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

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

  • genetic predisposition;
  • metabolic disorder;
  • immune disorders;
  • localized chronic infections.

Several interrelated factors underlie the development of the disease. Often, even in people with a genetic predisposition to psoriasis, it may not feel on its own for many years. The driving force for the development of the disease can be:

  • severe or prolonged stress
  • alcohol;
  • Hormonal disorder;
  • metabolic disorder;
  • taking certain medications;
  • infection;
  • skin damage (burns, cuts, wounds);
  • other factors.

In response to negative factors, foci of inflammation are formed on the skin, the process of cell division and maturation is interrupted. Cells begin to actively divide, the skin thickens at sites of inflammation, forming bright pink papules (nodules) that merge into psoriatic plaques covered with scales. If left untreated, a significant surface of the skin is gradually affected, and the inflammation spreads to the nails and joints.

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

All external factors (environment, stress, trauma) only exacerbate the course of the disease, not a single cause.

psoriasis on elbows

Types of diseases

There are a large number of classifications of psoriasis, based on the severity of the condition, the nature of the rash, the location of the lesion, and so on. v. Usually, the following types of diseases are distinguished:

  • Plaque (gross) psoriasis makes up the majority of psoriasis types. It is characterized by the appearance of patches traditionally covered with gray-white scales.
  • Intestinal psoriasis is manifested by numerous and rather small rashes with scabs over the entire surface of the body after a cold or sore throat.
  • The pustular variant is characterized by the formation of plaques with purulent inflammation.
  • Seborrhea - it is characterized by the presence of oily scales in the growth zone of the eyebrows, nasolabial folds, chest and back. It differs from seborrhea by a clearer plaque boundary.
  • With palmoplantar psoriasis, the elements are located on the respective areas of the skin.
  • The exudative variants are distinguished by the fact that the scales are saturated with a yellow liquid - exudate. As a result, they look stuck together and change color. Often observed in obesity.
  • Erythrodermic psoriasis is a severe form of the disease, as almost the entire surface of the skin is affected and systemic reactions (fever, weakness, malaise, swollen lymph nodes, impaired liver function andkidney).
  • The type of joint that causes joint damage, which is observed in 3-5% of all psoriasis patients, often leads to disability.

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

Typical signs and symptoms of psoriasis

Usually, with psoriasis, pinkish-red patches covered with gray or white scales (psoriatic plaques) appear on the surface of the skin. It is with this symptom that another name of the disease is associated - scaly lichen.

The size of the rash can vary. The main factors considered are small papules (nodules) that range 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 trio is detected by a doctor with a special diagnostic test - plaque scraping:

  1. Stearin stains - characterized by flaking when the plaque is scraped off and the separation of gray-white flakes, which look like crumbs from a candle.
  2. If you continue to scrape the surface of the plaque, after removing all the scales, a thin shiny film will appear, called a terminal.
  3. Symptoms of blood mist can be detected by removing the end membranes. At the same time, on the surface, tiny drops of blood appeared.

Rashes can be found on many different areas of the skin, but they are usually located in:

  • on the elongated surface of the extremities (elbows, knees);
  • along the hairline (the so-called "psoriasis crown");
  • in the sacral region.

In addition, the symptoms of psoriasis can worsen and fade depending on the season. For example, in the autumn-winter period, in most patients, the disease turns to an acute stage, while in the summer its symptoms subside.

Diagnosis of psoriasis

How to diagnose psoriasis?

Symptoms, stages and types of psoriasis

There are several stages of the disease process:

  • Progressive. It is characterized by an active increase in the symptoms of psoriasis, proliferation of lesions, thickening of the skin patches, an increase in the area of redness around them, as well as severe itching and peeling of the skin.
  • Freeze. At this stage, papules stop growing, stop forming new psoriatic plaques, and reduce the surrounding redness, itching, and more and more plaque peeling.
  • Depression. The activity of the disease is reduced, accompanied by a decrease in itching, the appearance of psoriatic plaques, in their place there are areas of reduced pigmentation of the skin. As a rule, even without an exacerbation, a person with psoriasis has 1-2 patches that never go away - this is called the "task array".

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

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

  • On the scalp, patches are formed, slightly raised above the main surface. Seen from above, they are covered with small scales, which look like dandruff. The structure of the hair remains intact. In addition to the fact that the patches are located on the scalp, often as the disease progresses, they extend beyond its boundaries, affecting the skin of the forehead, neck, and back of the scalp.
  • On the skin of the feet and palms, psoriasis is manifested by noticeable thickening, the skin becomes rough, their thickness increases. Usually, fissures and ulcers that are visible on external examination are formed at the site of the lesion. This feature is explained by the fact that the cells of the epidermis divide with high intensity, the skin simply does not have time to remove dead particles, because they accumulate and compress, depositing on the surface. face.
  • On the nail plate, psoriatic lesions present in a completely different way. Here there may be options: the surface of the nail is covered with small shallow pits - the nail acquires the so-called "fragile" shape. Or the second option - there is a thickening of the nail plate, the color of which changes, begins to peel off in some places. Also, characteristic papules with a red border can be seen through the nail. This form is sometimes confused with onychomycosis.

Recommendations to eliminate the symptoms of the disease

Effective treatment of psoriasis is possible only with an integrated approach. Adhering to maximum precautions is important to reduce the risk of exacerbations. So it is recommended:

  • avoid injury to the skin;
  • avoid hypothermia;
  • refuse bad habits;
  • avoid stressful situations;
  • timely treatment of infections and acquired diseases;
  • Avoid prolonged exposure to direct sunlight.

Patients with psoriasis must be especially careful to observe the requirements of personal hygiene. If you are showering or bathing, then:

  • use products that are free of dyes and fragrances;
  • choose a mild shampoo;
  • avoid using rough towels, creams, gels with abrasive particles;
  • Avoid harsh soaps as they dry out your skin.
  • adjust the water temperature so that it is warm;
  • stay in the water no more than 10-15 minutes;
  • Use a soft cloth, do not rub or brush the skin.

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

Choose clothes that are light, made of natural fabrics, with no cuts, so as not to restrict movement and not to rub.

In the summer, do not sunbathe for too long. To protect your skin from UV rays, use a sunscreen with a high SPF.

treatment of psoriasis with ointments

Treatment of psoriasis

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

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

The chronic process with multiple relapses throughout life forces patients and their caregivers to seek preventive methods that can prolong remission and improve patients' quality of life.

Basic approaches to the treatment of psoriasis

Treatment of a disease such as psoriasis should begin with identifying the cause of the exacerbation of the disease. If you systematically eliminate the factors that contribute to the exacerbation of this pathology, then it will be possible to control the course of the disease. The method of treatment for psoriasis is 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 adhere to medical recommendations.

In this regard, when choosing a treatment for psoriasis, doctors will be guided by the solution of the following tasks:

  • clean the skin from damage as much as possible;
  • obtain results in the shortest possible time;
  • reduce the main symptoms of the disease;
  • reduce the likelihood of recurrence or aggravation of the course of the disease.

General treatment chart

Most often, patients with this pathology are prescribed the following methods of psoriasis treatment:

  • Glucocorticosteroids - they give a good effect, help to relieve exacerbations, but they have many contraindications. If used improperly, it can reduce the effectiveness of the drug, atrophy the skin, also known as "withdrawal dermatitis".
  • Vitamin D3 analogs - such drugs are used to control psoriasis in remission and exacerbations, however, they cannot be used for extensive lesions of the skin, they are anti-inflammatory. Indicated in children under 18 years old and elderly people over 65 years old. , and they are also not recommended for patients with impaired calcium metabolism.
  • Means with salicylic acid - provide an exfoliating and anti-inflammatory effect, they are recommended to be used in the stopping phase of the disease and with severe flaking. Particularly impressive treatment results can be achieved with the combination of salicylic acid and corticosteroids.
  • Birch oil - despite the multitude 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 contain activated pyrithione zinc. They are included in modern clinical guidelines for the treatment of psoriasis and are prescribed to accelerate the resolution of the rash.

As a rule, experts recommend using several drugs at once. This approach helps to achieve significant results and control the disease.

Whole body treatment

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

External treatment

Particular attention in the treatment of psoriasis is the choice of external drugs, since among the patients, those with a mild and moderate course of the disease, characterized mainly by skin manifestations, are the main ones. weak.

These remedies are designed to deal with skin symptoms:

  • reduce and eliminate itching;
  • reduce inflammation;
  • reduce the volume of the lesion;
  • promotes plaque regression;
  • reduce skin flaking;
  • Moisturizes dry skin areas.

Zinc activates pyrithione 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 in demand. The suitability of its use is due to the fact that it helps fight exacerbations of psoriasis, in some cases, as an alternative to external hormonal drugs for the treatment of diseases. about skin. 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:

  • Treatment of skin psoriasis is genetically proven, as it has pronounced anti-inflammatory, antibacterial and antifungal properties
  • Long-term control of psoriasis, does not cause skin atrophy even with prolonged use (up to 6 weeks)
  • There is no restriction on the localization of the lesion, can be used to treat psoriasis on the face, scalp and anal area.

Treatment of psoriasis with drugs based on activated zinc pyrithione

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

A mild shampoo specially designed for patients with psoriasis. It is applied to damp hair with light massage movements, washed, then rinsed and left for five minutes for the active ingredients to work, then rinsed with warm water. The shampoo has a mild fragrance that is not harsh, the substances in the shampoo are anti-inflammatory, preventing skin irritation. And the menthol in the ingredient cools the scalp and helps relieve itching. For medicinal purposes, shampoo is used 2-3 times a week, and for preventive purposes - 1-2 times a week.

If the scalp is severely damaged, a spray can be used in addition to shampoo. It is convenient to apply on the scalp with a special nozzle.

If the disease has spread to smooth skin, patches of psoriasis have appeared behind the ears, on the neck, or on other parts of the body, a cream or spray containing activated zinc pyrithione can be applied to the affected areas. enjoy. Do this twice a day for four to six weeks.

Patients with severe psoriasis are often prescribed glucocorticosteroids. Preparations based on activated zinc pyrithione are recommended as a second phase of treatment. When the severity of the process can be reduced, they can be used to further control psoriasis.

Risk factors provoking the development of the disease

In a medical setting, there are often several specific factors that can initiate the process. Furthermore, the risk of developing the disease is increased if there is a combination of multiple triggers at the same time. Including:

  • genetic predisposition. Scientists hypothesize 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 with psoriasisIt is more likely that children will also be susceptible to this disease.
  • Dry, thin skin. Over the course of many studies, a link has been established between skin characteristics and the risk of developing psoriasis. It turns out that people with thin and dry skin are more prone to this condition. According to the researchers, the cause lies in the insufficient production of sebum, which acts as a natural humectant for the surface of the body, as well as in the structural features of the cells of the epidermis.
  • External influences. An important role in the increase in the number of people suffering from this disease can be played by the use of various cosmetic products, household chemicals, often containing alcohol, solvents, surfactants and other chemicals. other strong ingredients. These substances disrupt the natural functions of the skin, which can irritate and worsen psoriasis.
  • Excessive body hygiene. The obsessive pathology of cleanliness also plays a cruel joke on humans. The more proactive, thorough and regular you are to clean your skin, the more harmful it will be. Due to frequent use of soap in bathing or showering, the protective lipid layer of the skin is destroyed, leading to the formation of microscopic cracks in the surface, which can then cause an exacerbation or exacerbation. more psoriasis.
  • Unhealthy lifestyle. Alcohol, smoking, constant stress, poor quality and unbalanced nutrition, not getting enough rest and sleep - all these certainly affect human health. It has been noted that certain foods, such as tomatoes and eggplants, as well as alcohol and smoking, can worsen psoriasis.
  • Immune deficiency. Reduced immunity, especially in HIV-positive patients, causes skin problems and worsens the symptoms of psoriasis.
  • Medical therapy. Taking certain medications can stimulate the development of the disease. With special caution, you should use drugs of the group of beta-blockers, antidepressants, as well as antimalarials and convulsions.
  • related infections. In medical practice, many cases are described when signs of psoriasis develop in a patient following a skin lesion caused by a fungus or by a streptococcal infection.
  • Changing living conditions according to habits. Climate change, time zone changes, and seasons have negative impacts on people's general life. In the period of living conditions, the environment changes, the weakened body will pave the way for the development of diseases.
  • Effects of stress. Emotions and nervous tension, physical activity, violation of the work and rest regime are among the factors that provoke the appearance of the first symptoms of psoriasis.
  • Skin damage. Prolonged scratching, friction, and pressure on the skin can cause small cracks and damage. In certain situations, they can transform into the characteristic psoriatic plaques.

Is it possible to get psoriasis from someone else?

If we consider a disease such as psoriasis, what it is, its treatment, and what drugs are used to relieve the symptoms, a related question often arises - is psoriasis contagious andIs it possible to spread this disease from other people? How safe is it for relatives and close people in or near the patient? Can psoriasis be spread through household contact, personal items, contact, or blood transfusion?

Scientists clearly state that psoriasis is not contagious to others. It is not a virus or bacteria that can be passed from person to person in different ways. Psoriasis is not contagious, it is an autoimmune disease that results from an inappropriate response of the immune system to external factors (the body attacks itself).

Another thing is when it comes to heredity. So, if someone in the family or loved one has psoriasis, in this situation one should control the condition of the skin and try to rule out or minimize the factors that can trigger the disease first.

The 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

Allergic dermatitis

Seborrheic dermatitis

Psoriasis

Typical signs

Inflammation requires skin contact with an irritant.

Intense itching

Peeling skin with scab formation at the site of the sebaceous glands

The presence of characteristic psoriatic plaques, as a rule, with plaques on duty never completely disappear

Dry skin

Binds to allergens

Flow

Acute/chronic course

Chronic course with relapse

Chronic course with relapse

chronic progression course

Localization

Any localization at the site of skin contact with the irritant

Depends on age:

- face

- elbows, knees

- flexural and extensor surfaces of the extremities

- head skin

- crease

- face

- upper chest

- head skin

- neck

- armpit area

- sacral region

The nature of the rash

For the acute course:

Depends on the stage of the rash and the age of the patient

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

Pinkish-red patches covered with silvery scales (plaques of psoriasis)

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

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

Edema

Edema

Pain in the affected area

Thicken

Then there is peeling

Red

For the chronic course:

congestive congestion

Peeling / Wet

hyperpigmentation

Scratch marks