Psoriasis or psoriasis is a chronic disease that affects the skin and its appendages: the hair and nails. It is characterized by periods of worsening condition (relapses) and temporal well-being when the symptoms of the disease be less. This disease is not contagious and the patient is not dangerous to others. Since the appearance of the psoriasis is not associated with the microorganisms.
Psoriasis often occurs between the ages of 15-45 years. That most affects people with fair skin. In the developed countries, the number of patients with psoriasis reaches 2-4% of the population. That suffers every 25th inhabitant of the earth in all the continents.
This issue deals with a large number of medical institutions. Therefore, psoriasis has become the most studied of the disease. But although this disease is not fully understood. Officially, it is considered incurable and raises many questions.
Psoriasis is called by its own cells of the immune system of the body. They rise from the lower layers of the skin at the top, causing inflammation, proliferation of epidermal cells and the formation of small capillaries.
Symptoms of psoriasis on the skin are very various. Most often disease causes of red spots of psoriatic plaques. They are dry to the touch, rising above the surface of the skin and covered in white bloom.
Types of psoriasis
The disease is divided into two large groups: pustular and not pustulous psoriasis.
Not pustulous psoriasis
- ordinary (vulgar) or simple psoriasis (plaque-like psoriasis, chronic stable psoriasis)
- psoriatic erythroderma psoriasis or erythrodermal
Pustular psoriasis
- pustular psoriasis von Tsumbush or generalised pustular psoriasis
- palmoplantary psoriasis (pustular psoriasis of the extremities, chronic persistent palmoplantary pustules)
- annulary pustular psoriasis
- Palmar-plantar psoriasis
- herpetiform psoriatic impetigo
In addition there are the following types of psoriasis
- psoriasis
- psoriasis flexor surfaces and in the folds of the skin
- psoriasis Napkin
- psoriasis caused by medications
By severity distinguish these forms of psoriasis
- Light – struck less than 3% of the skin.
- Moderate 3-10% of the skin covered with plates.
- Heavy – there is joint damage, or involved more than 10% of the skin.
Causes of psoriasis
To date there is no unequivocal answer to the question: "why do I have psoriasis?". Scientists propose several theories.
Psoriasis is an autoimmune disease. It is based on the failure of the immune system. Immune cells, T-killers and T-helpers, the function of which is to protect the body from viruses, bacteria and tumor cells, for some reason, to penetrate into the upper layers of the skin. Here they produce inflammatory mediators – substances that trigger the inflammatory response. The result is improved skin cell division and multiplication (proliferation).
Psoriasis is a disease that causes the deterioration of growth, division and maturation of epithelial cells - queratinòcits.. The result of these changes in the skin, it returns to the attack cells of the immune system, T-lymphocytes and macrophages in diseased cells of the skin.
Factors that contribute to the development of psoriasis
The doctors noted a number of factors that can cause the disease. Of course, the more often the psoriasis occurs when the body acts in many of these conditions.
- The genetic predisposition. There is a theory that the genes responsible for the immune system and the function of T-lymphocytes are the carriers of the disease. Therefore, parents who suffer from psoriasis, the probability of giving birth to children who will develop the same symptoms.
- Fine dry skin. It was observed that people with these characteristics of the skin suffer from it more often than people with oily skin and well hydrated. This is probably due to the protection of the function of sebum and on the characteristics of the structure of the skin.
- External irritants. A high percentage of patients among the people who are constantly in contact with the alcohol solutions, solvents, household chemicals, cosmetics (lotions, cream for the hands).
- Excess of hygiene – excessive love to cleanliness also undermines the protective properties of the skin. Soaps, shower gels and washcloths wash away natural protective barrier and leave behind a microscopic lesion.
- Bad habits – alcohol, tobacco, and drugs is bad for the skin. It gets worse the circulation of blood and nutrition.
- HIV – AIDS patients are more prone to the appearance of psoriasis. Scientists can not explain this phenomenon. The fact that psoriasis is caused by the increase of the activity of lymphocytes and AIDS, their number decreases.
- Medications – some medications can trigger the disease. Among them are: beta-blockers, antidepressants, anticonvulsants, and medications antimalarial, lithium carbonate.
- Infection (fungi and Staphylococcus aureus). Very often there are cases in which the psoriasis appeared immediately after fungal infections or diseases caused by Streptococcus.
- Movement – the change climate or even the time of year, the deterioration of the environment can be a trigger for this disease.
- Stress is a strong shock, emotional or physical stress (prolonged periods of hypothermia, overheating, accidents) precede the appearance of the first symptoms of psoriasis.
- Injury permanent effects on the skin: pressure, friction, scratching. This regular injury can cause in this place for the first psoriatic plaques.
- Allergic conditions – allergic skin rash and processes that occur at the same time, in all layers of the skin, also increase the risk of disease.
What are the signs and symptoms of psoriasis?
Psoriasis is a systemic disease that affects not only the skin and nails. Affects the joints, tendons, and spine, immune, nervous and endocrine systems. Often affects the kidneys, the liver, thyroid. The patient feels tired, suffer from chronic fatigue and depression. This complex effect on the body, the disease in recent years is called psoriatic disease.
But the main manifestations of the disease occur on the skin. The name "psoriasis" is quite accurately transmitted the symptoms of psoriasis. The first manifestations are often papules are pink or bright red color, rounded shape, covered with scales – psoriatic plaques. They are located symmetrically, mostly on the extender surfaces, lower back and scalp. But can affect any area of the skin and the mucous genital. The size of a few millimetres, in the initial stages, up to ten centimeters or more.
Depending on the characteristics of the eruption, share this form of psoriasis:
- Point of psoriasis is the size of the elements smaller than a pinhead.
- Guttate psoriasis papules are in the form of tears and reaching to the size of a grain.
- Nummular psoriasis is plaques grow to 3-5 mm and have rounded edges.
There are also forms of the eruption when its elements have the form of rings, arcs, garlands, maps with jagged edges.
Papules covered with a layer that can be removed easily. Consists of keratinized epidermal cells. Psoriatic plaques began to be covered with scales from the center, then the RAID is spread to the edges. It is loose and light appearance due to the fact that keratinized cells are permeated by spaces filled with air. Around the elements that can be formed a pink ring is the site of the inflammation, the growth of the plaque. The skin around the lesions has not changed.
Under the touch detected by the shiny smooth bright red surface. This blood capillaries with thin walls, covered with a thin film. Become visible because of thinning of the upper layers of the skin. The normal structure of the skin breaks down due to the fact that the cells of the keratinocytes Mature and normally do not have the time to differentiate yourself.
Scalp psoriasis is a psoriatic plaques that significantly rise above the surrounding skin. They are densely covered with scales, resembling dandruff. While the hair is still not impressed. The rash can be not only for the hair, but soft skin of the neck and behind the ears. These changes can be explained by the active division of the keratinocytes in the affected areas
Psoriasis feet and palms causes severe thickening of the Horny layer of the skin in these areas of the body. The skin is thick, rough. Often permeate the cracks. This is caused by intensive cell division, which multiply up to 8 times faster than normal, but not removed in time from the surface of the skin.
Nail psoriasis is characterized by a variety of symptoms. But the most important are the two main types of injuries of the nail plate:
- The type of "thimble". In the nail plate are formed small holes, as the needle brand needle.
- The type of onychomycosis. The Lesions resemble those of fungi in the nails. The nails to thicken, discolor, peel. Through the nail plate is visible psoriatic papule surrounded by a border of red. She has the appearance of blobs of oil seen through the nail.
Signs and symptoms of psoriasis depend on the stage of the disease, which alternate cyclically throughout the year. Since the majority of patients have a "winter" kind of the disease, when exacerbation is necessary for the autumn and winter. Improvement in the summer is due to the fact that the ultraviolet light of the sunlight has a therapeutic effect. But some patients suffer from "summer" type.
There are stages of psoriasis:
- progressive– the appearance of new elements, the active growth of the plaques, pink growth of the area around them, intense itching and flaking.
- fix – stop the growth of the papules, the absence of new lesions, small folding the top layer of the skin around the psoriatic plaques.
- regressing– unpeeled, the disappearance of the plaques and the appearance in its place, the areas of pigmentation, the evidence of the attenuation process.
As aspect of the skin, eruptions of psoriasis?
Every body is different and reacts differently to the disease. Therefore, the nature of the injuries can be very diverse. This explains the diversity of forms and types of psoriasis.
However, the majority of people symptoms of psoriasis are similar. It is dyed red psoriatic plaques, rising by 1-3 mm above the level of skin health. Their appearance is caused by the fact that the cells of the superficial layer of the skin – keratinocytes, divide very actively, do not have time to Mature and become a full-fledged cells of the skin. As a result of this improved pathological growth of individual areas of the skin thicken. This happens under the influence that immune cells secrete chemicals that cause the inflammation of the skin.
The spots are red in color. And if you remove the top scales psoriasis patches, its surface begins to be covered in blood from the dew. This is due to the fact that, under the influence of T lymphocytes and immune dendritic cells is the increased formation of new blood vessels under the plaque. They have a fairly thin wall. This causes a bleeding of psoriatic plaques in the least damage.
Sometimes through the walls of the vessels is leaking lymph and inflammatory exudate. The bark is of the plaque becomes thick, of a yellowish colour. The surface on touch moist.
At the top of the plates can be covered with a gray, silver or yellowish coating that has the appearance of wax. Therefore, the so-called "paraffin lakes". Is cells dead of the skin, the rejection of which has been broken, and they accumulate on the surface of the affected area of the skin.
Place peel, hotter to the touch than the rest of the skin, and can reach large sizes. Often the patient experiences severe itching in this place. This is due to the fact that in the background of inflammatory process there is a cascade of neuro-reflex reactions and allergic reaction.
Another type is the papules. This small injury is similar to tubers. The size is about 1 mm. In the middle there is a cavity full of content. Often they are located in the knees and elbows. Are maintained even during periods in which the disease is in retreat.
The first of the plates occur in areas where the skin is drier and contact with household chemicals and detergents – in the open areas of the arms, the neck. Can be in any part of the body: scalp, face, trunk, genitals, buttocks, legs. Unlike fungal diseases, psoriasis, eruptions, do not occur in the armpits and the natural folds, where the skin is more moist and fatty. In some forms of the disease, which only appears a couple of boards that do not increase in size. When the hand-foot shaped lesions are only in these places.
During exacerbations the lesions gradually increasing in width and merge with the neighboring plates. During the periods of improvement (remission) spots began to clear from the center. Gradually acquire the form of a ring and to dissolve completely. After the plates in the body leaves marks of pigmentation. Can be significantly lighter or darker than the surrounding skin. Once people get a tan, the color of the skin is usually lined up.