Once it appears, psoriasis in most patients does not go away on its own, but only develops and becomes more widespread, spreading throughout the skin.
However, with timely diagnosis, it becomes easier to treat, and recovery is faster.
The main thing here is to pay attention to the first signs of psoriasis in time and immediately make an appointment with a dermatologist.
Characteristics of psoriasis
Early psoriasis can appear as small, red and scaly patches.
The appearance of such a rash directly depends on the persistent form of the disease.
In most cases, you can see this:
- at the elbows and knees;
- in the head (in the hairy area);
- on palms and feet;
- in the folds area (back, armpits, lower breasts in women).
Primary eruptions (papules) are very small: no more than 4 millimeters in diameter.
However, as the disease progresses, they grow and merge with each other, forming indistinct plaques.
Often, the appearance of papules is not accompanied by pain or itching. Discomfort increases with the development of psoriasis and an increase in the size of the affected skin area.
The affected area begins to ache and itch, and there is a strong burning sensation.
These symptoms of psoriasis are accompanied by emotional discomfort that can dramatically increase the rate of the disease spreading.
It is not appropriate when there is a rash like this, to start self-treatment, because psoriasis in the early stages of its development has similarities with other skin diseases.
Therefore, the wrong choice of medication will not lead to positive results, but will only worsen the condition.
Cumulative Symptoms
Scaly lichen belongs to the category of systemic pathology.
This means that it manifests itself not only on the skin and nails, but can also affect the spine, joints and tendons, some body systems (e. g. , endocrine, immune and nervous).
There are cases where the disease affects the digestive system (liver) and urinary tract (kidneys).
The first symptoms of psoriasis
- constant feeling of tiredness;
- weakness;
- a state of depression (up to depression).
Due to the effects of complex diseases on the body, experts consider it appropriate to refer to it as psoriatic disease.
But, nevertheless, the main aspect of the disease is based on damage to the skin.
As mentioned above, the first call for the onset of pathological development is a small papule in the color range between pale pink and red.
They differ in the symmetrical position on the surface of the skin (folds, lower back, head area covered with hair), sometimes - on the mucous membranes of the external genitalia.
The size of the papule in the course of the disease can exceed 10 centimeters.
Psoriatic eruption, depending on its characteristics, is divided into:
- dotted (the size is not larger than the pin head);
- in the shape of a tear (the shape is similar to a tear, the size is equivalent to a lentil);
- coin-shaped (5 mm diameter plaque, having rounded edges);
- Rarely arcuate, annular, or like a map.
Above the papule is covered with plaque with scales, which are formed from keratinized epidermal cells and removed without much effort. Initially, they appear in the center of the plaque and gradually spread further and further.
Keratinous cells have air gaps, resulting in visual fragility and light shading.
Sometimes the element is surrounded by a pink ring that serves as an area of plaque growth and inflammation. In this case, the surrounding skin condition does not change.
Removing the plaque shows a shiny dark red surface based on capillaries, which in turn have very thin walls.
The presence of small vessels of diameter is due to damage to the structure of the upper layers of the skin, its structure is disrupted due to incomplete maturation process of epidermal cells (keratinocytes), which makes improper differentiation impossible.
Symptoms of various forms of psoriasis
Normal psoriasis has fairly specific symptoms, so it is not difficult to diagnose.
Appears as a scaly and round area that protrudes above normal skin and is pink or red.
Sometimes, in the early stages of the disease, there are no special plaques: before appearing on the scalp and in the joint area (ankles, elbows and knees), small papules can be observed.
They can last for a long time and do not cause any inconvenience to the patient: there is no itching and pain or no pain at all, or practically they do not feel, the papules themselves are almost impossible to notice.
They do not peel off, but when lightly scraped, the scales immediately appear. Such pink seals can be lost or significantly reduced in the summer, as sunlight affects the skin.
Acute forms of psoriasis usually appear in the form of various itchy rashes on brightly colored papules and are the result of the influence of factors that activate the disease.
To avoid allergic errors, you need to scrape the surface of the plaque slightly before a characteristic phenomenon appears.
Seborrheic psoriasis starts on the scalp (in areas covered with hair) and then spreads to the face and shoulders.
It is characterized by severe exfoliation of the skin in the appropriate area, which is often considered by patients as dandruff, so they do not rush to a dermatologist.
This fact allows the disease to reach a stage of development quietly when the forehead and area behind the ear are peeled off. And only after that plaque is formed.
Skin folding lesions with psoriatic diseases (armpits, genitals and groin, under the breast in women) are often confused with common irritation caused by friction or sweating.
This type of disease is characterized by fine plaques that look like spots. Peeling is not observed, but they are often wet. The rash itself is bright red, even and shiny.
When genitals are affected, psoriasis can be misinterpreted as balanoposthitis (lesions on the head of the penis, as well as foreskin on the inside) in men and vulvitis (rash localized on the labia minora) in women.
The palmar-plantar form of the disease manifests itself in the form of compacted areas, similar to those of a vessel, the surface of which is covered with yellow scales that are difficult to remove.
Areas affected by cracks and pain. With this form of the disease, it is difficult to give rise to the appearance of terminal films and bloody dew by scraping.
Nail psoriasis begins with psoriatic onychodystrophy, which is one of the main symptoms of this form of the disease and appears earlier than the rash.
In the early stages, the edges of the nail are covered with grooves and small areas of stress.
With the development of this disease, they spread, to the roots, after which there is a change in color. Nails are dull and thick. Due to the failure in the blood circulation, the manifestations of the disease increase.
Epidermal cells accumulate under the nail plate, and it is bounded by reddish tissues on all sides, after which it can peel off after a few seconds.
This type of psoriasis is dangerous because it increases tissue sensitivity, which in turn increases the likelihood of infection. Often, this disease is mistaken for a fungus.
Moving bone joints (joints) are often affected. They are deformed, the joint capsule undergoes dystrophy modification.
Psoriatic arthritis begins with an increase in the number of joints, which is accompanied by pain.
The fingers and toes are most susceptible to this type of psoriasis.
In severe form, the shoulder and elbow joints, hips and knees, as well as some parts of the spine, are prone to this disease.
Effects on the manifestation of symptoms of psoriasis level
The symptoms of psoriasis correspond to the season and stage in which the disease is present.
Often in the spring-summer there is a significant decrease in the activity of the disease, which is facilitated by ultraviolet rays.
Thus, in the fall-winter due to lack of sunlight, the disease quickly gains momentum. There are almost no patients with summer exacerbations.
There are three stages of psoriasis:
- progressive- characterized by the constant appearance of new rashes, an increase in the size of previously visible and surrounding plaques with pink edges, the affected area is very itchy and unstable;
- stationary- new rash no longer appears, and old rash does not grow; the top layer of skin in the plaque area becomes wrinkled;
- regressive- skin does not peel off, plaques disappear, leaving highly pigmented areas.
Diagnostic Psoriasis
Diagnosis of psoriasis is made based on information received from medical examinations by interviewing patients, as well as symptoms inherent in one form of another disease.
The sooner the disease is detected, the sooner the treatment process begins. Therefore, more tangible results will be obtained.
Because the picture of the disease is very specific, the diagnosis of psoriasis can be limited to a simple examination by a dermatologist.
But in some cases, difficulties may arise due to the presence of witnesses or the absence of symptoms, which occur if the disease does not manifest itself in any way or appear to be unusual. This situation requires further research procedures.
A special method is used to make a diagnosis, which consists of gradual papulation of the papule along the lining.
As a result of such manipulation, it is possible to identify characteristic signs (psoriatic triad) to differentiate psoriasis from other diseases and make a final diagnosis:
- stearin stain;
- terminal film (pink epidermal cells);
- blood dew (drops of blood appear on the surface of the plaque due to rupture of capillaries).
If necessary, the patient is tested in the form of a sample of the affected tissue.
X-rays are taken if psoriasis-related arthritis is suspected.
If psoriasis is in its early stages, the diagnosis is not difficult: the picture of osteoporosis is clearly visible.
In later times, there is narrowing of the joint space, erosion of bone-forming tissues, osteosclerosis and periostitis.
If the disease is severe, then the wrists and metatarsal joints are destroyed, as a result, the joints lose mobility completely.
It should be noted that all tests performed are not only necessary for the final diagnosis, but also for differentiation with other diseases, which at first glance are the same.
These diseases include: psoriasis parapses, seborrheic eczema, lichen rosacea, atopic dermatitis, lupus erythematosus, rheumatoid arthritis and others.