Treatment of psoriasis. Symptoms, signs and effective treatment of the disease

The exact cause of the disease is still unknown. Currently, scientists distinguish several theories about the causes of psoriasis. These include:

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

The development of the disease is based on several interrelated factors. Even people who are genetically predisposed to psoriasis may not feel it for many years. There may be an impetus for the development of the disease:

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

In response to adverse factors, inflammatory foci appear on the skin, disrupting cell division and maturation. The cells begin to divide actively, the skin thickens in the foci of inflammation, forming bright pink papules (nodules), which merge into plaques called psoriatic plaques covered with scales. When left untreated, a significant area of skin is gradually affected, and the inflammation spreads to the nails and joints.

In fact, the consequences of exposure to all the causes of psoriasis can be combined into two groups: impaired cell division of the skin and changes in the functioning of the immune system.

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

psoriasis on the elbows

Types of disease

Depending on the severity of the condition, the nature of the rash, the location of the lesion, etc. The following types of diseases are often distinguished:

  • Plaque psoriasis (vulgar) makes up the majority of all types of psoriasis. It is characterized by the appearance of traditional boards covered with white-gray scales.
  • Gutt psoriasis is manifested by numerous and fairly small rashes that weigh on the entire surface of the body after a cold or sore throat.
  • The pustular variant is characterized by the formation of purulent inflammatory plaques.
  • Seborrheic - it is characterized by hair growth, nasolabial folds, the presence of oily scales on the chest and back. It differs from seborrhea by clearer plaque borders.
  • With palmar-plantar psoriasis, the elements are located in the relevant areas of the skin.
  • The exudative variant is characterized by the fact that the scales are saturated with a yellowish liquid - exudate. As a result, they appear to stick together and change color. It is often observed in obesity.
  • Psoriatic erythroderma is a severe form of the disease because almost the entire surface of the skin is affected and systemic reactions (fever, weakness, dysfunction, swelling of the lymph nodes, impaired liver and kidney function) occur.
  • Arthropathic type causes joint damage, occurs in 3-5% of all patients with psoriasis, and often leads to disability.

According to the stages of the pathological process, there are progressive, stationary and regressive stages of paid lichen.

Characteristic signs and symptoms of psoriasis

With psoriasis, pink-red plaques (psoriatic plaques) often appear on the surface of the skin, covered with gray or white scales. Another name of the disease is associated with this symptom - scaly lichen.

The size of the spills can vary. The main elements are small papules (nodules) ranging from pink to bright red or dark red. Over time, their size increases significantly, and they also tend to coalesce.

In 90% of cases, the symptoms of psoriasis include the formation of standard plaques characterized by triple symptoms. This triad is detected by a special diagnostic test by a doctor - by breaking the plaque:

  1. Stearin stain - is characterized by peeling off the plaque when removed and the separation of gray-white scales from the candle, which look like chips.
  2. If you continue to rub the surface of the board, a thin glossy film called a terminal will appear after removing all the scales.
  3. Symptoms of hemorrhage can be detected by removing the terminal film. At the same time, small drops of blood appear on the surface.

Rash can be found in different areas of the skin, but most often they are:

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

Also, the symptoms of psoriasis can get worse and go away depending on the season. For example, in the autumn-winter period, most patients have an acute phase of the disease, and in the summer its symptoms decrease.

diagnosis of psoriasis

How is psoriasis diagnosed?

Symptoms, stages and types of psoriasis

There are several stages of the disease:

  • Progressive. It is characterized by an active increase in the symptoms of psoriasis, the spread of lesions, thickening of the skin plates, an increase in the area of redness around them, as well as severe itching and peeling of the skin.
  • Stationary. At this stage, the growth of papules stops, the formation of new psoriatic plaques stops, then the redness around them decreases, itching continues, peeling of the plaques intensifies.
  • Regressive. The activity of the disease is reduced, it is accompanied by itching, a decrease in psoriatic plaques, in their place there 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 "duty plaques".

When diagnosing psoriasis, the doctor must determine the stage, because the choice of treatment depends on it.

Symptoms of psoriasis can vary depending on which part of the body is affected:

  • On the scalp there are plaques that rise slightly above the main surface. From above, they are covered with small scales, visually resembling dandruff. The structure of the hair remains intact. In addition to the location of plaques on the scalp, it often extends beyond the borders of the forehead, neck, and auricle as the disease progresses.
  • On the skin of the feet and palms, psoriasis manifests itself with a noticeable thickening, the skin becomes rough, the thickness increases. Often, cracks and ulcers appear at the site of the lesion, which are visible on external examination. This feature is explained by the high-intensity division of the cells of the epidermis, the skin simply does not have time to get rid of dead particles, because they accumulate and compress, remaining on the surface.
  • Psoriatic lesions on the nail plate manifest themselves in a completely different way. Here are the options: the surface of the nail is covered with small shallow holes - the nails get the so-called "high" look. Or the second option - there is a thickening of the nail plate, it changes color, begins to flake in some places. At the same time, characteristic papules with red edges may appear on the nail. Sometimes this form is confused with a fungal infection of the nail.

Recommendations to eliminate the symptoms of the disease

Effective treatment of psoriasis is possible only with an integrated approach. It is important to take maximum precautions to reduce the risk of disease outbreaks. Thus, it is recommended:

  • prevent skin damage;
  • avoid hypothermia;
  • to give up bad habits;
  • avoid stressful situations;
  • timely treatment of infections and accompanying diseases;
  • prolonged exposure to direct sunlight.

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

  • use products without dyes and fragrances;
  • choose a mild shampoo;
  • do not use dishwashing towels, creams, gels with abrasive particles;
  • Avoid harsh soaps as they dry out your skin.
  • adjust the water temperature to keep it warm;
  • not more than 10-15 minutes in water;
  • Use a soft towel, do not rub or comb the skin.

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

Choose clothes made of light, natural fabrics, loose-fitting so that they do not restrict movement and do not rub.

Do not sunbathe for too long in the summer. Use a sunscreen with a high SPF to protect your skin from ultraviolet rays.

Treatment of psoriasis with ointment

Treatment of psoriasis

Several important aspects determine the choice of approach 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), as well as physiotherapy, diet, balneotherapy. Special attention is paid to external therapy with ointments and creams, daily skin care.

The chronic course, which is accompanied by numerous relapses throughout life, forces the patient and his attending physician to look for preventive measures that can prolong remission periods and improve the patient's quality of life.

Basic approaches to the treatment of psoriasis

Treatment of a disease such as psoriasis should begin by identifying the causes of the exacerbation of the disease. If you systematically eliminate the factors that lead to the exacerbation of this pathology, it will be possible to control the course of the disease. Treatment of psoriasis is selected taking into account several aspects:

  • the complexity of the disease;
  • presence of accompanying pathology;
  • localization and size of psoriatic plaques;
  • the patient's ability to follow medical recommendations.

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

  • maximum possible cleansing of the skin from lesions;
  • to get results as soon as possible;
  • elimination of the main symptoms of the disease;
  • reduce the likelihood of recurrence or complication of the disease.

General therapy scheme

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

  • Glucocorticosteroids - they have a good effect, help stop inflammation, but have many contraindications. With misuse, there may be a decrease in the effectiveness of the drug, atrophy of the skin, the so-called "withdrawal dermatitis".
  • Vitamin D3 analogues - such drugs are used to control psoriasis in remission and exacerbation, but can not be used for extensive skin lesions, are contraindicated in children under 18 years of age and older than 65 years. , and is not recommended for patients with impaired calcium metabolism.
  • Means with salicylic acid - has an abrasive and anti-inflammatory effect, is recommended for use in the inpatient phase of the disease and with severe peeling. Particularly effective treatment results can be achieved with a combination of salicylic acid and corticosteroids.
  • Birch tar - despite the abundance of contraindications and side effects, drugs containing this substance are still prescribed to patients with psoriasis. Therefore, they should be used with caution, as charcoal resin can cause skin irritation.
  • Remedies for psoriasis with 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 a course of several drugs at once. This approach helps to achieve an open effect and keep the disease under control.

Systemic treatment

Systemic therapy is used in severe cases of psoriasis. This includes the use of standard immunosuppressive therapy, as well as genetically engineered biological drugs. Retinoids and systemic glucocorticosteroids may be used.

External treatment

In the treatment of psoriasis, special attention is paid to the choice of external drugs, as patients with mild to moderate course of the disease, which is characterized mainly by skin manifestations, predominate.

These products are designed to cope with skin symptoms:

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

Activated zinc pyrithione in the treatment of psoriasis

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

Preparations based on recently activated zinc pyrithione are especially in demand. The urgency of its use is due to the fact that in some cases, as an alternative to drugs containing external hormones for the treatment of skin diseases, it helps to combat the exacerbation of psoriasis. The activated zinc pyrithione molecule is 50 times more stable than standard zinc pyrithione.

Benefits of using activated zinc pyrothion in the treatment of psoriasis:

  • Pathogenetically justified treatment of skin psoriasis because it clearly has anti-inflammatory, antibacterial and antifungal properties.
  • Psoriasis does not cause skin atrophy with long-term control, even with long-term use (up to 6 weeks)
  • It can be used to treat psoriasis on the face, scalp and anogenital area without restricting the localization of lesions.

Treatment of psoriasis with drugs based on activated zinc pyrithione

There are many difficulties in the treatment of psoriasis, especially in the head. Because it is difficult to use many drugs in this area, they can remain in the hair and do not reach the surface of the skin. The way out of the situation may be the use of drugs based on activated zinc pyrithione.

A mild shampoo specially formulated for patients with psoriasisApply to damp hair with light massage movements, rinse, then shampoo again and leave for five minutes for the active ingredients to move, then rinse with lukewarm water. The shampoo has a faint odor, its ingredients fight inflammation by preventing skin irritation. Menthol cools the scalp and helps reduce itching. Shampoo for medicinal purposes is used 2-3 times a week, and for prophylactic purposes 1-2 times a week.

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

If the disease has spread to smooth skin, psoriatic plaques appear behind the ears, neck or other parts of the body, a cream or aerosol based on activated zinc pyrithione 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. Preparations based on activated zinc pyrithione are recommended as the second stage of treatment. When it is possible to reduce the severity of the process, they can be used to further control psoriasis.

Risk factors for the development of the disease

There are several characteristic factors in the medical environment that can usually trigger the process. In addition, the risk of developing the disease increases when there is a combination of several triggers at once. These include:

  • genetic predisposition. Scientists claim that the carriers of the disease are certain genes that affect the immune system and the activity of T-lymphocytes. Therefore, parents suffering from psoriasis are more likely to have children who are also susceptible to this disease.
  • Dry, thin skin. Numerous studies have linked skin features to the risk of developing psoriasis. It has been found that people with thin and dry skin are more likely to suffer from this disease. According to researchers, the reason is the insufficient production of sebum, which acts as a natural moisturizer on the body surface, as well as the structural properties of epidermal cells.
  • The influence of the external environment. The use of various cosmetic products, often household chemicals containing alcohol, solvents, surfactants and other aggressive components, can play an important role in increasing the number of people suffering from this disease. These substances disrupt the natural functions of the skin, can cause irritation and exacerbate psoriasis.
  • Excessive body hygiene. The pathological obsession with cleanliness is also a cruel joke to people. The more active, intensive and frequent you clean your skin, the more damage you can do to it. Frequent use of soap while taking a bath or shower destroys the protective lipid layer of the skin, which leads to the formation of micro-lesions on the surface, which can later lead to 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. Some foods, such as tomatoes and eggplant, as well as alcohol and smoking, can worsen psoriasis.
  • Immune Deficiencies. Decreased immunity, especially in HIV-positive patients, triggers skin problems and exacerbates the symptoms of psoriasis.
  • Medical therapy. Taking certain medications can cause the disease to develop. You should be especially careful to use drugs from the group of beta-blockers, antidepressants, as well as drugs for malaria and seizures.
  • related infections. In medical practice, many cases are described when patients develop psoriasis symptoms after skin lesions caused by a fungus or as a result of a streptococcal infection.
  • Changes in normal living conditions. Climate change, time zones and seasons have a negative impact on people's overall well-being. During the period of changing living conditions, the environment and the organism weaken, which leads to the development of various diseases.
  • The effects of stress. Emotional and nervous tension, physical activity, work and rest disorders are among the factors that cause the first symptoms of psoriasis.
  • Skin damage. Prolonged scratching, friction, pressure on the skin can cause microdamages and injuries. In some cases, they can turn into characteristic psoriatic plaques.

Is it possible to get psoriasis from another person?

When we think about a disease like psoriasis, what it is, what treatments and medications to use to relieve the symptoms, the question often arises - is psoriasis contagious and is it possible to get this disease from another person? How safe is it for relatives and close people to stay or live with the patient? Is it possible to get psoriasis through household contact, personal belongings, touch or blood?

Scientists unequivocally state that psoriasis is not contagious to others. It is not a virus or a bacterium that can be transmitted from person to person in different ways. Psoriasis is not transmitted from person to person, it is an autoimmune disease caused by the immune system not responding properly to external factors (the body attacks itself).

Another thing, when it comes to heredity. Therefore, if you have psoriasis in the family or close relatives, you should monitor the condition of the skin in such a situation and try to exclude or minimize the factors that 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 symptoms

Inflammation requires skin contact with an irritant.

Severe itching

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

The presence of characteristic psoriatic plaques, as a rule, has a plaque that never disappears completely.

Dry Skin

Combination with allergens

Flow

Acute / chronic course

Chronic course with relapses

Chronic course with relapses

chronic progressive course

Localization

Any localization at the point of contact with skin irritants

Depends on age:

- face

- Elbows, knees

- bending, extensor surfaces of the extremities

- scalp

- curls

- face

- upper chest

- scalp

- neck

- axillary region

- sacral region

The nature of the spill

For an acute course:

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

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

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

Hyperemia (bright redness with an increase in temperature in the skin area)

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

Edema

Edema

Pain in the affected area

Concentration

Then there's the shelling

Redness

For a chronic course:

congestive hyperemia

Bark / age

hyperpigmentation

Scratch marks