Psoriasis - what is this disease?

Psoriasis on the elbow

Although psoriasis is a common and well-known disease, it is still not fully understood. And most of the time, patients don’t know at all that psoriasis is not a bacterial infection or a fungus, but a non-standard reaction of the immune system triggered by unknown causes. Information about the causes and symptoms of psoriasis will be very helpful for patients as it will help fight the disease.

What is this disease?

Scaly lichen is another name for psoriasis, and this name perfectly describes this disease. Psoriasis is manifested by the formation of inflamed plaques of various sizes on the skin, which are densely covered with thick skin scales.

Surely almost everyone has heard of a disease like psoriasis. And this is not surprising, as the scaly lichen is quite common. This disease is diagnosed in 4-10% of the world’s population. Moreover, statisticians who gather information on the incidence of psoriasis argue that the number of patients is constantly increasing.

Scaly lichens have been known to humans since ancient times, and in ancient Greece even healers tried to treat this disease. The modern history of the study of psoriasis is about 150 years. But during this rather significant period, researchers have failed to learn enough about the causes and treatment of psoriasis.

Widespread prevalence, uncertainty of etiology (causes of occurrence), ineffective treatment - all characteristic of psoriasis as one of the most difficult problems in dermatology.

Today, dermatologists consider psoriasis to be a complex systemic disease associated with disorders of the immune system, malfunction of metabolic processes, and the appearance of trophic disorders. These failures result in specific skin changes.

Therefore, the modern dermatologist, in answer to the question of what is psoriasis, answers that these are abnormalities in the trophism and metabolic processes of the skin caused by a malfunction of the body system. Today, two theories about the etiology of psoriasis are considered the most likely: genetic and viral.

  • Genetic theory has many proponents, as psoriasis often acts as a hereditary or familial dermatosis. A careful 60-80% examination of the patient’s family history confirms the presence of psoriasis among the patient’s relatives. However, in some patients, the inherited origin of psoriasis cannot be confirmed. This circumstance justifies the classification of these cases into a special group in which the main cause is not genetic but phenotypic failures.
  • There are supporters of the virus theory that psoriasis develops as a result of infection. Confirmation of information on the viral origin of psoriasis is the detection of antibodies in the blood of patients as well as "elemental bodies" in the cells of the epidermis. According to this theory, psoriasis is not only infected with a virus but also develops under certain conditions.

Other theories explain psoriasis. For example, endocrine, neurogenic, metabolic, etc. Of course, these theories are not unfounded, and their study allows them to obtain more important information about the psoriasis of the disease. However, it is now well known that the condition of the endocrine and nervous systems, as well as the work of the digestive system, do not cause psoriasis, but they do have a significant effect on the course of this disease.

For example, pathologies affecting the liver lead to a significant deterioration in the quality of blood purification performed by this organ. This, in turn, can trigger a variety of skin appearances, including psoriasis.

Girl with psoriasis

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc. ) lead to the regeneration of the tissues of this organ, ie the liver is gradually replaced by connective tissue. As a result, the liver is no longer able to cope with its cleansing functions. From the outside, this is manifested by yellowing of the mucous membranes and skin, and the development of skin diseases, including psoriasis, is possible.

There is also an inverse relationship, psoriasis is often associated with fatty degeneration, affecting the liver. Therefore, in the treatment of this skin disease, it is important to follow a diet so as not to overload the liver unnecessarily. Patients are advised to limit fatty foods, to completely eliminate alcohol.

Thus, despite numerous studies, it has not been possible to obtain an accurate answer to the question of what is psoriasis. However, work continues, so there is a chance that the mystery of this mysterious disease will be solved, and we can learn a lot about psoriasis of the skin disease.

International Classification

Psoriasis disease takes many forms. A generally accepted classification for psoriasis is used to make it easier for professionals to find their way around.

Psoriasis has been included in the International Classification of Diseases (ICD). To date, 10 versions of the International Register of Diseases are used, hence the abbreviation ICD 10. Work on the 10 revisions of the International Classification of Diseases began in 1983 and was completed in 1987.

Essentially, ICD 10 is a standard assessment tool used in medicine and health management. The Version 10 manual is used to monitor the prevalence of various diseases and other health problems.

Using ICD version 10, it is possible to compare morbidity and mortality data from different countries, allowing statistics to be obtained and diagnostic information to be systematized. With the consent of WHO members, ICD 10 is used to assign codes to various diseases. In version 10 of the classifier, alphanumeric codes are adopted to make it convenient to store information in electronic form.

Each type of psoriasis is listed in ICD 10 and has a separate code for each. The following forms and types of psoriasis are distinguished in dermatology:

  • Common psoriasis(synonyms: vulgar, simple, plaque-like). The disease is ICD 10 - L-40. You received a code according to 0. This is the most common form, observed in 80-90% of patients. The main symptoms are the formation of plaques covered with white-gray skin scales raised above the surface of the unchanged skin. This shape is characterized by a slight peeling of the balance. Once removed, the inflamed red skin opens, which is very easily damaged and begins to bleed. As the inflammatory process progresses, the size of the plaques can increase significantly.
  • Inverse psoriasis. It is a disease that affects the folds of the skin (bending surfaces). For this form of the disease, the code L83-4 is adopted in ICD 10. Dermatosis appears as the formation of folds on the skin of smooth or minimally flaky patches. Deterioration is observed when the skin is damaged due to friction. The disease is often complicated by a related streptococcal infection or fungus.
  • Guttate psoriasis. This form of psoriasis is characterized by the formation of a large number of small red or purple patches on the skin that resemble water droplets in shape. According to version 10 of the International Classification, such a disease was given the code L4. Most often, guttate psoriasis affects the skin of the legs, but rashes can also occur in other parts of the body. However, guttate psoriasis is known to develop as a complication of streptococcal infections - pharyngitis, tonsillitis, and so on.
  • Pustular or exudative psoriasisis ​​a severe skin form according to ICD 10 with codes L1-3 and L 40, 82. It is characterized by the formation of blisters or pustules. The skin of the lesions is swollen, red, inflamed, easily peeled. If a fungus or bacterium penetrates the pustules, the contents of the pustules become purulent. Pustular psoriasis often affects the distal limbs, but in the most severe cases, a general process can develop with the spread of the rash in the body.
  • Psoriatic arthritis or arthropathic psoriasis. According to version 10 of the ICD pathology, the code L5 was assigned. It is manifested by inflammation of the joints. Arthropathic psoriasis can affect all types of joints, but most of the joints in the wall of the toes and hands are inflamed. The joints of the knee, hip or shoulder may be affected. The lesions can be so severe that they lead to the patient's disability. Therefore, psoriasis should not be thought of as a purely skin disease. Severe types of psoriasis can lead to systemic damage, disability, or even death.
  • Healthy skin and psoriasis
  • Erythrodermic psoriasis. A rare but severe type of psoriasis, according to ICD 10, this disease has been given the code L85. Erythrodermic psoriasis often manifests itself in a generalized form, with all or almost all of the surface of the skin entering the affected area. The disease is accompanied by severe itching, swelling and pain.
  • Onychodystrophy psoriasis or nail psoriasis. According to version 10 of the ICD, the code L86 was assigned to the disease. The pathology is manifested by a change in the appearance of the nails on the toes and hands. Nails can change color, become thicker and start to deteriorate. Complete loss of nails is possible.

In psoriasis, the classification of the disease takes into account not only the types of the disease but also the severity of the symptoms:

    Localized psoriasis is a disease in which less than 20% of the skin is affected;
  • widespread psoriasis affects more than 20% of the body surface;
  • If it affects almost the entire surface of the skin, we speak of universal psoriasis.

If all types of the disease are considered, common psoriasis is more common than other forms.

Flow stages

Limited or widespread psoriasis goes through three stages: progressive, stable, and regressive.

The progressive stage of psoriasis has the following characteristics:

  • appearance of new rashes;
  • growth of pre-existing plaques;
  • appearance of new elements of the rash at the site of skin lesions (scratches, abrasions);
  • Rich scaling of existing plaques.

The following symptoms are common in the inpatient phase of psoriasis:

  • no new items appear;
  • Psoriasis on the face
  • moderate peeling of elements;
  • No sign of item growth.

The appearance of wrinkles in the stratum corneum around the elements is a sign of the transition from the stationary section to the regressive.

The regression stage is characterized by the following types of symptoms:

  • decrease in exfoliation intensity;
  • Resolution of
  • elements.

After the psoriatic plaques dissolve, hypo- or hyperpigmented spots remain in place.

Scaly lichen is characterized by a long period with intermittent exacerbations. The following types of psoriasis are distinguished:

  • winter (worsens in autumn and winter);
  • summer (with exacerbations during the warm period);
  • out-of-season psoriasis is the most severe type, as there is no clear relationship between relapses and seasons, and periods of remission may be virtually absent.

Diagnostic Features

If psoriasis has a typical clinical picture, the diagnosis will not be that difficult. However, this disease is often disguised as other pathologies.

For example, nail psoriasis is often mistaken for a nail fungus because the external manifestations of these diseases are very similar in the early stages. However, nail fungus and psoriasis are completely different in nature, so the treatment should be different.

A layman can be fooled by psoriasis and fungal fungi. Because mycoses of the skin (skin fungus) have similar symptoms - with the formation of scaly plaques. Therefore, once you notice suspicious symptoms on your body or nails, you do not need to diagnose yourself and continue reading about treating the fungus with pharmacy or folk remedies.

If the diagnosis is wrong and in fact the cause of the symptoms is not fungus but psoriasis, then the treatment will not be beneficial but, on the contrary, will aggravate the symptoms.

When you contact a dermatologist, they do an analysis of the fungus, scraping your nails or skin. The resulting material is then placed in medium. If the fungus is present in the material, after a few days a large colony grows in the test sample. With the appearance of the substance, it is possible to understand the type of fungus that caused the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, be it a bacterial infection or a fungus. Therefore, when the clinical picture changes (appearance of purulent discharge, discoloration of plaques, etc. )Diagnosis of psoriasis by a dermatologist, patients should be examined regularly for fungi and other infectious agents.

A certain role in the diagnostic process is assigned to a set of phenomena called the psoriatic triad. The phenomena appear one after the other when the element of the rash is scraped.

The psoriatic triad looks like this:

  • when scraping the rash element, the scales are removed in the form of "chips";
  • After removing the chips, a thin transparent film similar to polyethylene opens;
  • when the film is damaged, the exact bleeding will open.

A dermatologist will diagnose psoriasis, but if necessary, the doctor may refer the patient for consultation with other specialists - a rheumatologist, gastroenterologist, surgeon, etc.

Interesting Facts About Psoriasis

People have known about psoriasis for a long time. Even the name of the disease came into our language from ancient Greek. At the time of the heyday of the ancient Hellas, the word "psora" meant all skin diseases manifested in the form of peeling and itching.

The first to write a detailed treatise on psoriasis was a Roman named Cornelius Celz. The fifth volume of his work, "But Medicine, " contains an extensive chapter on this disease.

They knew about psoriasis, but this disease was not clearly evaluated as it was sometimes called an "imperial" and then a "devil's" disease.

Of course, the ancient healers knew very little about psoriasis. Until the 19th century, this disease was often mixed with other skin diseases. It was first identified in 1799 as an independent nosological form of psoriasis. This was done by English dermatologist Robert Villan, who selected psoriasis from an extensive group of skin conditions that appeared with itching and peeling.

Not only ordinary people but also prominent political figures knew about psoriasis first hand. For example, Winston Churchill, who suffered from this disease, promised to erect a pure gold monument to a person who can learn all about psoriasis and offer effective treatment for this disease.

Modern understanding of the disease

It must be said that modern science does not know much about this mysterious disease. There are various theories about the origin and the course and treatment of psoriasis.

Here are some facts to be sure:

  • Although the causes of the disease were not clear, it was possible to know the nature of psoriasis. This disease is caused by autoimmune, i. e. , malfunction of the immune system;
  • is ​​another established fact about psoriasis: the disease can be inherited. However, this is not always the case, even if both parents are sick, their child has a 65% risk of developing the disease. However, some patients develop psoriasis, although none of their relatives are ill;
  • An interesting fact about psoriasis is that it is characterized by the Kebner phenomenon. This phenomenon is manifested in the fact that the elements of the rash develop at the site of skin lesions - scratches, burns, frostbite. Sometimes psoriasis appears after a while, in place of scars;
  • An important observation that allows you to get more information about psoriasis is the relationship of this disease to climatic factors. The timing of exacerbations and relapses often coincides with the change of seasons;
  • In practice,
  • patients may have noticed an association between exacerbations and stress. All patients need to know for sure that the disease is recurring or exacerbating its course in the background of nervous tension and experience;
  • is ​​a new fact about psoriasis that the disease can debut at any age, although it was previously thought that lichen occurs after scaly 30;
  • It is important for everyone to know that psoriasis is not a contagious disease. Even in close contact with the patient, there is no risk of infection;
  • Almost everyone has heard about the incurability of psoriasis, and this is true as they have not found a cure that can surely defeat the disease. But patients need to be aware that psoriasis can be controlled. Proper and timely treatment allows for long-term remission.

Modern treatment methods

Speaking of the common disease of psoriasis, the treatment of this common disease cannot be betrayed. It must be said that it is impossible to cure psoriasis with pills or ointments alone.

In order to forget about the manifestations of psoriasis for a long time, the patient should make an effort to work closely with the doctor. You will need to organize the food properly. Some experts argue that psoriasis can be forgotten forever only with a properly formulated diet and regular cleansing of the body.

Your doctor will make a preliminary plan for your treatment. As a general rule, external (ointments, creams) and systemic (tablets, injections) therapy are used. In addition, physiotherapy methods are used and treatment at resorts is recommended. It is recommended to treat psoriasis using medicinal mud, mineral and thermal water.

Resorts may offer non-traditional treatments. For example, with the help of fish living in thermal springs. These little healers effectively remove dead skin scales and disinfect the skin, promoting the fastest healing.

Other treatments for scaly lichens may be offered at resorts. For example, leech therapy, spas and applications, sun therapy, etc.

You should be prepared for changes in your treatment schedule from time to time. Because not all methods are suitable for a particular patient. If the selected treatments do not work, they must be replaced.

Alternative treatments for psoriasis are also widely advertised. Some of them can really contribute to achieving remission. However, when choosing a method, you need to remember common sense so as not to harm your health. If a recipe or recommendation is in doubt, it is better not to use it. Seek medical advice before using any treatment.

You need to understand that psoriasis can only be forgotten forever if the patient and their immediate surroundings are positively attuned. Only faith in success and an optimistic attitude will help overcome this mysterious and insidious disease.