything at all, but radiographs show arthrosis-like changes on the articular surfaces.

Joint pain and restriction of movement in the joints lead to disability in patients. Such patients should be sent for examination by MSEC to determine their disability group.

Other psoriasis

ICD 10 code: L40.8

This type includes inverse psoriasis (inverse, intertriginous).

Localization, on the contrary, is not on the extensor surfaces, but on the flexor surfaces. Elbow folds, popliteal fossae, armpits, inguinal folds, under the mammary glands. However, there are no rashes on other parts of the body.

Develops in patients with obesity and diabetes.
Manifestation: red spots appear on the skin, practically without peeling, slightly raised above the surrounding skin.

Psoriasis, unspecified

ICD 10 code: L40.9

All other species that, for one reason or another, cannot be attributed to the species described above, are classified in this group.

Seasonal forms of psoriasis

1. Winter form (photosensitive psoriasis). Rashes appear during the cold season. They are well treated with ultraviolet irradiation.
2. Summer form (phototoxic psoriasis). Exacerbations occur in the summer. UV irradiation leads to an exacerbation of the disease.

Stages of psoriasis

If the crust of psoriasis disappears, but the skin remains red and shiny, while new rashes appear, this may be a signal of progression of the disease. Treatment should begin!

Course of the disease

1. Light flow. No more than 3% of the skin area is involved in the process.
2. Moderate weight. From 3 to 10% of skin.
3. Severe course of the disease. More than 10% of the skin is affected by psoriasis.
   The pustular form, exudative form and joint damage are always a severe form of the disease.

Remember: The area of ​​the palm with fingers is 1% of the skin. You can use your palm to measure the area of ​​the lesion.

In Western medicine, the PASI and DLQI indices are used to assess the severity of the lesion and the activity of the process. In Russian practice, these indices are rarely used and do not affect the effectiveness of patient treatment.

Diagnostics

The diagnosis is made based on the patient's clinical symptoms and complaints.

Differential diagnosis of psoriasis is carried out with the following diseases:

• Lichen planus -
• Pityriasis rosea -
• Atopic dermatitis
• Eczema
• Papular syphilide
• Seborrheic dermatitis on the head
• Dermatophytosis on the head
• Reiter's disease, rheumatoid arthritis, arthrosis
• Drug allergic dermatoses
• Hives

Treatment of psoriasis

Remember: it is impossible to completely cure psoriasis. You can only achieve long-term remission.

Local treatment

Attention: if pustules appear from the ointment, then the ointment should be discontinued and consult your doctor for treatment correction!

1. Ointments and creams with vitamin D. For example, preparations containing Daivonex, Psorcutan.
2. Corticosteroid ointments and creams. These drugs reduce the immune response in the skin and reduce the activity of inflammation.
   Ointments: prednisolone ointment, locoid, acriderm (), sinaflan, belosalik (betamethasone + salicylic acid -), elocom-S (mometasone + salicylic acid).
3. Combinations of vitamin D and corticosteroids in one formulation. For example, or.
4. Preparations based on naphthalan.
   Cream Losterin (), Naftaderm ().
   Apply to the affected area of ​​skin 2-3 times a day – 4 weeks.
5. Birch tar and preparations based on it.
   Berestin, birch tar.
   Lubricate the affected areas and leave for 15-30 minutes, then wash off with warm water and soap.
6. Creams and ointments based on solid oil. You can use the grease itself, but you need to find the old Soviet grease, and not the grease that is now sold in car dealerships with various additives.
   Creams and ointments: kartalin, cytopsor.
   Solidol and creams based on it help in half of the cases of psoriasis. The itching decreases on the 3rd day, the peeling goes away and the spot itself gradually decreases.
7. Keratolytic (exfoliating) ointments and creams. Not used regularly! Only for removing excess peeling. Often - in combination with corticosteroid drugs to reduce itching and inflammation.
   Cannot be used for exudative psoriasis!
   Belosalik ointment: glucocorticoid Bepanten + keratolytic agent Salicylic acid.
8. Zinc preparations.
   Skin cap - in the form of an aerosol, shampoo or cream. Reduces skin irritation and redness, dries the skin. Skin cap is especially useful for exudative psoriasis, as well as in children. Does not contain hormones.
   Attention: do not use tar and salicylic acid on “standby plaques”! Irritation of regular plaques can provoke the spread of pathological rashes further along the skin.

General treatment

1. First of all, we eliminate the provoking factor (see above)!!! Otherwise, all our treatment will not have an effect on the disease.
2. Retinoids. Tigazon and . These are one of the main drugs for psoriasis. The effect of the drugs is to inhibit excess growth and normalize the processes of keratinization of skin cells. The membrane structures of cells are stabilized.
   Neotigazon is taken in the following dosage:
   25-30 mg per day – 8 weeks.
   For severe forms, 50-75 mg per day also for 8 weeks.
3. Antihistamines. Prescribed to all patients. They reduce the activity of the immune response, reduce allergies, relieve itching and inflammation in the skin in general.
   Medicines: Claritin, loratadine, Erius, Telfast, Tavegil, Suprastin, Diphenhydramine.
4. Enterosorbents. These drugs reduce the absorption of various toxins from the intestines into the blood. Used only in combination with other drugs and diet.
   Drug: enterosgel.
5. Cytostatics and immunosuppressants. These are drugs that inhibit cell growth and reproduction and suppress the immune system. Prescribed only for severe psoriasis by a dermatologist.
   Methotrexate, fluorouracil, cyclosporine, neoral. The course of treatment is 4 weeks.
6. Corticosteroids in tablets and injections (intravenously): dexamethasone, prednisolone, betamethasone (diprospan). Also prescribed for severe disease and in short courses under the supervision of a doctor. Mostly prescribed in inpatient settings.
7. NSAIDs (non-steroidal anti-inflammatory drugs) – for joint damage. Drugs: indomethacin, voltaren, ibuprofen, diclofenac.
8. Infusion therapy. Flushes toxic immune complexes from the body. It is carried out in a hospital setting for severe cases with general manifestations of the disease. Intravenously administered: sodium chloride, rheopolyglucin, hemodez.
9. 30% sodium thiosulfate intravenously. Currently not used due to the low effectiveness of thiosulfate, the presence of side effects and the release of more effective drugs for psoriasis.
10. Psychotropic substances. These can be antidepressants, anxiolytics (or tranquilizers). They reduce anxiety, depression, and increase stress resistance.
    Drugs: afobazole, amitriptyline.
    Prescribed only for appropriate manifestations in patients.
11. Sedatives. Reduce excitability and increase stress resistance. Infusion of motherwort herb, valerian.
12. Multivitamin preparations. Complivit, selmevit, undevit and others.
13. Drugs that improve metabolism.
    Befungin is a preparation made from the birch mushroom “chaga”.
    Folic acid.
14. Psychotherapy. Used in combination with other areas of treatment.

Instrumental treatment methods

An effective treatment regimen for psoriasis (example)

• Neotigazon 25 mg – 2 months
• xamiol - lubricate the affected areas once a day
• PUVA therapy – 15-20 procedures
• motherwort infusion at night
• strict adherence to diet

Diet for psoriasis

Exclude:

Citrus fruits, tomatoes, pineapples and other overseas fruits, honey, candy, sugar, cookies, spices, alcohol, spicy and salty foods, coffee, white bread, smoked meats, products with dyes and sweeteners, potatoes and semolina porridge.

Don't overeat!

Necessarily:

Porridge (buckwheat, oatmeal),
vegetable oils (sunflower, olive),
fruits and vegetables – apples, carrots, beets, cabbage, cucumbers,
boiled meat,
fish,
one day a week (usually Saturday) - fasting (or even fasting). On this day, drink only water or eat buckwheat porridge doused with water.

Folk remedies

At home, you can use various folk remedies for psoriasis. But their effect is minimal or zero.

Remember: self-treatment at home in half of the cases leads to progression of the disease and transition to a more severe form.

List of folk remedies for psoriasis used in patient reviews:

1. Solid oil.
2. Therapeutic mud of salt lakes.
3. Baths with sea salt.
4. Birch tar.
5. Naftalan oil.
6. A decoction of the string - compresses (applications) to the affected areas of the skin.
7. Decoction of celandine herb.
8. Nettle decoction.
9. Aloe juice.
10. Turpentine baths.
11. Starvation.
12. ASD fraction 3.
13. Linseed oil.
14. Milk thistle.
15. Dietary supplements and anthelmintic drugs. Ineffective or with zero effectiveness. At best, they contain extracts of ordinary herbs, or even ordinary starch with vitamins and microelements. They are very expensive and bring good profits to manufacturers and distributors of dietary supplements. They are not a cure, so you cannot expect them to help in the treatment of psoriasis.
16. Ointment for psoriasis Akrustal. The actual active agent is solid oil. The cost is about 1000 rubles. At the same time, the composition also contains many herbal extracts and bee products, which can cause an allergic reaction and exacerbation of the disease.
17. Chinese lotion Fufan. The drug contains acids that can lead to skin irritation and progression of the disease.

Exotic treatments

Ichthyotherapy.
Gara Rufa fish are found in Turkey. They pinch off dead areas from human skin and help “rejuvenate” the skin. This effect is also used in the treatment of patients with psoriasis.
In the video - treatment with gara-rufa fish:

The effect of ichthyotherapy is positive only if the technique is carefully followed and the exact fish is selected. There are similar “chin-chin” fish - they pinch off scales with sharp teeth, thereby injuring psoriatic plaques. The effect of the influence of “chin-chin” fish is exactly the opposite - the spread of plaques similar to the Koebner phenomenon.
In the video - fish "chin-chin":

Failure to maintain hygiene in some spas can lead to the appearance of fungal or viral lesions on the skin (mycosis, warts).

Relapse Prevention

• Eliminate risk factors!
• Maintain a daily routine, work and rest schedule
• Proper nutrition
• Timely treatment of infectious and endocrine diseases
• UV and PUVA therapy courses
• Complex vitamins
• Spa treatment, swimming at sea
• Healthy lifestyle!

Is psoriasis contagious?

No, it's not contagious! This is a non-communicable disease.

Attention: If the doctor did not answer your question, then the answer is already on the pages of the site. Use the search on the site.

Every year, millions of people experience skin diseases of various types. They can be infectious or non-infectious. Most often (people who are completely healthy at first glance) are diagnosed with psoriasis. It occurs in different parts of the body and can be of varying intensity. It worries patients and those around them, as people fear infection. Let's look at what psoriasis is, the causes of its occurrence, symptoms and treatment methods.

What is psoriasis

Psoriasis on the skin is a chronic disease that is not transmitted from person to person. Previously, this diagnosis was considered a nutritional inflammation of the skin, but today it is called psoriatic disease, due to the fact that it is systemic in nature, that is, it occurs as a result of a malfunction in the endocrine, immune, and nervous systems.

The mechanism of development of psoriasis on the body

It is impossible not to notice the source of the pathology, since burning, itching sensations, redness and peeling skin appear in that area of ​​the body. Every person faced with a diagnosis begins to feel discomfort when communicating with people, because the disease disfigures the affected area of ​​the body.

The mechanism of development is that skin cells die after 4-5 days, but do not fall off, but form into papules and begin to peel off, provoking an inflammatory process. The disease is not transmitted by touch, so there are no epidemics. The occurrence of psoriasis is associated with hyperactivity of immune T-lymphocytes.

Usually the disease appears in people genetically predisposed to it:

• If one of the parents has a predisposition to the disease, then the probability of this diagnosis occurring in the child is 25%.
• If you have 2 parents – 65%.

Psoriasis can occur at any age, even if there were no signs of its presence in childhood. The trigger mechanism can be treatment with antibiotics, alcoholic drinks, stress, skin injuries, vitamin deficiency.

Causes, symptoms and treatment of psoriasis

Although the disease psoriasis has been affecting people for many centuries, its original source has not yet been established. The disease can affect any person, even those who do not have a predisposition to developing the pathology.

Doctors have put forward the following theories regarding the causes of psoriasis:

• Viral.
• Immune.
• Infectious.
• Genetic.
• Caused by metabolic disorders.

Each of these reasons can provoke a focus of pathology, localized in any part of the body: on the head, arms (especially on the elbows), legs, and psoriasis also appears under the chest and on the abdomen.

Why does a person develop psoriasis: viral theory

Scientists, searching for the causes of psoriasis, have discovered changes in the peripheral lymph nodes, which is a sign of a viral form of the disease.

Doctors believe that retroviruses, transmitted genetically, are the cause of the activation of psoriasis, but to prove this, it is required:

• Isolate a retrovirus and identify it.
• Determine the habitat.
• Carefully study what modern medicine cannot do.

Retroviruses have the ability to change the genetic structure of a person through DNA synthesis and the formation of a “false program”. This factor is still being studied by doctors, but when blood is transfused from a patient with psoriasis to a healthy one, the appearance of the disease in the second has never been observed, which casts doubt on this theory.

Immune dysfunction

Disturbances in the immune system affect many structures of the body, but experts have noticed that when sinusitis, tonsillitis and other autoimmune diseases appear, pathological foci worsen.

When psoriasis first appears, doctors consider autoimmune aggressiveness to be the primary source.

Many diagnostic measures were carried out to study the occurrence of Munroe microabscesses in patients, which appeared as a result of abnormalities in:

• Immunoglobulins.
• Antibodies.
• Immune complexes.

The inflammatory process of the skin caused by psoriasis increases the sensitivity of the epidermis, especially in areas affected by chemical or physical means. Then, the rash and irritation increase in size. When conducting research, experts identified antibodies to antigenic components and the antigens themselves, which are absent in people who do not have a predisposition to the pathology.

Infection theory

It is believed that the causes of psoriasis are directly related to infection. An exacerbation of the pathology is often recorded in people admitted to the hospital, despite the fact that no pathogenic fungi and microorganisms have been detected. Judging by the opinion of scientists, psoriasis appears against the background of an infectious lesion as a result of impulses entering the autonomic and endocrine systems, which provokes changes in the structures of the body due to immune dysfunction.

There is also an allergic-infectious theory, characterized by an allergic reaction to viruses, microorganisms and their toxic secretions, but this theory has not yet been officially confirmed.

Genetic theory

This theory suggests that psoriasis is transmitted from parents to children, as well as from close and distant relatives.

This is due to the fact that most people who come to the skin-vein dispensary with psoriasis have a history of this disease in their relatives for 3-5 generations, but the disease cannot be called strictly genetic, since it occurs against the background of a complex of disorders:

• Changes in enzymatic, lipid, carbohydrate, protein metabolism.
• Immune, endocrine, autonomic dysfunction.
• Viral and infectious diseases.

Metabolic abnormalities

Metabolic disorders are the source of many diseases.

For psoriasis, research shows:

• High cholesterol
• The temperature is below normal.

In this case, experts classify psoriasis as a cholesterol diathesis, because improper lipid metabolism provokes the occurrence of skin keratinization.

Also, the clinical picture of the patient may have the following indicators:

• Violations of vitamin metabolism of groups B6/12, A, C. At the same time, the amount of vitamin C in the body is more than required.
• Lack or excess of zinc, copper, iron.

These factors reduce a person’s adaptive capabilities and contribute to the development of diabetes mellitus, which often accompanies psoriasis.

Where else does the disease come from - psoriasis (additional causes):

• Stress.
• Acclimatization.
• Vaccination.
• Allergy.
• Female hormonal disorders.
• Burns, injuries, bites.
• Taking medications and alcohol.
• Hypothermia.
• Abuse of certain products.
• Food poisoning.

Psoriasis can appear in any person, regardless of age and gender, but the earlier it appears, the more damage it causes to the patient’s body and changes the quality of his life.

The first signs of psoriasis

Initially, the disease manifests itself in the form of small papules prone to peeling, localized in the area of ​​the previously affected area of ​​the skin. At the initial stage, psoriasis may develop gradually or suddenly. Further, pinkish nodules that appear on the skin are very itchy, burn and begin to become covered with a rash or flaky crust. The patient strives to comb the pathological lesions, as this brings relief, but further injures the skin. Scratching psoriasis can cause the disease to spread to nearby tissues, so when the first symptoms appear, you should immediately consult a doctor.

The first signs of psoriasis are rashes on the following areas of the body:

• Inguinal folds.
• Head.
• Shins.
• Lower back.
• Abdomen (under the chest).
• Nails/fingers.
• Arms, legs (knees, elbows, palms, feet).

To facilitate the diagnosis of psoriasis, experts have divided the disease into several forms, each with its own symptoms and individual localization. For example:

• Symptoms of plaque psoriasis are characterized by red, scaly papules with clear boundaries. They are usually located in the head, lower back, elbows and knees.
• With guttate psoriasis, the symptoms are completely different. Many small spots or pustules appear on the affected area; when pressed, a clear liquid is released from them. They usually occur on the backs of the hands and feet.

These are mild forms of psoriasis. Their development does not provoke fever, joint pain, or chills. However, any form of the disease must be treated, because if you do not resort to therapy as soon as the first signs appear, psoriasis can spread to the joints, nail plates and mucous membranes.

To find out what the disease looks like in the initial stages, see photographic signs of psoriasis developing on the skin.

Typical signs of psoriatic arthritis

Refers to severe psoriasis. Then the disease affects the joints, which leads to their deformation, and then to partial/complete dysfunction. At the initial stage, the disease is localized in the area of ​​​​the feet and hands, and then transferred to the segments of the spinal column and large joints. Then the joints increase in volume and begin to hurt.

During the examination, the doctor pays special attention to the following factors:

• Is there a genetic predisposition to psoriasis?
• Swelling of the joints.
• Pain syndrome when walking, touching objects.
• Limitation of mobility.
• Stiffness in the joints (during the day and in the morning).

Also, the specialist will prescribe tests. First, he needs to make sure that the joint pain is caused by psoriasis. To do this, the patient needs to take a test for rheumatoid factor. If the result is negative, then the doctor will diagnose psoriatic arthritis.

The first signs of nail psoriasis

The initial signs of damage to the nail plate by psoriasis are identical to fungus. Then along the entire perimeter of the nail you can notice depressed points or longitudinal grooves. They may appear on 1 nail or on all of them at once, but the onset of changes is recorded at the extreme part of the nail plate.

If untreated, the disease:

• Moves towards the root.
• The nail becomes inflamed, thickens, and becomes dull.
• A red border of skin forms around the nail.

This risks the fact that as a result, the nail plate may completely peel off from the skin or become similar to a bird’s claw, since the disease affects not only the skin, but also the nerve endings.

Treatment of psoriasis

It is impossible to cure psoriasis completely, since the disease is chronic. The maximum that doctors can do is prescribe drug therapy that creates a strong remission of the disease.

For medicinal purposes, local medications are prescribed. They increase skin infiltration, reduce flaking and eliminate the inflammatory process that causes itching.

These drugs include ointments and creams containing:

• Dithranol.
• Salicylic acid.
• Seru.
• Urea.

Also, specialists prescribe local glucocorticoids and lotions suitable for treating the scalp.

The prescription of therapy is influenced by many factors:

• Patient's age.
• Primary manifestation of the disease or exacerbation.
• How far does inflammation progress?
• Where is the lesion located?
• Duration of the disease.
• In what form does it appear, etc.

At the appointment, the specialist will examine the patient, collect anamnesis and prescribe a biopsy of the affected area.

After receiving the results, he will apply such treatment methods.

Today, scientists have invented a new drug that can cure chronic psoriasis in humans - Psorcutan. It has a direct effect on the pathogenetic factors that provoke the development of the disease. The main medicinal component is calcipotriol, which reacts with keratinocytes and suppresses their division. This component also has anti-inflammatory and immunomodulatory effects.

The advantage of this product is the absence of adverse reactions, manifested in the form of skin atrophy. After 2 months of treatment, the rash disappears partially or completely, even with treatment for guttate psoriasis. If the patient is responsible for drug treatment, successful remission can be achieved, lasting up to 12 months or more. SFT irradiation and PUVA complement the action of the drug well, so it is not recommended to abandon physical therapy.

In addition to these methods, there are others that are no less effective, but they should be selected exclusively by a doctor. Incorrectly selected therapy can worsen the patient’s condition and provoke a progressive inflammatory process against the background of an allergic reaction, so you should not experiment with medications. In addition, they should be constantly changed, because the body gets used to the effects of drugs and the effectiveness of therapy gradually decreases.

Psoriasis can have different symptoms. There are a number of specific signs that distinguish it from other diseases. Sometimes it is necessary to carry out differential diagnosis with other dermatoses.

The rationality of the selected therapy depends on the correct interpretation of the clinical picture. Therefore, it is important to know how psoriasis manifests itself.

Basic characteristics

The disease is classified as a dermatoses. The epidermis is predominantly involved in the pathological process. The first symptoms of psoriasis always appear as characteristic rashes.

They are represented by papules (plaques). These are pathological elements that develop inside the superficial layers of the skin. They have a whole set of features:

• Red or pink rash. This is due to the rather strong vascularization of the affected areas of the body.
• Size up to 3-4 cm. It can vary significantly.
• Clear boundaries. Pathological elements are often round, sometimes drop-shaped.
• Merger trend. In the absence of adequate treatment, rashes on the epidermis can connect with each other, creating entire “paraffin lakes” or “islands”.
• Elevation of 1-3 mm above the surface of the skin.
• Concentric growth.
• Cover of silvery scales. Almost all plaques contain these elements.

Psoriasis in humans occurs with the appearance of a rash, which almost always has all the indicated properties. Sometimes there may be minor nuances that characterize a specific form of the disease.

With timely consultation with a doctor, you can stop the progression of psoriasis, the symptoms of which have begun to actively develop. The main thing is to choose the right treatment. Typical plaques are the main symptom of a specific dermatosis.

Thanks to him, diagnosing pathology is rarely too difficult for a doctor.

Classic triad of symptoms

The disease is not very common among the world's population. According to statistics, from 2 to 5% of the world's population suffer from it. However, this figure is growing every year. Therefore, it is important to be able to diagnose pathology in time, and then begin to fight it.

Some people have no idea what psoriasis looks like. If there is a characteristic rash, its treatment may be reduced to the use of folk remedies, which does not give a tangible result. However, time is lost.

There is a special triad of symptoms that are characteristic only of this dermatosis. Once detected, the diagnosis is made very simply. These signs include:

1. The phenomenon of "stearin stain". After removing the outer scales, a peculiar stain appears underneath them, which resembles paraffin. It is formed due to the accumulation of air in a specific area, a change in lipid synthesis.
2. The phenomenon of "terminal film". With further scraping of the contents of the plaque, a shiny surface appears. It resembles polyethylene. It is the last element that can be removed from the skin.
3. The phenomenon of "blood dew". With further scratching of the plaques, multiple droplets of blood appear. They progress due to damage to microvessels located in the affected area.

It is important to clarify that scraping must be carried out either with a blunt scalpel or with a glass slide. Do not scratch the plaques with your nails.

Factors that provoke symptoms

The first signs of psoriasis do not appear on their own. It is important to understand that everything has a reason. However, it is not always known to doctors. At the moment, it is not precisely established why exactly a particular disease develops. There are quite a few theories, but none of them are universal.

Symptoms of psoriasis appear after exposure to certain triggering factors. They are triggers of a pathological reaction, and the main ones remain:

• Genetic predisposition. If one of your close relatives suffers from dermatosis, then the chance of passing it on to the next generation increases significantly.
• Past infectious skin diseases. Psoriasis on the body develops due to a decrease in the protective forces of the epidermis. He becomes vulnerable to negative environmental factors.
• Chronic stress. Nervous stress has a bad effect on the functional activity of almost any organ of the human body. The greater the load, the higher the chance of progression of dermatosis.
• Use of certain medications. Signs of psoriasis may be an adverse reaction to certain medications. A lot depends on the individual characteristics of the patient’s body.
• Bad habits (alcohol, nicotine, drugs).
• Poor nutrition, poor environment.

Symptoms of psoriasis may occur after exposure to these factors. The more of them affect a person at the same time, the higher the chance of the manifestation of the disease. However, it is important to understand that not all people develop the disease.

There is a specific mechanism according to which psoriatic rash develops. It includes several sequential reactions:

• An autoimmune disorder that interferes with normal T-lymphocyte function.
• Their migration into various layers of the skin.
• Release of a large number of inflammatory mediators.
• Activation of the reaction.
• Additional infiltration of the skin with dendritic cells, macrophages, and leukocytes.
• Disruption of epidermal cell division processes.
• Proliferation of keratinocytes.
• The appearance of a characteristic rash.

The causes of psoriasis and its development mechanism are still being actively studied by doctors. Disputes on this topic are still raging.

Auxiliary manifestations of psoriasis

In addition to the typical rash, there are other signs of the disease. In most cases they accompany plaques, but sometimes they may be absent. They help to more accurately navigate the diagnosis and prescribe the correct treatment to the patient.

The most common symptoms of psoriasis are:

• Peeling of pathological elements.
• Excessive dry skin.
• General poor health.

Each of the symptoms has its own characteristics. It may not occur in every patient, however, you need to remember about possible ways to eliminate it. Below is a brief description of each feature.

Itching

Psoriasis on the skin is accompanied by this symptom in approximately half of all patients suffering from a particular dermatosis. It refers to nonspecific manifestations, since it has a common nature with other dermatological diseases.

Its development is associated with the release of inflammatory mediators (mainly histamine). These biologically active substances irritate microscopic nerve endings and change the features of local microcirculation.

Against the background of such reactions, a person may feel an unpleasant symptom. It does not always accompany the disease. There are situations when typical plaques do not cause the patient any discomfort at all, except for a visual defect.

Much depends on the sensitivity of receptors to histamine and its amount in tissues. To successfully combat a specific manifestation of psoriasis, antihistamines and other antiallergic drugs are used.

Anti-inflammatory and sedative medications show good results. Itching may appear even before the formation of typical plaques. However, it is almost impossible to make a correct diagnosis due to the diversity of auxiliary symptoms.

Peeling

Almost all pathological elements in psoriasis are covered with silvery scales. They are dead keratinocytes. They accumulate on the surface of the skin and are then rejected.

Having appeared once, plaques will accompany the patient for the rest of his life. However, peeling is an optional symptom. It largely depends on the correct selection of special therapy and the patient’s compliance with the doctor’s recommendations.

Only the growth zones of pathological elements do not peel off. They are characteristic of young plaques that begin to spread to healthy areas of the skin.

Excessive dryness of the body

Dryness of the epidermis is caused by several changes in its functioning against the background of the disease, which are:

• Microcirculation disorders.
• Metabolic pathology, endocrine disorders.
• Excessive reproduction (proliferation) of keratinocytes.
• Genetic predisposition.
• Individual characteristics of the skin.

Dryness of the epidermis leads to the formation of cracks and microtraumas. They are entry points for various infections. If a patient has such miniature wounds, it is necessary to use healing agents.

They will prevent bacterial invasion with progression of the following additional symptoms:

• Pain.
• Edema.
• Redness.
• Local temperature increase.

In this case, to combat psoriasis, you will have to additionally use antibacterial agents.

General poor health

General poor health is a very nonspecific sign of psoriasis. They are inherent in almost any ailment. May progress at different ages. It all depends on the individual characteristics of the patient’s body.

In psoriasis, it reflects the body's overall response to the developing problem. To eliminate it, it is necessary to combat the main manifestations of the pathology.

The auxiliary signs of psoriasis listed above will help you choose the right therapy and improve the well-being of the sick person. The main thing is to see a doctor in time. Self-medication may be a factor in aggravating the patient's condition.

Depending on the clinical picture, the doctor’s decision on how to treat a particular patient may depend. Each organism is individual. The selection of therapy must be appropriate.

Stages of psoriasis symptoms

Psoriasis in adults almost always develops according to the same pattern. Its activity may vary, but its phasing does not. This fact sometimes makes it possible to distinguish the disease from other dermatoses (pseudopsoriasis, various lichens, etc.).

There are three main stages in the development of symptoms:

1. Progressive.
2. Stationary.
3. Regressive.

All of them have their own characteristics and a certain nature of their course. Depending on what stage the patient is in, the doctor’s approach to his treatment may differ. Below we will discuss the basic nuances of each phase.

Progressive stage

The manifestation of psoriasis at this stage is not very pronounced. It is of a beginner nature. More often it manifests itself after severe stress or illness. Features of this phase of the disease are:

• Constant appearance of new papules.
• Active growth of old elements, if present. The tendency to merge remains characteristic of them. They often form “paraffin lakes” or “islands”.
• Positive Koebner's sign. Active formation of rashes occurs on healthy skin after mechanical damage.
• Peeling. The plaques are covered with scales, which are constantly torn off.
• Presence of the classic triad of symptoms.

Many patients are interested in what age the first signs of the disease appear. More often it manifests itself in people under 20 years of age (approximately 65%). However, there are cases of the onset of the disease in adulthood and older age. Sometimes children suffer even before school.

Stationary stage

The plateau phase begins. Plaques stop growing. A kind of stabilization of the patient’s condition occurs. It can be triggered by properly selected treatment or the natural course of the disease. Features of this period are:

• New plaques do not appear.
• Old pathological elements stop growing and merging.
• Koebner's sign is negative.
• Itching and flaking almost completely disappear.
• The formation of a pseudoatrophic Voronov's rim is possible. A characteristic shiny ring appears around the plaques. It indicates the beginning of regression of a particular papule.
• The classic triad of symptoms persists.

The duration of the plateau phase and its further progress or regression depend on the correctness of the selected therapy.

Regressive stage

The last phase of the onset of psoriasis symptoms. It marks the end of a certain exacerbation of the disease. Its onset does not mean a cure for the disease. At the moment it is impossible to completely get rid of it. It is realistic to only achieve long-term remission.

At this stage, all symptoms of psoriasis subside. The skin gradually clears of plaques. Visually, they can become completely invisible. The person does not experience any discomfort and can return to their normal lifestyle.

Psoriasis of different localizations

The symptoms of this dermatosis are almost always the same. The main target of pathology remains the skin. However, it is known that it differs in different parts of the body. There are also some features of the clinical picture.

They depend on the localization of the process and its activity. Below we will discuss the nuances of the symptoms of psoriasis when different parts of the patient’s body are affected.

Arms and legs

The most common localization of the pathological process, especially in the early stages, remains the extensor surface of the elbows and knees. Typical plaques here develop according to the standard pattern described a little above.

First, individual papules are formed, covered with scales, and then they merge, creating large conglomerates. In the atypical form of psoriasis, skin elements are found on the flexible surfaces of the joints.

What remains characteristic is that plaques with such localization often turn red due to constant contact with clothing. This can sometimes be used to differentiate dermatosis from other diseases.

Face and neck

In the area of ​​the face and neck, papules are smaller in size with clear edges. They retain all the typical features, but are limited in character. They mainly occur:

• Around eyes .
• In the eyebrow area.
• In the area of ​​nasolabial folds.
• On the earlobes.

Such localization causes the patient a lot of discomfort due to the visual defect.

Scalp

A psoriatic “crown” is formed at the junction of the forehead and hair. The rash is located here, forming a special rim, which received a characteristic name. At the same time, dandruff progresses.

Psoriasis develops as seborrhea with disruption of the functioning of the sebaceous glands. Dry scalp progresses.

Body and back

Psoriasis on the body occurs during generalization of the pathological process. Plaques practically do not differ in any serious features. They often merge into large conglomerates that constantly itch and flake.

Pathological elements occur mainly on the back. The abdomen is affected less frequently. Sometimes the plaques may appear as purple droplets, forming large areas of a reddish color.

Palms and soles

This localization is predominantly characteristic of a limited form of psoriasis. The layers of the epidermis thicken. Cracks appear due to dry skin. A fungal or bacterial infection is often associated.

Nails

Psoriasis as a pathology involving the nails in the process is characterized by changes in the plate. Psoriatic onychodystrophy is formed. It is accompanied by the following symptoms:

• Thickening or thinning of the nail plate.
• The appearance of transverse or longitudinal lines on its surface.
• Changes in the color and consistency of the nail.

The plate may crumble. Symptoms of psoriasis of this localization can easily be confused with a fungal infection. The worst case scenario remains onycholysis. It is accompanied by nail detachment.

Pseudopsoriasis

Pseudopsoriasis is another dermatosis that visually resembles the traditional disease. It is also accompanied by auxiliary symptoms (itching, flaking, general deterioration in a person’s well-being, dry skin).

The pathology, like psoriasis, remains poorly studied. The two diseases can be distinguished by the absence of the traditional triad of symptoms for pseudopsoriasis. It is characterized by the “wafer phenomenon.”

When carefully removing the scales from the surface of the papule, they separate completely in a single layer. The treatment for a specific illness also differs. It is based on the use of the following groups of medications:

• Broad-spectrum antibiotics.
• Antimalarial drugs.
• Desensitizing agents.
• Vasoprotectors.

The question of a complete cure for pseudopsoriasis remains open. He is put into remission and preventive medications are used to consolidate the result. In any case, therapy should be carried out by a specialist.

Treatment of psoriasis

The study of psoriasis, its symptoms and treatment in adults should be carried out by a qualified doctor. Now there are several basic approaches to treating the disease:

• Local healing.
• Systemic treatment.
• Physiotherapeutic and instrumental methods of therapy.

Sometimes the use of traditional medicine is allowed, but it should be limited. An unconventional approach to healing may not have the desired effect, and in the absence of basic medications, this will lead to a deterioration in the patient’s condition.

Local treatment of psoriasis

Local therapy is based on the use of topical agents. They allow you to act only on the affected areas. Effective in the early stages of disease progression. To achieve the goal, the following groups of medications are most often used:

• Topical corticosteroids (Elocom, Akriderm, Lokoid).
• Products based on vitamin D (Calcipotriol).
• Keratolytics (salicylic ointment).
• Zinc and sulfur preparations.

To combat common forms of psoriasis, topical therapy is less suitable. This is due to the need to apply medications to very large areas of the body, which is not always convenient.

Systemic therapy for psoriasis

Medicines that affect the patient's entire body are used:

• Cytostatics.
• Immunosuppressants.
• Reninoids.

They block cell division and help reduce the number of plaques.

Among physiotherapeutic procedures, phototherapy remains the most promising. Using ultraviolet irradiation, it is possible to block the proliferation of keratinocytes. Due to this, the skin is cleansed.

Psoriasis is a serious disease. When the first symptoms appear, you should immediately consult a doctor for help. Timely initiation of treatment helps prevent the progression of the disease.

One of the most mysterious autoimmune diseases is. The disease cannot be completely cured, affects patients of different age categories and manifests itself in the form of raised red-pink spots. If you have the necessary information, you can recognize the first signs of psoriasis on your own, but to accurately diagnose the pathology and prescribe a course of treatment, you should contact a specialist. Timely detection of pathology helps to quickly reduce symptoms and gives a greater chance of achieving long-term remission.

The presented material contains information about the first manifestations of psoriasis in women and men. In addition, the article gives a detailed answer to the question of how to recognize psoriasis at the initial stage and what to do to avoid progression of the disease.

Before moving on to the signs of the disease, it is necessary to become more familiar with the causes of its occurrence.

Additional Information! The exact cause of the disease is currently unknown to science. There are a number of scientific theories that explain the manifestation of the disease.

The most justified among them are:

1. immune;
2. genetic.

Since psoriasis belongs to the category of autoimmune diseases and dysfunction of the immune system can actually provoke the development of the disease, which has been repeatedly proven, the immune theory is the most justified.

However, the importance of the genetic theory should not be underestimated, since according to statistical studies, the probability of a patient whose parents have psoriasis being affected is 70%.

Factors contributing to the manifestation of signs of psoriasis:

1. abuse of fatty foods, foods high in emulsifiers, leavening agents, dyes and other food additives;
2. excessive alcohol consumption;
3. smoking, drug use;
4. exposure to stress, frequent emotional outbursts, increased anxiety;
5. frequent use of chemically aggressive drugs;
6. excessive use of certain medications;
7. mechanical damage to the skin.

Psoriasis onset, general signs of the disease

There are several forms of psoriasis, each of which is characterized by certain signs and symptoms. However, some manifestations of the disease, the occurrence of which indicates the development of the disease, are inherent in all forms of pathology.

The onset of psoriasis signs (common to all forms of the disease):

• the appearance of pimples (papules) on the skin;
• increase in the affected area, spread of the rash;
• lamination of the nail plate;
• peeling of the skin;
• the appearance of blisters on the palms and feet;
• the appearance of burning and itching.

Additional Information! The first signs of psoriasis in women are identical to those that appear in men and children. The nature of the rash that occurs in the initial stages of development of the pathology is mistakenly confused with an allergic one, but the nature, as well as the causes, of this lesion are somewhat different.

Most often, patients are exposed to the following forms of psoriasis:

• Vulgar or simple psoriasis;
• Seborrheic;
• Psoriasis of the soles and palms;
• Nail psoriasis;
• Inverse or fold psoriasis;
• Teardrop-shaped.

Let us dwell in more detail on the signs and symptoms of these forms of pathology.

Signs of vulgar psoriasis

Psoriasis vulgaris can be diagnosed in the early stages. The first signs of this disease are expressed by the appearance of rounded pink-red plaques, covered with silvery scales, which after a certain time begin to peel and itch.

In some cases, the appearance of plaques may be preceded by the formation of papules on the skin of the head and in the joints (ankles and knees).

Note! At the initial stage of the disease, papules formed on the epidermis may not bother the patient for quite a long time. They do not cause pain, are hardly noticeable and do not itch, so some patients mistakenly confuse them with allergies.

How to distinguish a psoriatic rash from manifestations of an allergic reaction:

• psoriatic papules are easy to peel;
• when a papular rash is scraped, terminal film phenomena appear;
• Further scraping of the papule leads to the appearance of small droplets of blood.

A feature of psoriatic rash that distinguishes it from signs of other diseases is the fact that in summer the affected area decreases or even disappears completely, and in winter it increases.

Seborrheic psoriasis

The first signs appear on the scalp, later the pathology spreads to the shoulders and facial skin. The danger of this form lies in its secretive nature, since, unlike simple seborrheic, the formation of papules is not typical; sometimes it can only manifest itself in the form of peeling of the scalp. To get rid of flaking, many patients use special anti-dandruff shampoos, mistaking psoriasis for ordinary seborrhea.

Important! After detecting the first signs of the disease, you should seek advice from an experienced specialist who will be able to diagnose the disease and prescribe treatment. It is recommended to fight the disease at the initial stages of its development, this significantly increases the chances of reducing the symptoms of the disease and achieving long-term remission.

If treatment for seborrheic psoriasis is not prescribed in a timely manner, the disease gradually affects the skin on the shoulders, ears, forehead, etc. Subsequent stages of pathology development are characterized by the appearance of plaques, increased burning and itching. Getting rid of these symptoms is much more difficult than getting rid of the peeling characteristic of the first stage of the disease, but with the help of modern methods it is still possible to achieve the desired result.

Features of inverse psoriasis:

• the location of the disease is the folds under the armpits, on the genitals, in the groin, under the mammary glands;
• psoriatic spots are shiny, smooth, bright red;
• plaques that look like ordinary spots practically do not peel off, so the manifestations of the disease are often confused with irritation resulting from increased sweating;
• signs of psoriasis in men - rashes on the inner surface of the foreskin, the head of the penis is also usually affected;
• For women, a rash in the area of ​​the labia minora is typical.

Psoriasis of the palms and soles

The localization sites for this form of pathology are the palms and feet. The plaques have a callus-like shape with a dense surface; subsequently, such phenomena of psoriasis as terminal film and bloody dew appear. Cracks sometimes form on the affected surface, which causes physical discomfort while walking.

The symptoms of the disease can be alleviated through the use of special ointments and medications.

Nail psoriasis

The first signs of nail psoriasis include:

• separation of the nail plate;
• brittleness of nails, their thickening;
• change in the color of the nail plate;
• the appearance of white transverse stripes, dots and spots on the nail;
• formation of hemorrhages under the nail plate.

Patients whose relatives suffer from psoriasis, and from any form of it, are more susceptible to psoriatic onychodystrophy, so these individuals should be more attentive to their health, in particular to the condition of their nails.

Guttate psoriasis

The pathology manifests itself mainly on the thighs; papules have papules, which, in fact, explains the etymology of the name of this type of disease. Over time, rashes form on other areas of the skin, which indicates the progression of the disease.

To summarize, we can highlight the fundamental rules that must be followed in case of psoriasis:

• the occurrence of an autoimmune pathology indicates the presence of disturbances in the functioning of the systems of the whole body, in particular the immune system;
• If the disease is detected in the early stages, you should immediately contact a dermatologist and not self-medicate, which can lead to the development of the disease and deterioration of health.

Video, description, symptoms and treatment of psoriasis