Psoriasis — a chronic, non-communicable diseases, dermatosis, affecting primarily the skin. Usually psoriasis causes the formation of excessively dry, red, small spots about the surface of the skin. However, some patients with Psoriasis have no visible skin changes.
The Psoriasis patches as psoriatic Plaques. These spots are, by nature, a parcel of chronic inflammation and excessive Proliferation of lymphocytes, macrophages, and keratinocytes of the skin, as well as excessive angiogenesis (formation of new small capillaries) layer of skin. Excessive Proliferation of keratinocytes in psoriatic Plaques occur and Infiltration of the skin by lymphocytes and macrophages leads to a thickening of the skin at the points of the defeat, his exaltation above the surface of the healthy skin and the formation of the characteristic pale grey or silvery spots, similar to the solidifying wax or Paraffin wax ("Paraffin-pond").
Psoriasis Plaques most often appear for the first time on friction and pressure places the surfaces of the elbows and knee bends, on the buttocks. However, the psoriatic Plaques caused and on any point of the skin, including the scalp, the surface of the brush, the plantar surface of the stop, Vulva. In contrast to skin rashes eczema, often by the inner surface of the knee and elbow joints, psoriatic Plaques often located on the outer side, the extensor sides of the joints.
Psoriasis is a chronic disease, characterized by typically, in the course of the waves with periods of spontaneous or evoked these or other healing effects remissions or improvements and periods of spontaneous or provoked by adverse external influences (alcohol, intercurrent infections, Stress), relapses or exacerbations.
The severity of the disease varies in different patients and even in the same patient in periods of Remission and exacerbation in a very wide range, from small local lesions to fully cover the entire body psoriatic Plaques. Often there is a tendency to Progression of the disease over time (especially if untreated), to the weighting and frequency of exacerbations, increasing the area of the lesion and involvement of new areas of the skin. In some patients, a continuous course of the disease without spontaneous remissions, or even a continuous development. Often also affects the nails of the hands and/or feet (psoriatic onychodystrophy). Nail infections can be isolated and observed, in the absence of skin lesions. Psoriasis can also cause inflammatory lesion of the joints, called psoriatic arthropathy or psoriatic Arthritis. From 10% to 15% of patients with Psoriasis also have psoriatic Arthritis, and suffering.
There are many different means and methods for the treatment of Psoriasis, but due to the chronic relapsing nature of the disease and the often observed tendency to Progression in the course of the time, Psoriasis is a fairly harsh treatment for the disease. A complete cure is not currently possible (that is, Psoriasis is not curable at the current level of development of medical science), but it can be more or less oblong long, more or less complete Remission (including life). However, the risk of relapse always remains.
The causes of psoriasis
- Stress, Depression;
- Infection of the skin, in particular viruses, bacteria (staph. Streptococcal), fungal (Candida);
- Hereditary Predisposition;
- Metabolic disorders, the influence on the Regeneration of the skin cells;
- Errors in the work of the endocrine system (hormonal disorders)
- Gastro-Intestinal Diseases, Enteritis, Colitis, Goiter (Dysbiosis);
- Disease of the liver.
More Details about the causes of psoriasis
The broken Barrier function of the skin (in particular, mechanical injury or Irritation, friction and pressure on the skin, misuse of soap and cleaning agents, substances, contact with solvents, household cleaners, alcohol-containing solutions, the availability of infected lesions on the skin or skin Allergy, excessive dryness of the skin) also play a role in the development of Psoriasis.
Psoriasis idiosyncratic skin disease is largely. The experience of the majority of patients suggests that Psoriasis may spontaneously improve or, on the contrary, escalate, for no apparent reason. The investigation of the various factors in connection with the creation, development or exacerbation of Psoriasis, a tendency, based on the study of small, usually the hospital (not outpatient), then there is obviously harder for groups of patients with Psoriasis. Therefore, these studies often suffer from the lack of representativeness of the sample and of the inability of cause-and-effect relationships in the presence of large amounts of other (including unknown) factors that influence the character of the course to reveal the Psoriasis. Often, in various studies have found conflicting findings. Nevertheless, the first signs of Psoriasis often show after suffering Stress (physical or mental), damage to the skin in the areas of the first formation of the psoriatic lesions, and/or a previous streptococcal infection. The conditions, according to some sources, all of which contribute to the aggravation or worsening of Psoriasis, include acute and chronic infections, Stress, climate changes, and the changing of the seasons. Some medications, particularly lithium carbonate, Beta blockers, antidepressants, fluoxetine, paroxetine, antimalarial drugs chloroquine, hydroxychloroquine, carbamazepine, valproate, according to multiple sources, which can provoke, in connection with the worsening of Psoriasis, or even it occurs primary. Excessive alcohol consumption, Smoking, overweight or obesity, poor diet Psoriasis can impair or impede his treatment, to provoke aggravation. Hair spray, some of the creams and lotions for the hands, cosmetics and perfumery, household chemical can also exacerbation of Psoriasis provoke in some patients.
The patients suffering from HIV infections or Aids, Psoriasis often suffer. This seems to be a Paradox to researchers Psoriasis as a treatment to reduce the number of T cells or their activity, in General, the healing is accompanied by promotes for psoriasis, HIV infection or aids with a decrease in the number of T-cells. However, in the course of time, with the progression of HIV infection or Aids progression, increase in viral load and a decrease in the number of circulating CD4+ T-cells, Psoriasis in HIV-infected patients or Aids patients worsened or exacerbated. In addition to this, puzzles, HIV-infection in General, cytokine profile towards Th2, accompanied by a strong shift, while vulgar Psoriasis in non-infected patients is characterized by a strong shift of cytokine profile towards Th1. Pursuant to the current hypothesis, a decreased number and abnormal activity of CD4+ T-lymphocytes in patients with HIV infection or Aids cause hyperactivation of CD8+ T-lymphocytes, the patients responsible for the development or exacerbation of Psoriasis in HIV-infected or Aids. However, it is important to know that the majority of patients with Psoriasis healthy in terms of HIV-carrier and HIV-infection is responsible for less than 1 % of cases of Psoriasis. On the other hand, Psoriasis in HIV-infected occurs, according to different data, with a frequency of 1% to 6%, which is about 3 times higher than the prevalence of Psoriasis in the General population. Psoriasis in patients with HIV infection and, in particular, Aids is often extremely difficult, and only very poorly or not at all to standard methods of therapy.
Most often the psoriasis develops in patients with first drier, thinner, more sensitive skin than patients with oily skin, and significantly more common in women than in men. In the same patient Psoriasis most often dry or thin skin appears first on the land, as the land is oily skin, and most frequently to the integrity of the skin appears in the places of the damage, including scratching, scuffing, abrasions, scratches, cuts, in areas of friction, pressure, or contact with aggressive chemical substances, cleaning agents, solvents (this is called the phenomenon Kebner). It is assumed that this phenomenon lesions of Psoriasis especially a dry, thin, or injured skin associated with an infection, the fact that the infection (probably the most commonly streptococci) easily penetrates into the skin with minimal secretion of sebum (which protects, among other conditions, the skin from infections), or in the case of damage to the skin. The most favorable conditions for the development of Psoriasis, so contrary to the favourable conditions for the development of a fungal infection Stop (the so-called "leg Lifter"), or armpits, the groin area. For the development of fungal infections, the most advantageous humidity, wet skin, psoriasis, on the contrary, dry. Message in the infection causes dry skin dry chronic inflammation, which in turn causes symptoms characteristic of Psoriasis, such as itching and increased proliferation of skin cells. This in turn leads to a further enhancement of the dryness of the skin as a result of inflammation and increased Proliferation of keratinocytes, and due to the fact that the infection consumes the moisture that would otherwise to moisturize the skin. In order to avoid excessive dryness of the skin and reduce the symptoms of Psoriasis patients with Psoriasis recommended, not with a bast wisp to provide, and scrubs, particularly hard, since they not only damage the skin, so that microscopic scratches, but also from the skin scraped off the upper protective stratum corneum and sebum, the standard protects the skin against drying out and against the penetration of germs. We also recommend the use of talc or baby powder after washing or bathing to absorb excess moisture from the skin, otherwise you get "" infection. In addition, we recommend the use of agents, moisturizing and nourishing skin, and lotions, the sebaceous glands function. Do not abuse the recommended soap, cleaning agent. You should try to avoid skin contact with solvents, household chemicals.
Symptoms of psoriasis
- Severe itching on the skin;
- The appear on the skin, small lesions burst, with the development of liquid, recruited, forming crusts, combine in a single inflammatory areas and with grey-white, sometimes yellowish lining (called - psoriatic Plaques);
- The blood of Plaques;
- Psoriasis nails thickened initially, then coated nail;
- Pain in the joints.
The quality of life of Psoriasis patients
It has been shown that the Psoriasis is the situation, the deterioration of the quality of life of patients in the same degree as other severe chronic diseases, such as Depression, myocardial infarction, hypertension, congestive heart failure, or Diabetes mellitus type 2-Diabetes. Depending on the severity and location of psoriatic lesions, patients with Psoriasis, it can require significant physical and/or mental complaints, difficulties with social and occupational adjustment, and even disability. Severe itching or pain, interfere with vital functions, such as personal care, walking, can lead to sleep. Psoriatic Plaques on the exposed parts of the hands or feet can prevent the Patient to work and specific work in a fume hood, in some sports, the care of family members, Pets or house. Psoriasis Plaques on the scalp are often used for patients with special mental problems and produce considerable distress and even social phobia, as pale Plaques are confused on the skin of the head the other for the result of the presence of dandruff or lice. Still a big psychological Problem and the presence of psoriatic lesions formed on the skin of the face, the earlobes. Psoriasis treatment can be expensive and for the patient to take a lot of time and effort, without work and/or school, socialization of the patient, the device of the personal life.
Patients with Psoriasis can also be (and often are) overly concerned about their appearance, give this a large value (sometimes to the extent of Obsessive fixation on this one, almost BDD) suffer from a reduced self-assessment, which is associated with the fear of public rejection and the rejection or fears of sexual partners problems due to the appearance. Psychological distress in combination with pain, itching and immuno-pathological disorders (increased production of inflammatory cytokines), this can. to the development of a distinct Depression, the alarming condition, or social phobia, which to a considerable social Isolation and exclusion of the patient It should also be noted that comorbidity (the combination) of Psoriasis and Depression, as well as the Psoriasis and social phobia occurs with increased frequency in those patients, not the subjective experience of psychological discomfort from the presence of Psoriasis. It seems likely that genetic factors for the predisposition to Psoriasis, and a predisposition to depression, worrying conditions, social phobia overlap to a large extent. It is not excluded also, that in the pathogenesis, such as Psoriasis and depression play a role, common immunopatologicakie and/or endocrine factors (so also in the case of depression show increased concentrations of inflammatory cytokines, an increased cytotoxic activity of Neuroglia).