The basis of psoriasis is:
- excessive multiplication of cells;
- Disruption in the keratinocytes;
- The appearance of inflammatory infiltrate in the dermis.
Speaking on the chronic nature, it should be emphasized that if the young man appeared a tiny plaque and soon disappeared — it means that in 20 years he can again see the new plaque.
Psoriasis "snoozing", but not cured, and his behavior reminds of a man who many years ago "cured" from alcoholism, but for obvious reason, avoid any alcohol because after 30 years of sobriety to get in the bout.
Causes of psoriasis
The incidence of psoriasis is very high: even in the successful countries of Western Europe it is found in 2% of the population. The disease can begin at any age, but the debut often occurs at a young age, and only in 1/3 of patients it occurs after 40 years.
It is believed that the presence of family members with psoriasis significantly increases the risk of its occurrence, and there is an autosomal dominant type of genetic defect (i.e., not affiliated with the floor). But, most often, the causes of psoriasis are the effects of a number of adverse factors that contribute to changes in the body.
List the most important of the causes of psoriasis:
What happens in the skin, or the pathogenesis of psoriasis
- Chronic stress, emotional stress, adverse social climate;
- Microbial and viral infections, prone to chronicity, (e.g., steptokokkovaya infection );
- Direct physical effects on the skin (excess friction, pressure, frequent insolation);
- Trauma to the skin.
- Hormonal imbalance. Often the psoriasis occurs when entering puberty, and rarely in menopause. This is due to the influence of the thyroid gland and hormones of the adrenal cortex;
- Taking certain medicines. This effect was observed in lithium salts used in psychiatry, anti-malaria treatment chloroquine;
- Alcohol, especially beer. Contributes as a more severe course of the disease, and elementary, it started;
- Obesity or excess body weight. There are indisputable facts that show that the people who brought their weight back to normal after years of excess, the psoriasis has almost disappeared and even psoriatic arthritis
- Climatic factors. Psoriasis takes place in seaside, a warm, Sunny climate. But continental, humid and cold climate can help both the beginning and the progression of the disease;
- HIV infection. This disease contributes to the emergence of a variety of diseases that "are" defect of the immune system, and psoriasis is no exception.
One of psoriasis is a skin plaque, flowing immune inflammatio, as well as in the joints when psoriaticheskom arthritis.
In blayshkah discovered many substances, for example, analogs of leukotrienes that attract leukocytes into the center inflammatio. The interaction of keratinocytes with immunokompetentnymi cells occurs area inflammatio, with the release of mediators of inflammatio.
In psoriaticheskih blayshkah, and in the synovial fluid when present psoriaticheskom arthritis TNF-alpha, or tumor necrosis factor. The tumor itself has nothing to do with is the historical name. It is known that TNF is actively involved in different chronic inflammatio.
In the skin there are a variety of inflammatory changes that lead to extremely characteristic of psoriasis the triad of symptoms: spots, terminal protectors and a bloody dew.
- With a light poskablivanii plaque (e.g., a nail), there is typical crushing and exfoliation of scales.;
- Under certain conditions (e.g. after a shower, have dried skin), you can lift the edge of the scales and remove it in the form of a grayish – yellow, like parchment, thin films, which sometimes reaches the area 3-4 sq cm is a symptom of terminal protectors;
- If in place of the removed film poskoblit still, there is the appearance of small drops of blood like dew, which is called blood.
It can cause skin itching at night, the patient stryahivaet from sheets a lot of dead skin flakes which resemble a mixture of flour with bran, and the sheets can be droplets of blood. The symptoms characteristic of the acute stage.
Psoriasis — the initial stage, photos
Psoriasis plaques affect all skin layers. In psoriasis, initial stages of plaque after full development, does not differ in its main features from the usual plaques, but in the beginning has the following characteristics:
- occurs on the surface of intact skin flat bump, 1-3 mm in diameter;
- its clear boundaries;
- color: deep red or pink, occasionally bluish, especially at psoriasis on the legs;
- the surface becomes friable, formed layers of scales that are silvery-white hue;
- plaques merge, the result is a large rash.
From the phenomenon Kebnera or primary trauma to the skin, and often starts psoriasis.
Where lesions are localized?
Symptoms early stages of psoriasis can be seen in "favorite places." These include:
- The surface of the elbow and knee joints (and sometimes the back, this is called "inverse psoriasis");
- Volosennaya of the head. Lifting the hair, you can see on the edge of the red rim of the skin with fever, who stands slightly behind the hairline: "psoriaticheskuyu crown";
- Psoriasis likes to settle behind the ears near the hair growth, and inside the ears;
- A few less commonly affects the major skin folds.
In some cases, the development of plaques contributes to severe itching. This is often together with reddening of the skin on the periphery of said progressive stage of psoriasis when there are new scales.
Psoriasis on the nails of feet and hands + photo
The nail psoriasis, surprised almost 50% of patients. They appear pits and spots.
Their free edge is growing poorly, it is yellowish that can raise suspicion for fungal disease. The body of the nail changes color, it appears as if transparent areas, which are called "oil."
Most often, loss of nails suggests that the patient has psoriatic arthritis, or has a predisposition to its development.
Affected by psoriasis can not all nails, but only on the feet or hands. And even if there is arthritis of the finger nail on the hand will not necessarily be struck precisely where the pain in your joints. May be damaged by small fingers, and index fingers hurt. There is no direct connection.
Stage of psoriasis — exacerbation, stability, and regression
All the troubles and disorders accounted for the progression of the disease, when symptoms are exacerbated. In each patient the aggravation has individual character. Sometimes aggravation occurs in response to "good deeds".
For example, the patient several years of Smoking. Deciding that Smoking has a harmful effect on psoriasis (and rightly so), he throws, but after a month adds up to 5-8 kg. the result is a significant increase, resulting in weight gain and "ignored" the fact that a successful fight against Smoking.
Despite the "special way", there are some common signs:
- Aggravation appears after a cold, sore throat, stress, binge;
- There is the appearance of new spots;
- On old spots expanded peripheral area, spot "grow";
- Thickened layer of scales;
- Increases itching. In the room where there lives the patient with psoriasis, it is better to put laminate and linoleum, as they are less visible skin flakes that appear in large numbers after itching plaques;
- In severe forms there is increased pain in the joints is a common ailment;
- For progressive stage characterized by the phenomenon of Kebnera. Any trauma to the skin turning into the new plaques.
Reducing the signs of exacerbation of psoriasis — plaques are not changed, the particular itching occurs. "Husk" of a patient spilling a little.
On blayshkah stops the growth, is "psevdoartoficheskyi" bezel that can disappear and will arise again relapse.
Most often, the improvement starts from the center of the plaque. There begins the disappearance of the scales, there is a new skin. The peripheral area of the growth is pale and inactive, the result is a "garland" of rings and a variety of bizarre spots. If the rash has disappeared completely, it is often at this place there is a patch of skin with reduced pigmentation.
Very often regress psoriaticheskih rash develops in the summer, if the patient is in the sun. Exacerbation, on the contrary, occur in spring and autumn, when the skin suffers from a lack of sunlight.
- When a partial regression of the lesions often remain "on-duty plaques", which are localized in the region of the elbows and knees.
The types of psoriasis, especially on the skin
The ordinary, skin psoriasis there are several types: seborrheic, exudative psoriasis skin folds, palms and soles. Nail psoriasis usually does not occur separately.
- Seborrheic form is very similar to the dermatitis. Scales localized on the scalp, behind the ears, on the chest. The lesions are diffuse boundaries, they are impregnated with cutaneous fat and have thick, thick and loose scales;
- In exudative psoriasis (which is more common in obesity) fluid, which impregnates the flakes, a little change in symptoms. In result, cells lose their silvery hue, glued, and resemble become yellow crust;
- Psoriasis of the palms and soles, which is more common in persons who perform physical work (chronic injury), sometimes of rash isolated. Often develops hyperkeratosis, ;
- Psoriasis of skin folds mainly developed with a strong pathology for example, diabetes. Plaques arise around the navel, under the Breasts, perineum and inguinal folds.
Sometimes psoriaticheskie the rashes occur on the genitals. In that case, if you are the only symptom of the disease and psoriasis the body is not, then there are certain difficulties in the differential diagnosis of psoriasis and urogenital infections.
Get acquainted briefly with generalizovannimi forms of psoriasis is psoriaticheskaya aritrodermiya , pustuleznyi psoriasis and arthritis.
- psoriaticheskaya aritrodermiya is nothing else than progressive stage of psoriasis, exciting the entire skin.
The skin becomes hot, the overall temperature rises to high numbers. Against the background of General aritrodermii not distinguish between the image of the previous psoriasis: everything merges in one common inflammatio. This condition can cause aletrolitnye disorders and heart failure.
- When Pustuleznom psoriasis is characteristic appearance of pustules, or abscess.
These ulcers are at first sterile, and consist of neutrophils, but may then infect. The disease is also severe, with signs of inflammatio, burning and soreness on the skin, a common reaction, changes in blood, increased ESR. Pustules fuse together and appear purulent "lake". Pustules are in different stages of development, and also can develop severe complications (kidney and heart).
- Psoriatic arthritis pain, more often on the hands and feet.
Sometimes pandaktilit – finger inflammatio, reminiscent of "sausage", the skin on it has a bluish tint.
Usually appear first cutaneous lesions, and then affected joints. Also affects joints, spine, temporo – mandibular joint.
Involvement of the joints of the axial skeleton suggests an unfavorable course of the disease. In severe cases, the end-phalanges being completely destroyed and there mutiliruyushaya form of psoriasis.
Psoriasis treatment drugs, ointments and methods of treatment
Should firmly remember: a full treatment of psoriasis is not possible, and a universal cure for psoriasis does not exist. But you can obtain permanent a lifetime of remission, a normal state of health, and the absence of plaques.