Psoriasis - what kind of disease is it?

Despite the fact that psoriasis is a common and long-known disease, it has not yet been fully studied.And patients most often do not know at all that psoriasis is not a bacterial or fungal infection, but a non-standard reaction of the immune system, provoked by unknown reasons.Information about the causes and symptoms of psoriasis will be very useful for patients, as it will help to overcome this disease.

What type of disease is this?

Lichen squamosus is another name for psoriasis, and this name perfectly characterizes this disease.Psoriasis manifests itself in the formation of inflamed plaques of various sizes on the skin, which are densely covered with thick skin scales.

Of course, almost everyone has heard of a disease like psoriasis.And this is not surprising, because scaly lichen is quite widespread.This disease is diagnosed in 4-10% of the world's population.In addition, statisticians who collect information about the prevalence of psoriasis claim that the number of patients is increasing.

Scaly lichen has been known to people since ancient times;even physicians in Ancient Greece tried to treat this disease.The modern history of the study of psoriasis dates back about 150 years.But in this relatively significant period of time, researchers have not been able to learn enough about the causes and treatment of psoriasis.

Widespread prevalence, uncertainty of etiology (cause of appearance), insufficiently effective treatment - all this characterizes psoriasis as one of the most difficult dermatological problems.

Today, dermatologists consider psoriasis as a complex systemic disease associated with disturbances in the functioning of the immune system, with the failure of metabolic processes and the appearance of trophic disorders.The result of this failure is a specific skin change.

Therefore, when answering the question of what psoriasis is, modern dermatologists will answer that it is a disorder of trophism and metabolic processes in the skin caused by a malfunction in the body's system.Today, two theories about the etiology of psoriasis are considered the most likely: genetic and viral.

• The genetic theory has many supporters, as psoriasis often acts as a hereditary or family dermatosis.A thorough examination of the patient's family history confirms in 60-80% the presence of psoriasis in one form or another in the patient's relatives.However, in some patients it is not possible to confirm the fact of hereditary origin of psoriasis.This situation is the reason to separate these cases into a special group, where the main cause is not genetic, but phenotypic failure.
• The viral theory, according to which psoriasis develops as a result of an infection, has its supporters.Confirmation of information about the origin of the psoriasis virus is the detection of antibodies in the patient's blood, as well as "basic bodies" in epidermal cells.According to this theory, psoriasis develops not only in cases of viral infections, but also in the presence of certain conditions.

There are other theories that explain the appearance of psoriasis.For example, endocrine, neurogenic, metabolic, etc.Naturally, all these theories are not without foundation and their study allows us to obtain more important information about psoriasis.However, today it is known for sure that the state of the endocrine and nervous systems, as well as the functioning of the gastrointestinal tract, do not cause psoriasis, but have a significant effect on the course of the disease.

For example, pathology affecting the liver leads to the fact that the quality of blood purification performed by this organ is greatly reduced.And this, in turn, can trigger the appearance of various skin lesions, including psoriasis.

Pathologies affecting the liver (hepatitis, primary cirrhosis, etc.) lead to the tissue of this organ degenerating, that is, the liver is gradually replaced by connective tissue.As a result, the liver stops to cope with its cleaning function.Externally, this is shown by the yellowing of the mucous membranes and skin, and the development of skin diseases, including psoriasis, is also possible.

There is also an inverse relationship: psoriasis is often accompanied by fatty degeneration that affects the liver.Therefore, in the treatment of this skin disease, it is important to follow a diet so as not to burden the liver unnecessarily.Patients are advised to limit fatty foods and eliminate alcohol completely.

Therefore, despite many studies, it is not possible to get an exact answer to the question of what psoriasis is.However, work continues, so it is possible that the mystery of this mysterious disease will be solved, and we will learn a lot about the skin disease psoriasis.

Classification according to the international system

Psoriasis manifests itself in many forms.To make it easier for experts to navigate, the generally accepted classification of psoriasis is used.

Psoriasis is also included in the International Classification of Diseases (ICD) system.Today, the 10th revision of the international register of diseases is already in use, which is why the abbreviation ICD 10 is used.Work on the 10th revision of the international classification of diseases began in 1983, and was completed in 1987.

Basically, ICD 10 is a standard assessment tool used in medical and health care management.The 10th revision of the reference book is used to monitor the prevalence of various diseases and other problems related to public health.

Using version 10 of the ICD, it is possible to compare data on morbidity and mortality in different countries, which allows one to obtain statistical data and systematize diagnostic information.As agreed by WHO members, ICD 10 is used to assign codes to various diseases.In version 10 of the classifier, alphanumeric codes are adopted, with the convenient help of storing information in electronic form.

All types of psoriasis are included in ICD 10, and each of them is assigned a specific code.In dermatology, the following forms and types of psoriasis are distinguished:

• Common psoriasis(synonyms: vulgar, simple, plaque-like).This disease is coded according to ICD 10 - L-40.0.This is the most common form, it is observed in 80-90% of patients.The main symptom is the formation of plaques that arise on the surface of the unchanged skin, covered with gray-white skin flakes.This form is characterized by a slight peeling of the scales.After their removal, inflamed red skin is revealed, which is very easily injured and begins to bleed.As the inflammatory process progresses, the size of the plaque can increase significantly.
• inverse psoriasis.This is a disease that affects the folds of the skin (flexible surface).For this form of the disease, the ICD 10 code is L83-4.Dermatosis appears with the formation of folds of smooth spots or minimal peeling of the skin.The condition worsens when the skin is injured by friction.The disease is often complicated by streptococcal or related fungal infections.
• Guttate Psoriasis.This form of psoriasis is characterized by the formation on the skin of a large number of small red or purple spots, shaped like drops of water.According to the 10th version of the international classification, this disease receives the L4 code.Most often, guttate psoriasis affects the skin of the feet, but the rash can also occur on other parts of the body.At the same time, it is known about guttate psoriasis that it develops as a complication after streptococcal infection - pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasis– this is a severe form of skin, according to ICD 10 it is given codes L1-3 and L 40.82.Characterized by the formation of blisters or pustules.The skin in the lesion is swollen, red, inflamed, and peels easily.If fungus or bacteria penetrate the pustule, the contents of the pustule become purulent.Pustular psoriasis most often affects the distal parts of the limbs, but in the most severe cases, the general process may develop with a rash spreading throughout the body.
• Psoriatic arthritis or arthropathic psoriasis.According to the 10th version of the ICD, pathology is coded L5.Manifested by joint inflammation.Arthropathic psoriasis can affect all types of joints, but in most cases the joints in the phalanges of the toes and hands become inflamed.Knee, hip or shoulder joints may be affected.Lesions can be so severe that they cause the patient's disability.Therefore, you should not think about psoriasis that it is exclusively a skin disease.Severe types of psoriasis can cause systemic lesions, disability, or death of the patient.

• Erythrodermic psoriasis.A rare but severe type of psoriasis, according to ICD 10 this disease receives code L85.Erythrodermic psoriasis often manifests itself in general;the affected area may cover the entire or almost the entire surface of the skin.The disease is accompanied by severe itching, swelling, and pain.
• Psoriatic onychodystrophy or nail psoriasis.According to version 10 of the ICD, this disease is coded L86.Pathology manifests itself as a change in the appearance of the nails on the toes and fingers.Nails may change color, become thicker, and begin to break.Possible complete loss of nails.

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

• limited psoriasis is a disease in which less than 20% of the skin is affected;
• extensive psoriasis affects more than 20% of the body surface;
• When almost the entire surface of the skin is affected, we are talking about universal psoriasis.

If we consider all types of diseases, then widespread psoriasis is more common than other forms.

Stream level

Psoriasis is limited or extensive through three stages in its course: progressive, stable and regressive.

The progressive stage of psoriasis is characterized by the following:

• the appearance of a new rash;
• existing plaque growth;
• the appearance of new elements of the rash at the site of skin injury (scratches, abrasions);
• excessive exfoliation of existing plaque.

The following symptoms are characteristic of the stationary stage of psoriasis:

• lack of emergence of new elements;

• moderate exfoliation of elements;
• no signs of elemental growth.

The appearance of folds in the stratum corneum around the element is a sign of the transition from the stationary stage to the regressive stage.

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

• reduce the intensity of peeling;
• element resolution.

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

Lichen squamosus is characterized by a long course with periodic exacerbations.The following types of psoriasis are distinguished:

• winter (with aggravation in autumn and winter);
• summer (with exacerbation in the hot period);
• non-seasonal psoriasis is the worst type, since there is no clear connection between relapses and the season of the year, the period of remission may be almost absent.

Diagnostic features

If psoriasis has a typical clinical picture, then the diagnosis will not be so difficult.However, this disease often disguises itself as another pathology.

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

A non-expert might mistake it for fungus and skin psoriasis.Since skin mycoses (skin fungus) manifest themselves with the same symptoms - the formation of peeling plaques.Therefore, if you notice suspicious symptoms on your body or nails, you do not need to make a self-diagnosis and start treating the fungus using pharmaceutical 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 worsen the symptoms.

When contacting a dermatologist, a fungal test will be performed and a scraping will be taken from the nail or skin.Then the resulting material is placed in nutrient media.If the fungus is present in the material, then in a few days large colonies will grow in the test sample.By the appearance of the material, you can understand the type of fungus causing the infection.

Sometimes psoriasis is complicated by the addition of a secondary infection, this can be a bacterial or fungal infection.Therefore, patients who change the clinical picture (appearance of purulent discharge, discoloration of the plaque, etc.)You should be tested regularly for fungi and other infectious agents.

In the diagnostic process, a certain role is assigned to a set of phenomena called the psoriatic triad.The phenomenon appears sequentially when the elements of the rash are scraped off.

The psoriatic triad manifests itself as follows:

• when the elements of the rash are scraped off, scales are removed in the form of "chips";
• after removing the chip, a thin transparent film similar to polyethylene is lowered;
• When the film is damaged, proper bleeding occurs.

Dermatologists diagnose psoriasis, but if necessary, doctors can refer patients to consult with other specialists - rheumatologists, gastroenterologists, surgeons, etc.

Interesting facts about psoriasis

People have known about psoriasis since ancient times.Even the name of the disease entered our language from ancient Greek.During the prosperity of Ancient Hellas, the word "psora" meant all skin diseases that manifested as peeling and itching.

The first person to write a detailed treatise on psoriasis was a Roman named Cornelius Celsus.In the fifth volume of his work "De medicina" there is an extensive chapter devoted to this disease.

They know about psoriasis, but this disease is not clearly evaluated, because it is called either "imperial" or "demon" disease.

Of course, the ancient healers knew little about psoriasis.Until the 19th century, this disease was often confused with other skin diseases.Psoriasis was first identified as an independent form of nosology in 1799. This was done by the English dermatologist Robert Willan, who identified psoriasis from a large group of skin diseases manifested by itching and peeling.

Not only ordinary people, but also prominent political figures know about psoriasis firsthand.For example, Winston Churchill, who suffered from this disease, promised to erect a monument made of pure gold to someone who could learn everything about psoriasis and offer an effective treatment for this disease.

Modern ideas about this disease

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

Here are some facts about psoriasis that are beyond doubt among experts:

• Despite the fact that the cause of the disease is not clear, we managed to find out about the nature of psoriasis.This disease is autoimmune, that is, it is caused by damage to the immune system;
• Another fact about psoriasis: this disease can be inherited.However, this is not always the case;even if both parents are sick, the risk of developing the disease in their child is 65%.At the same time, some patients develop psoriasis, although none of their relatives are ill;
• An interesting fact about psoriasis is that this disease is characterized by the Koebner phenomenon.This phenomenon manifests itself in the fact that elements of the rash are formed at the site of skin damage - scratches, burns, frostbite.Sometimes psoriasis appears after some time, at the scar site;
• An important observation that allows us to get more information about psoriasis is the connection of this disease with climatic factors.Exacerbations and relapses often coincide with seasonal changes;
• Patients may have noticed in practice the relationship between exacerbation and stress.All patients should know for sure that the disease recurs or worsens its course against the background of nervous tension and anxiety;
• a new fact about psoriasis is that the disease can debut at any age, although previously it was believed that pityriasis versicolor appeared after 30;
• It is important for everyone to know that psoriasis is not a contagious disease.Even with close contact with the patient, there is no risk of infection;
• Almost everyone has heard about the disability of psoriasis, and this is true, because no treatment has been found that can be guaranteed to defeat this disease.But patients should know that psoriasis can be controlled.Adequate and timely treatment allows you to achieve long-term remission.

Modern treatment methods

Talking about the common disease psoriasis, we cannot fail to talk about the treatment of this common disease.It must be said that it is impossible to cure psoriasis with tablets or ointments alone.

To forget the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, needs to make an effort.It will be necessary to organize the food properly.Some experts say that you can forget about psoriasis forever just with the help of a properly formulated diet and regular body cleansing.

The doctor will make an initial regimen according to which the treatment will be carried out.As a rule, external (ointment, cream) and systemic (tablet, injection) therapy methods are used.In addition, physiotherapeutic methods will be used, and treatment at the resort will be recommended.It is recommended to treat psoriasis using healing mud, minerals and thermal water.

Resorts can also offer non-traditional treatment methods.For example, with the help of fish that live in thermal springs.This little healer effectively removes dead skin flakes and disinfects the skin, promoting faster healing.

Resorts may offer other methods of treating lichen planus.For example, leech therapy, healing baths and rubs, sun treatments, etc.

You need to be prepared for the fact that the treatment regimen will change periodically.Because not all methods are suitable for certain patients.If the chosen treatment method does not have an effect, it needs to be replaced.

Traditional methods of treating psoriasis are also widely advertised.In fact, some of them can help achieve remission.However, when choosing a method, you need to remember common sense so as not to harm your health.If there is a recipe or recommendation that is doubtful, then it is better not to use it.Consult your doctor before using any treatment method.

You need to understand that it is possible to forget psoriasis forever only if the patient himself and his immediate environment are in a positive mood.Only faith in success and an optimistic attitude will help defeat this mysterious and dangerous disease.