Psoriasis treatment. Symptoms, signs of the disease and effective treatments

The exact cause of the disease is not yet known. Currently, scientists distinguish several theories about the causes of psoriasis. These include:

  • genetic predisposition;
  • metabolic disorders;
  • immunity disorders;
  • chronic focal infection.

Several related factors underlie the development of the disease. Often, even in people with a genetic predisposition to psoriasis, it may not be felt for many years. The impetus for the development of the disease can be:

  • severe or prolonged stress
  • alcohol;
  • hormonal disorders;
  • metabolic disorders;
  • taking certain medications;
  • infections;
  • damage to the skin (burns, cuts, injuries);
  • other factors.

In response to negative factors, foci of inflammation are formed in the skin, the processes of cell division and maturation are disrupted. The cells begin to actively divide, the skin thickens at the sites of inflammation, forming bright pink papules (nodules), which merge into the so-called psoriatic plaques covered with scales. If left untreated, a significant surface of the skin is gradually damaged, the inflammation spreads to the nails and joints.

Indeed, the results of exposure to all causes of psoriasis can be combined into two groups: a violation of the cell division of the skin and a change in the functioning of the immune system.

All external factors (environment, stress, trauma) only aggravate the course of the disease, but cannot act as a single cause.

elbow psoriasis

Types of diseases

There are a number of classifications of psoriasis, which are based on the severity of the condition, the nature of the rash, the location of the lesion, etc. Most often, the following types of diseases are distinguished:

  • Plaque (vulgar) psoriasis makes up the majority of all types of psoriasis. It is characterized by the appearance of traditional plates covered with white-gray scales.
  • Guttate psoriasis is manifested by numerous and rather small rashes with scales all over the body after suffering from a cold or sore throat.
  • The pustular variant is characterized by the formation of plaques with purulent inflammation.
  • Seborrheic - is characterized by the presence of oily scales in the area of hair growth, nasolabial folds, chest and back. It differs from seborrhea by the more distinct plaque boundaries.
  • With palmar-plantar psoriasis, the elements are located on the corresponding areas of the skin.
  • The exudative variant is distinguished by the fact that the scales are saturated with a yellowish liquid - exudate. Due to this, they look glued together and change color. Often observed in obesity.
  • Psoriatic erythroderma is a severe form of the disease, as almost the entire surface of the skin is affected and systemic reactions occur (fever, weakness, malaise, enlarged lymph nodes, impaired liver and kidney function).
  • The arthropathic type causes damage to the joints, is observed in 3-5% of all patients with psoriasis, often leads to disability.

According to the stages of the pathological process, the progressive, stationary and regressive stages of the squamous lichen are distinguished.

Characteristic signs and symptoms of psoriasis

Most often, with psoriasis, pink-red plaques appear on the surface of the skin covered with grayish or white scales (psoriatic plaques). It is with this symptom that another name for the disease is associated - squamous lichen.

The size of the rashes can be various. The primary elements are considered to be small papules (nodules) from pink to bright red or burgundy. Over time, their size increases significantly and they also tend to merge.

In 90% of cases, the signs of psoriasis include the formation of standard plaques, which are characterized by a triad of signs. This triad is detected by the doctor with a special diagnostic test - plaque scraping:

  1. Stearin stain - characterized by peeling when plaque is scraped off and the separation of gray-white scales, similar to splinters of a candle in appearance.
  2. If you continue to scrape the surface of the plaque, after removing all the scales, a thin shiny film will appear, called the terminal.
  3. The symptom of blood dew can be detected by removing the end film. At the same time, tiny droplets of blood appear on the surface.

Rashes can be found on a variety of areas of the skin, but most often they are found:

  • on the extensor surfaces of the limbs (elbows, knees);
  • along the hairline (the so-called "psoriatic crown");
  • in the region of the sacred.

Additionally, psoriasis symptoms can worsen and fade depending on the season. For example, in the autumn-winter period, in most patients, the disease passes into an acute stage, while in the summer its symptoms subside.

psoriasis diagnosis

How to diagnose psoriasis?

Symptoms, stages and varieties of psoriasis

There are several stages of the course of the disease:

  • Progressive. It is characterized by an active increase in the symptoms of psoriasis, proliferation of lesions, thickening of skin plaques, an increase in the surrounding area of redness, as well as severe itching and peeling of the skin.
  • Stationary. At this stage, the papules stop growing, the formation of new psoriatic plaques stops, while the redness around them decreases, the itching persists, and the peeling of the plaque intensifies.
  • Regressive. The activity of the disease subsides, which is accompanied by a decrease in itching, psoriatic plaques, in their place are areas of skin with impaired pigmentation. As a rule, even without exacerbation, a person suffering from psoriasis has 1-2 plaques that never go away - these are the so-called "service plaques".

When diagnosing psoriasis, the doctor necessarily determines the stage, since the choice of treatment depends on it.

Depending on which part of the body is affected, the symptoms of psoriasis can vary:

  • Plaques are formed on the scalp, slightly rising above the main surface. From above, they are covered with small scales, visually similar to dandruff. The hair structure remains intact. In addition to the fact that the plaques are found in the scalp, often as the disease progresses, they go beyond its boundaries, affecting the skin of the forehead, neck and the area behind the auricle.
  • On the skin of the feet and palms, psoriasis is manifested by a noticeable thickening, the skin becomes rough, their thickness increases. Often at the sites of the lesion, cracks and ulcers are formed that are visible on external examination. This feature is explained by the fact that the cells of the epidermis divide at a high intensity, the skin simply does not have time to get rid of dead particles, because they accumulate and compress, remaining on the surface.
  • On the nail plate, psoriatic lesions manifest themselves in a completely different way. Options are possible here: the surface of the nail is covered with small shallow dimples - the nails acquire the so-called "thimble" appearance. Or the second option - there is a thickening of the nail plate, its color changes, it begins to flake off in some places. At the same time, characteristic papules with red edges can be seen through the nail. Sometimes this form is confused with a fungal nail infection.

Recommendations for eliminating the symptoms of the disease

Effective treatment of psoriasis is only possible with an integrated approach. Observance of the utmost precautions is of great importance in reducing the risk of exacerbation of the disease. Hence, we recommend:

  • avoid injury to the skin;
  • avoid hypothermia;
  • reject bad habits;
  • avoid stressful situations;
  • promptly treat infections and concomitant diseases;
  • avoid prolonged exposure to direct sunlight.

Patients with psoriasis should be especially careful to comply with personal hygiene requirements. If you take a shower or a bath, then:

  • use products without dyes and perfumes;
  • choose a mild shampoo;
  • avoid using rough wipes, creams, gels with abrasive particles;
  • Avoid harsh soaps as they dry out the skin.
  • adjust the water temperature so that it is warm;
  • stay in the water no more than 10-15 minutes;
  • use a soft towel, do not rub or comb the skin.

After showering and bathing, it is recommended to use special moisturizers for the body. Try to comb your hair as little as possible so as not to irritate the surface of the head again. The same goes for drying. If you can't do without it, choose a hot or cold jet.

Choose light clothes, made from natural fabrics, free cut, so that they do not restrict movement and do not rub.

In summer, don't sunbathe for too long. To protect your skin from UV rays, use a sunscreen with a high SPF.

treatment of psoriasis with ointment

Psoriasis treatment

Several important aspects determine the choice of approaches and methods for the treatment of psoriasis.

The systemic nature of the disease predetermines a comprehensive approach to its treatment, which includes both drugs (sedatives, antihistamines, vitamin complexes, sorbents), and physiotherapy, diet, balneotherapy. Particular attention is paid to external therapy with ointments and creams, to daily skin care.

The chronic course with numerous relapses in the course of life forces the patient and his doctor to seek prevention methods that can prolong the periods of remission and improve the patient's quality of life.

Basic approaches to the treatment of psoriasis

Treatment of a disease such as psoriasis should begin with determining the causes of the exacerbation of the disease. If you systematically eliminate the factors contributing to the exacerbation of this pathology, it will be possible to keep the course of the disease under control. Methods of treatment of psoriasis are selected taking into account several aspects:

  • the complexity of the course of the disease;
  • the presence of concomitant pathology;
  • localization and size of psoriatic plaques;
  • the patient's ability to comply with medical recommendations.

In this regard, when choosing methods of treating psoriasis, doctors are guided by the solution of the following tasks:

  • the maximum possible cleansing of the skin from lesions;
  • obtain results in the shortest possible time;
  • relief of the main symptoms of the disease;
  • reducing the likelihood of relapse or worsening of the course of the disease.

General therapy scheme

Typically, patients with this condition are prescribed the following treatments for psoriasis:

  • Glucocorticosteroids - give a good effect, help stop exacerbation, but have many contraindications. With improper use, there may be a decrease in the effectiveness of the drug, skin atrophy, the so-called "withdrawal dermatitis".
  • Vitamin D3 analogues - such drugs are used to control psoriasis in the phase of remission and exacerbation, however, they cannot be used for extensive skin lesions, they are contraindicated in children under the age of 18 and in the elderly over the age of 65 , and they are also not recommended for patients with impaired calcium exchange.
  • Means with salicylic acid - provide an exfoliating and anti-inflammatory effect, are recommended for use in the stationary phase of the disease and with severe peeling. Particularly impressive treatment results can be achieved with a combination of salicylic acid and corticosteroids.
  • Birch tar - despite the abundance of contraindications and side effects, preparations containing this substance are still prescribed to patients with psoriasis. Therefore, they must be used with caution, as coal tar can cause skin irritation.
  • Means for the treatment of psoriasis containing activated zinc pyrithione. They are included in modern clinical guidelines for the treatment of psoriasis and are prescribed to accelerate the regression of rashes.

As a rule, experts recommend using the course of several drugs at once. This approach helps to achieve a pronounced effect and to keep the disease under control.

Systemic treatment

In severe cases of psoriasis, systemic therapy is used. It includes the use of standard immunosuppressive therapy, as well as genetically modified biologics. Systemic retinoids and systemic glucocorticosteroids can be used.

External treatment

Particular attention in the treatment of psoriasis is given to the choice of external drugs, since among patients, people with a mild and moderate course of the disease predominate, characterized mainly by skin manifestations.

These remedies are designed to cope with skin symptoms:

  • reduce and eliminate itching;
  • relieve inflammation;
  • reduce the volume of lesions;
  • promote plaque regression;
  • reduce skin peeling;
  • moisturize dry areas.

Zinc pyrithione activated in the treatment of psoriasis

Zinc pyrithione is a complex compound of zinc with sulfur and oxygen. Used in the treatment of various skin diseases, including psoriasis.

Recently, preparations based on activated zinc pyrithione have become particularly popular. The relevance of its use is due to the fact that it helps to combat the exacerbation of psoriasis, being in some cases an alternative to external drugs containing hormones for the treatment of skin diseases. The activated zinc pyrithione molecule is 50 times more stable than standard zinc pyrithione.

Benefits of Using Activated Zinc Pyrothion in Psoriasis Treatment:

  • Pathogenetically proven treatment of skin psoriasis, as it has strong anti-inflammatory, antibacterial and antifungal properties
  • Long-term control of psoriasis, does not cause skin atrophy even with prolonged use (up to 6 weeks)
  • Without restrictions on the localization of lesions, it can be used for the treatment of psoriasis on the face, scalp and in the anogenital region

Treatment of psoriasis with activated zinc pyrithione drugs

Especially many difficulties arise in the treatment of psoriasis on the head. This is because many preparations are difficult to use in this area, they can remain on the hair and not reach the surface of the skin. The way out of the situation may be the use of preparations based on activated zinc pyrithione.

A mild shampoo designed specifically for psoriasis patients. Apply to damp hair with light massaging movements, wash, then wash again with shampoo and let the active ingredients act for five minutes, then wash with warm water. The shampoo has a light and discreet aroma, the substances contained in it fight inflammation, preventing skin irritation. And menthol in the composition cools the scalp and helps reduce itching. For medicinal purposes, shampoo is used 2-3 times a week, and for preventive purposes - 1-2 times a week.

With severe damage to the scalp, an aerosol can be used in addition to shampoo. It is convenient to apply to the scalp with a special nozzle.

If the disease has spread to smooth skin, psoriatic plaques have appeared behind the ears, neck or other parts of the body, then an activated zinc pyrithione cream or aerosol can be applied to the affected areas. Do this twice a day for four to six weeks.

Patients with severe psoriasis are usually prescribed glucocorticosteroids. As a second phase of the treatment, preparations based on activated zinc pyrithione are recommended. When it is possible to reduce the severity of the process, they can be used to further control psoriasis.

Risk factors provoking the development of the disease

In the medical setting, there are usually several characteristic factors that can initiate the process. In addition, the risk of developing the disease increases if there is a combination of several provoking factors at the same time. These include:

  • genetic predisposition. Scientists have advanced the theory that carriers of the disease are certain types of genes that affect the functioning of the immune system and the immune cells of T lymphocytes. For this reason, parents suffering from psoriasis are more likely to have a child who will also be susceptible to this disease.
  • Dry and thin skin. A link between skin characteristics and the risk of developing psoriasis has been established in numerous studies. It has been found that people with thin and dry skin are more likely to suffer from this disease. The reason, according to the researchers, lies in the insufficient production of sebum, which acts as a natural moisturizer of the body surface, as well as in the structural characteristics of the cells of the epidermis.
  • The impact of the external environment. A significant role in increasing the number of people suffering from this disease can be played by the use of various cosmetic products, household chemicals, which often contain alcohols, solvents, surfactants and other aggressive components. These substances disrupt the natural functions of the skin, can cause irritation and exacerbate psoriasis.
  • Excessive body hygiene. The pathological obsession with cleanliness also plays a cruel joke on people. The more actively, the more intensively and the more often you clean the skin, the more damage can be done to it. Due to the frequent use of soap when bathing or showering, the protective lipid layer of the skin is destroyed, which leads to the formation of micro-damage on the surface, which can subsequently provoke an exacerbation or worsening of the course of psoriasis.
  • Unhealthy lifestyle. Alcohol, smoking, constant stress, poor quality and unbalanced nutrition, lack of normal rest and sleep - all this inevitably affects human health. It has been noted that certain foods, such as tomatoes and eggplant, as well as alcohol and smoking, can make psoriasis worse.
  • Immunodeficiencies. Reduced immunity, especially in HIV-positive patients, causes skin problems and aggravates the symptoms of psoriasis.
  • Medical therapy. Taking certain medications can provoke the development of the disease. With particular caution, you should use drugs from the group of beta-blockers, antidepressants, as well as drugs against malaria and seizures.
  • associated infections. In medical practice, many cases are described where the signs of psoriasis develop in patients after skin lesions due to a fungus or as a result of a streptococcal infection.
  • Change in habitual living conditions. Climate change, the change of time zones, the seasons have a negative impact on the general well-being of people. During the period of changing living conditions, the environment, the body weakens, which opens the way for the development of various diseases.
  • The impact of stress. Emotional and nervous tension, physical activity, violation of the regime of work and rest are among the factors that provoke the appearance of the first symptoms of psoriasis.
  • Injury to the skin. Scratching, friction and prolonged pressure on the skin can cause micro-damage and injury. In certain situations they can turn into characteristic psoriatic plaques.

Is it possible to get psoriasis from another person?

If we consider a disease such as psoriasis, what is it, what treatment and drugs to use to relieve symptoms, a related question often arises: is psoriasis contagious and is it possible to contract this disease from another person? How safe is it for relatives, close people to stay or live near the patient? Is it possible to contract psoriasis through household contacts, personal items, through touch or blood?

Scientists unequivocally state that psoriasis is not contagious to others. It is not a virus or bacterium that can be passed from person to person in various ways. Psoriasis is not transmitted from person to person, it is an autoimmune disease resulting from an improper response of the immune system to external factors (the body attaches itself).

Another thing is when it comes to inheritance. Therefore, if there is psoriasis in the family or close relatives, then in such a situation one should check the condition of the skin and try to exclude or minimize in advance the factors that can trigger the onset of the disease.

Table. How to distinguish psoriasis from dermatitis

Redness of the skin at the site of inflammation

Lichenification (thickening of the skin)

Diagnostic criteria

contact dermatitis

Atopic dermatitis

Seborrheic dermatitis

Psoriasis

Typical signs

Inflammation requires skin contact with an irritant.

Severe itching

Peeling of the skin with the formation of scales in the localization of the sebaceous glands

The presence of characteristic psoriatic plaques, as a rule there is a service plaque that never completely disappears

Dry skin

Association with allergens

Flow

Acute / chronic course

Chronic course with relapses

Chronic course with relapses

chronic progressive course

Location

Any localization at the site of skin contact with an irritant

It depends on the age:

- face

- elbows, knees

- flexion, extensor surfaces of the limbs

- scalp

- folds

- face

- upper chest

- scalp

- neck

- axillary region

- sacral region

The nature of the rash

For acute course:

It depends on the stage of the rash and the age of the patient

Well-defined areas of redness with pink papules, covered with yellow scales and crusty scales

Red-pink plaques covered with silver scales (psoriatic plaques)

Hyperemia (bright redness with increased temperature of the skin area)

Papules (raised skin) / Blisters (blisters on the skin up to 5 mm)

Edema

Edema

Pain in the affected area

Thickening

Later there is peeling

Redness

For chronic course:

congestive hyperemia

Peel / Wet

hyperpigmentation

Traces of scratches