Having appeared, psoriasis in most patients does not go away on its own, it only progresses and becomes more extensive, spreading over the skin.
However, with timely diagnosis, it becomes easier to treat and recovery is much faster.
The main thing here is to pay attention to the first signs of psoriasis in time and immediately schedule an appointment with a dermatologist.
Characteristic signs of psoriasis
Early psoriasis can present as small reddish, scaly patches.
The place of appearance of such eruptions depends directly on the way the disease progresses.
In most cases, you can see them:
- on the elbows and knees;
- on the head (in the hairy area);
- on palms and feet;
- in the area of the folds (buttocks, armpits, areas under the breast in women).
Primary eruptions (papules) are very small in size: their diameter does not exceed 4 millimeters.
However, as the disease progresses, they enlarge and fuse with each other, forming unclear plaques.
Most of the time, the appearance of papules is not accompanied by pain or itching. The feeling of discomfort increases with the development of psoriasis and an increase in the size of the affected skin areas.
The affected area begins to hurt and itch, and there is a strong burning sensation.
These signs of psoriasis are complemented by emotional disturbances that can significantly increase the rate at which the disease spreads.
It is inappropriate, when such rashes are found, to start self-treatment, since psoriasis in the early stages of development has similarities with other skin diseases.
Consequently, the wrong choice of drugs will not produce positive results, but will only make the situation worse.
Cumulative symptoms
Squamous lichen belongs to the category of systemic pathologies.
This means that it manifests not only on the skin and nails, but can also affect the spine, joints and tendons, some body systems (eg endocrine, immune and nervous).
There have been cases in which the disease affects the digestive (liver) and urinary (kidney) systems.
The first symptoms of psoriasis
- constant feeling of tiredness;
- weakness;
- a state of depression (even depression).
Due to the complex effect of the disease on the body, experts consider it appropriate to call it psoriatic disease.
But despite this, the key aspects of the disease are based on the damage to the skin.
As mentioned above, the first call at the beginning of the development of the pathology are small papules in the color range between pale pink and red.
They differ in a symmetrical position on the surface of the skin (folds, lower back, head area covered with hair), sometimes - on the mucous membrane of the external genitalia.
The size of the papules in the later course of the disease can exceed 10 centimeters.
Psoriatic eruptions, according to their characteristics, are subdivided into:
- dotted (its size is not larger than the head of a pin);
- teardrop-shaped (similar in shape to a teardrop, equivalent in size to a grain of lentils);
- in the shape of a coin (plates of 5 mm in diameter, with rounded edges);
- Rarely arched, annular, or map-like.
Above the papules are covered with scaly plaques, which are formed from keratinized cells of the epidermis and are removed without much effort. Initially, they appear in the center of the plate and gradually spread further and further.
Keratinous cells have air gaps, resulting in visual friability and light tone.
Sometimes elements are surrounded by a pink ring that acts as an area for growth of plaque and inflammation. In this case, the condition of the surrounding skin does not change.
Removal of the plaque reveals a bright, deep red surface based on capillaries, which in turn have very thin walls.
The presence of vessels so small in diameter is due to damage to the structure of the upper layers of the skin, whose structure is altered due to the incomplete maturation of epidermal cells (keratinocytes), which makes it impossible to correct them. differentiation.
Symptoms of different forms of psoriasis
Common psoriasis has fairly specific symptoms, so it won't be difficult to diagnose.
Appears as rounded, scaly areas that protrude from normal skin and are pink or red.
Sometimes, in the early stages of the disease, there are no typical plaques: before they appear on the scalp and in the area of the joints (ankle, elbows and knees) small papules can be observed.
They are able to persist for a long enough period of time and not cause any inconvenience to the patient: nothing itches or pain or no pain at all, or they are practically not felt, the papules themselves are almost impossible to notice.
They do not flake, but when lightly scraped, the scales appear immediately. These pink seals can disappear or decrease significantly in size in summer, as the sun's radiation affects the skin.
The acute form of common psoriasis manifests itself as multiple, constantly itchy rashes of brightly colored papules and is the result of the influence of factors that trigger the disease.
To avoid mistaking it for an allergic reaction, it is necessary to scrape the surface of the plate a little before the characteristic phenomena appear.
Seborrheic psoriasis begins on the scalp (in the hair-covered area) and then spreads to the face and shoulders.
It is characterized by severe peeling of the skin in the corresponding area, which patients more often consider as dandruff, so they do not rush to see a dermatologist.
This fact allows the disease to quietly reach the developmental stage when the forehead and areas behind the ears are peeled. And only after the plaques are formed.
Lesion of the skin folds with psoriatic disease (armpits, genitals and groin, under the breasts in women) is often mistaken for common irritation caused by friction or sweat.
This type of disease is characterized by smooth patches that look like spots. It is not seen peeling, but they often get wet. The rashes themselves are bright red, uniform and shiny.
When the genitalia are affected, the characteristic signs of psoriasis can be incorrectly interpreted as balanoposthitis (lesions of the head of the penis, as well as the foreskin on the inside) in men and vulvitis (localized eruptions on the labia minora)in the women.
The palmar-plantar form of the disease manifests itself in the form of compacted, callus-like areas, the surface of which is covered with yellow scales that are difficult to remove.
The affected areas are cracked and sore. With this form of the disease, it is difficult to induce the appearance of a terminal film and a bloody dew by scraping off.
Nail psoriasis begins with psoriatic onychodystrophy, which is one of the main symptoms of this form of the disease and manifests itself long before the rashes.
In the early stages, the edge of the nail is covered with grooves and small depressions.
With the development of the disease, they spread all the way to the root, after which there are changes in their color. The nail becomes dull and thickened. Due to failures in blood circulation, the manifestation of the disease increases.
Epidermal cells collect under the nail plate and it is lined with reddened tissues on all sides, after which it can shed after a while.
This type of psoriasis is dangerous because it increases the sensitivity of the tissues, which, in turn, increases the likelihood of infection. Most often, this disease is mistaken for a fungus.
The mobile joints of the bones (joints) are often affected. They are deformed, the joint capsule undergoes dystrophic type modifications.
Psoriatic arthritis begins with an increase in joint volume, which is accompanied by pain.
The fingers of both hands and feet are the most susceptible to this type of psoriasis.
In severe forms, the shoulder and elbow, hip and knee joints, as well as some parts of the spine, are exposed to the disease.
Effect on the manifestation of symptoms of the stages of psoriasis
The symptoms of psoriasis are in direct proportion to the season of the year and the stage of the disease.
Most of the time, in the spring-summer period, there is a noticeable decrease in the activity of the disease, which is facilitated by ultraviolet rays.
Consequently, in the autumn-winter period due to lack of sun, the disease is rapidly gaining momentum. There are practically no patients with summer exacerbations.
There are three stages of psoriasis:
- progressive- characterized by the continuous appearance of new eruptions, an increase in the size of the plaques that appeared previously and their surroundings with pink edges, the affected area is very itchy and scaly;
- stationary: new eruptions no longer appear and old ones do not grow; the top layer of the skin in the area of the plates is wrinkled;
- regressive: the skin does not peel off, the plaques disappear, leaving highly pigmented areas.
Psoriasis diagnosis
The diagnosis of psoriasis is made on the basis of the information obtained from a medical examination when interviewing a patient, as well as the symptoms inherent in one or another form of the disease.
The earlier a disease is detected, the faster the treatment process begins. Consequently, more tangible results will be obtained.
Due to the very specific picture of the disease, the diagnosis of psoriasis can be limited to a simple examination by a dermatologist.
But in some cases, difficulties may arise due to the implicit or absence of symptoms, which occurs if the disease is not manifested in any way or seems uncharacteristic. This situation requires further investigation procedures.
A specific method is used to perform the diagnosis, which consists of the gradual scraping of the papules along the layer.
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 staining;
- terminal film (pink epidermal cells);
- blood spray (drops of blood appear on the surface of the plate due to broken capillaries)
If necessary, the patient is tested as affected tissue samples.
X-rays are taken if psoriasis-related arthritis is suspected.
If psoriasis is in an early stage, its diagnosis is not difficult: the picture of osteoporosis is clearly visible.
In later periods, there is a narrowing of the joint space, erosion of the tissues that form the bones, osteosclerosis and periostitis.
If the disease is severe, the wrist and metatarsal joints are destroyed, as a result, the joint completely loses its mobility.
It should be noted that all the tests performed are necessary not only for the final diagnosis, but also for the differentiation with other diseases, which, at first glance, are identical.
These diseases include: parapsoriasis, seborrheic eczema, lichen rosacea, atopic dermatitis, lupus erythematosus, rheumatoid arthritis, and others.