Psoriasis (flake ringworm) – chronic, non-contagious disease that affects the skin, nails and joints. Is characterized by the appearance on the skin monomorphic rash: nodules that are bright pink, covered in silvery scales. Elements of acne may merge in various configurations, resembling a geographic map. Accompanied moderate skin problem itchy. Psoriasis impairs the appearance of the skin, gives the psychological discomfort to the patient. When the defeat of the joint evolution of the psoriatic arthritis. It is dangerous to generalized pustular psoriasis pregnant, leading to the defeat of the fetus and abortion.
Psoriasis – a common chronic skin disease, characterized monomorphic an eruption of flat papules, with a tendency to merge in large plates, which very quickly covered by loose scales silver-white. Psoriasis has wavy-term, the incidence of 2% of the entire population, is diagnosed equally in men and women.
The cause and pathogenesis of psoriasis
The etiology and pathogenesis of psoriasis is still not studied, but the results of the research suggest that the hereditary, infectious or neurogenic nature is more likely to occur. Hereditary nature of psoriasis confirm the facts that the incidence is higher in families in which psoriasis have been diagnosed, in addition, monozygotic twins concentration of incidence is also higher than in other groups. The infectious aetiology of psoriasis comes down to have changed to complex inclusions, such as during viral infection, but, however, identify a virus that is not possible.
And today, psoriasis, consider the disease with a large number of factors of infection, with a share genetic and infectious components. In the group of risk of incidence of psoriasis, which fall into the people with the constant trauma of the skin, with the presence of chronic strep infections of the skin, with disabilities and autonomous nervous system, endocrine disorders, additionally, alcohol abuse increases the likelihood of the occurrence of psoriasis.
The clinical manifestations of psoriasis
A key element to psoriasis is the single wheal rose or the red, which is covered by a large number of loose silver-white scales. Important diagnostic symptom is the triad of psoriasis: the phenomenon stearic point, film type and map bleeding when you try to remove flakes.
At the stage of development of psoriasis, rashes a little, gradually, over months and even years, their number increases. Psoriasis is a very rare premiere intense and widespread eruptions, this beginning can be observed, after acute infectious diseases, severe neuro-mental overload, and after a huge drug therapy. If the psoriasis has a beginning, the precipitation edematous, have a bright red color and quickly spread throughout the body, psoriatic plaque hyperemic, edematous, and, often, itching. Papules are localized on flexural surfaces, especially in the area of knee and elbow joints, on the trunk and scalp.
For the next phase of psoriasis characterized by the appearance of new small elements on the ground, scratching, lesions and excoriations, this clinical feature is called phenomenon Kebner. The result of peripheral growth, emerging elements merge with the already available and form the symmetrical plate, or located in the form of lines.
In the third stage, the psoriasis intensity in the peripheral growth plate is reduced, and its limits become clearer, the color of the affected skin acquires cianótica shadow, can occur a intense peeling on the entire surface of items. After stopping the growth of plaques psoriasis in its periphery formed pseudoatrophic frame - rim Voronov. In the absence of treatment of psoriasis plaque thickens, sometimes, it can be observed papillomatous and warty expansion.
In the phase of regression, the symptoms of psoriasis starts to fade, with the normalization of the skin will center the affected surface to the periphery, the first disappears, the shell, normalizes the skin color of the integument, and, finally, disappears in the infiltration of the tissues. When deep lesions of psoriasis and defeats, thin and loose skin can sometimes occur temporary hypopigmentation after cleaning of the skin rashes.
Exudative psoriasis different from the usual the presence of scabs-flaking-on catch plate, which are formed due to the impregnation of the exudate, in the folds of the body may be crying. In the group of risk of incidence of exudative psoriasis fall sick diabetics, people with hypofunctions of the thyroid (hypothyroidism) and excess body weight. Patients with this form of psoriasis point itching and burning sensation in the affected areas.
Psoriasis, passes by the type of seborrheic, is located in areas prone to seborrhea. A large number of dandruff does not allow the time to diagnose psoriasis, as well as it masks the rash. With time, the areas of the skin that is affected by psoriasis, grow, and pass the skin of the forehead in the form of "psoriatic crown".
In people who are busy with physical work, it is more common psoriasis of the palms of the hands and soles. In this type of psoriasis the main part rash located on the palms of the hands, in the body are only found in rare patches of acne.
Pustular forms of psoriasis start with a small bubble, which quickly rises into a pustule, and in the hour of truth, form a crust. In the future, the process is distributed to a healthy skin, in the conventional way psoriatic plaques. When severe forms of widespread pustular psoriasis in inflammatory skin may appear intraepithelial small pustules that merge to form a festering lake. Such pustules are not willing to open and dry in the brown opaque chips. When pustular forms of psoriasis lesions symmetrical, often, in the process involved nail plate.
Arthropathy form of psoriasis is one of the most serious, can occur pain without deformation of the joint, but, in some cases, the joint with deformation, which leads to the ankylosis. When psoriatic arthritis symptoms of psoriasis with the skin side may occur much later, that arthralgic phenomenon. In the first place, they are surprised with the small joints later in the process to involve the large joints and the spinal column. Because of the gradual evolution of osteoporosis and the degradation of the joints arthopathic form of psoriasis often ends up disabled patients.
In addition to eruptions on the skin when the psoriasis are the observed I-dystonic and the neuroendocrine disorder, even in times of exacerbations of the patients pointed to the increase of the temperature. Some patients of psoriasis can be asthenic syndrome, and muscular atrophy, internal injuries and symptoms of primary immunodeficiency. If the psoriasis progresses, the visceral violation become more pronounced.
Psoriasis has seasonal during the majority of relapses occur in the cold season, and very rarely the psoriasis worsens in the summer. Although, recently, a composite form of psoriasis, recurring at any time of year, are diagnosed increasingly.
The diagnosis of psoriasis
The diagnosis is dermatologists on the basis of external skin manifestations and the patient's complaints. For psoriasis characterized psoriatic triad, which includes the phenomenon stearic point, the phenomenon psoriatic film and a phenomenon of condensation. When poskablivanii the same smooth papules intensifies the peeling and the surface adopts a similarity with stearic point. When, later poskablivanii after the complete removal of scales occurs the detachment superfine delicate film translucent that it covers the entire element. If you continue with the impact, the terminal film rejected and exposed to moisture of the surface, occurs where the vertices of a bleeding (drop of blood, like a drop of dew).
When atypical forms of psoriasis it is necessary to perform differential diagnosis with seborrheic eczema, papular form of syphilis, and pink stealing. When histological study revealed hyperkeratosis, and almost total absence of granular layer of the dermis, the spinous layer of the dermis edematous with areas of agglomerations neutrophil of granulocytes, at least, an increase in the volume of such home, it migrates under the horny layer of the dermis and form neutrophil.
The treatment of psoriasis
The treatment of psoriasis should be comprehensive, in principle, apply local medications, and ongoing medication treatment connect to the inefficiency of the treatment site. Observance of the regime of work and leisure, hypoallergenic, diet, avoidance of physical and emotional loads are of great importance in the treatment of psoriasis.
Sedatives, such as tincture of peony and valerian to relieve anxiety the anxiety of the patients, thus reducing the emission of adrenaline in the blood. The receipt of a new-generation antihistamines reduces the swelling of tissues, and prevents the exudates.
The application of lung diuretics when exudative form of psoriasis reduces exudate and as a consequence decreases the formation of extensive layers of crusts. If there is defeat with the side of the joints, demonstrates a technique to non-steroidal anti-inflammatory drugs to decrease pain threshold of the syndrome. If psoriatic arthritis disorders of the joints more serious, use of cure for joint aspiration with the introduction of the inside of the joints, betamethasone and triamcinolone.
When pustular form of psoriasis, psoriatic lesions of the nail and when erythrodermic psoriasis aromatic retinoids assigned for a period of at least a month to give a good effect. The use of corticosteroids is justified only when crises psoriasis, preparations of long duration of action, with the consequent plasmaphoresis allow you to stop psoriatic crises.
Such physical therapy treatment, such as paraffin appliques, UV-radiation, shows different forms of psoriasis. In a phase of psoriasis apply anti-inflammatory ointment, if there is an infectious process, the ointment with antibiotic. Effectively, the laser treatment, the psoriasis and phototherapy. During the transition of psoriasis in the phase of hospitalization shows keratolytic ointments and creams. Performed cryotherapy psoriatic plaques.
In the phase of return of development topically applied reducing ointment, gradually increasing its concentration. The topical application of low concentrated corycosteroids ointments indicated in all stages of psoriasis. Drugs that modulate the proliferation and differentiation of keratinocytes is a promising direction in the modern therapy of psoriasis. In a period of rehabilitation for a spa treatment with sulphide and radon sources help to reach the reception and long-lasting remission.