Psoriasis (psoriasis) is a chronic non-contagious disease of the skin, nails and joints. By the appearance on the skin monomorphic rash: nodules of bright-pink color, covered with silvery scales covered. Elements of the rash merge in a variety of configurations, similar to a map. Accompanied by moderate itching. Psoriasis affects the appearance of the skin, it provides the psychological burden for the patient. With the defeat of the joints psoriatic Arthritis develops. Dangerous generalized pustular Psoriasis of pregnancy, to the defeat of the fetus and of abortion.
Psoriasis – a common chronic skin disease, characterized by monomorphic rash of flat papules, the tendency to merge into large patches that covered very quickly with loose silvery-white scales. The psoriasis diagnosed by a wave – shaped profile, incidence-2% of the total population, as well as in men and in women.
Causes and pathogenesis of Psoriasis
The etiology and the pathogenesis of Psoriasis is not fully understood, but the results of the examinations give reason to believe that hereditary, infectious or neurogenic nature the most. Heritability of Psoriasis is confirmed by the facts that the incidence is higher in families in which psoriasis was diagnosed, also in the case of identical twins, the concentration of morbidity is also higher than in the other groups. Infectious etiology of Psoriasis on the presence of an altered complex, and inclusions, as in the case of Virus infection, but, however, identify the Virus is not yet possible.
And today, psoriasis is considered a disease with many factors of infection, with a share of genetic and infectious components. In the group of risk according to the morbidity of Psoriasis people with the constant trauma to the skin, with the presence of chronic streptococcal infections of the skin, disorders of the autonomic and Central nervous system, endocrine disorders, in addition to the abuse of alcohol increases the probability for the occurrence of psoriasis.
Clinical manifestations of Psoriasis
The primary Element of the Psoriasis is a single papel pink or red, with many loose silvery-white scales. An important diagnostic feature is the triad of Psoriasis: to remove the phenomenon Stearin spot, End-of-Film-and point-shaped bleeding, if you are trying to shed.
In the Phase of development of the psoriatic lesions a little, gradually over a period of months and even years, their number is increasing. Psoriasis very rare debuts intense and generalized skin rashes, can be observed, the early after acute infectious diseases, severe Neuro-psychological overload, and after a massive drug therapy. If the psoriasis is edematous the beginning, then skin rashes, have a bright red color and quickly spread throughout the body, psoriatic Plaques hyperemic, swollen, and often itch. Papules are skin on the flexor surfaces, especially in the area of the knee and elbow joints, torso, and head.
For the next Phase of Psoriasis is scratching by the appearance of new, small items to places, injuries, and scratches, this clinical feature as a phenomenon Kebner. As a result of peripheral growth, the resulting new elements merge with the already existing, and form a symmetrical Plaques, or in the Form of lines.
In the third Phase of Psoriasis intensity of the peripheral growth of the Plaques reduced and their borders are clear, the color of the affected skin is bluish, there was an Intensive exfoliation over the entire surface of the elements. After the final withering of Psoriasis Plaques on the periphery of pseudo-atrophic bezel - bezel Voronov formed. In the absence of treatment of Psoriasis Plaques thicken, papillomatous, sometimes watching and warty growths.
In the Phase of Regression of the symptoms of Psoriasis starts to fade, the normalization of the skin goes from the center of the affected area on the periphery, first, the Peeling disappears, the normal color of the skin, and finally the Infiltration of the tissue disappears. In the case of deep lesions of Psoriasis and in patients with lesions of the thin and fragile skin, occasionally it can cause temporary hypopigmentation of skin cleansing of skin rashes.
Exudative Psoriasis differs from the usual presence of crusts scales on the plate, which is formed by impregnating the exudate, in the folds of the body can oozing. In the group of risk for morbidity exudative Psoriasis, diabetics, people with hypofunctions of the thyroid gland (hypothyroidism) and excess weight dropping. Patients with this Form of Psoriasis notice the itching and burning on the affected land.
Psoriasis, flows through the seborrheic type, localized in areas prone to seborrhea. A large number of sheds are not allowed psoriasis in a timely manner, the diagnosis, since they are masked rash. With time, patches of skin Psoriasis affected, grow and go out on the skin of the forehead in the Form of "Psoriasis crown".
In the case of people engaged in heavy physical work, frequent Psoriasis of the palms and soles of the feet. In this Form of psoriasis, most of the lesions localized on the hands, on the body there are only isolated areas of the rash.
Pustular forms of Psoriasis start with a small bubble, which soon puts you in the pustule, and at the autopsy forms a crust. In the further process extends to the healthy skin in the Form of a conventional Psoriasis Plaques. In severe forms of generalized pustules Psoriasis-infiltrated skin intraepithelial appear to be small pustules, which have been pulled together, forming purulent the lake. These pustules are not susceptible to break and dry up in the middle of thick brown crusts. In pustular forms of Psoriasis lesions symmetrically, often in the process nail included plate.
Arthropathy type of Psoriasis is one of the most severe that there is pain without deformation of the joint, but in some cases, the joint deformation, ankylosis. In the case of psoriatic Arthritis symptoms of Psoriasis of the skin a lot of can occur later than arthralgic phenomena. Primarily the small joints, and only later in the process involved large joints and the spine. Because of the gradually developing osteoporosis and destruction of the joints arthopathic Form of Psoriasis often disability of the patient ends.
In addition to the lesions on the skin in Psoriasis vegeto observed disease-dystonic and neuro-endocrine, in times of exacerbations of the patients, an increase in the temperature notice. In some patients with Psoriasis asthenic Syndrome, and muscle atrophy, disorders of the internal organs, and symptoms of immune deficiencies. If psoriasis progresses, visceral disorders are becoming clearer.
Psoriasis has a season, a large portion of the relapses occur in the cold season, and very rarely psoriasis in the summer of escalated. Although lately mixed forms of Psoriasis, relapsing at any time of the year, more often.
Diagnosis of psoriasis
The diagnosis is based dermatologists on the basis of external cutaneous manifestations and complaints of the patient. Characteristic of Psoriasis psoriatic triad, the phenomenon Stearin spot, the phenomenon of the psoriatic Film and the phenomenon of blood dew. At poskablivanii even smooth papules, increased exfoliation, and the surface adopts the similarity with stearic stain. In further poskablivanii after complete removal of the scales separation occurs, the finest delicate translucent film covering the whole Element. If you still see the effect, the Terminal-movie rejected and exposed wet surface, it creates localized bleeding (drops of blood, reminiscent of a drop of dew).
In the case of atypical forms of Psoriasis, a differential diagnosis must deprive with seborrheic dermatitis, papular Form of Syphilis, and pink. By histological examination, hyperkeratosis, and almost total absence of returned granular layer of the Dermis, prickly leather granulocyte layer of the skin, drowsy centres with collections of neutrophils, while the increase in the amount of such a stove, it moves under the Horny layer dermis and forming micro abscesses.
Psoriasis treatment should be complex, first of all, the local drugs, course and pharmacotherapy connect with the ineffectiveness of local treatment. The observance of the regime of work and rest, hypoallergenic diet, the avoidance of physical and emotional stress have a great importance in the therapy of Psoriasis.
Sedatives, such as tincture of peony and Valerian relieve nervous excitability of the patient, causing the release of adrenaline in the blood. The intake of antihistamines of new Generation reduces the swelling of the tissue and impedes the excretion.
Application of the lungs of diuretics in the exudative Form of Psoriasis reduces the secretion and as a result reduces the formation of extensive layered crusts. If sions on the part of the joints, shows the recording of non-steroidal anti-inflammatory drugs for the relief of pain. If psoriatic more serious injuries in the joints, therapeutic puncture of joints to use with the introduction of the joints to the inside, betamethasone and triamcinolone.
In the case of pustular Form of Psoriasis, psoriatic lesions of the nails and erythrodermic Psoriasis aromatic retinoids a good effect appointed for a period of at least a month. Application of corticosteroids is justified only in the case of crises, Psoriasis, to enable sustained release formulations, followed by plasma phoresis fast-Psoriasis-crisis.
Such physiotherapy treatments, such as paraffin baths, UV-irradiation shows that various forms of psoriasis. In the advanced stage of Psoriasis anti-inflammatory ointment to use, if you have an infectious process, then ointment with an antibiotic. Effective Laser treatment of Psoriasis and photo therapy. The transition from Psoriasis in the stationary Phase, the keratolytic shows tables ointments and creams. Cryotherapy is psoriatic Plaques.
In the Phase of reverse development of topically applied reducing ointments, gradually increasing their concentration. Local application of low concentrations of corycosteroids are ointments at all stages of Psoriasis. Drugs that modulate the Proliferation and differentiation of keratinocytes are the most promising direction in the modern therapy of Psoriasis. During the Rehabilitation treatment with sulphide and radonovimi of the sources, and contribute to a sustained Remission.