Psoriasis: types, treatment, advice for the doctor

Psoriasis is a chronic skin disease with an unknown cause, manifested by the appearance of red peeled spots on the skin.

The treatment is performed by a dermatologist.Synonym - Licen Scaly.MKB 10: L40 code.According to the international classification, it refers to Papuloskvamous skin diseases.

Psoriasis as a disease is studied for approximately 200 years.Before this period, these patients were considered patients with leprosy and treated them accordingly as lepers.Difference: Lepra (leprosy) - Infectious disease (pathogen - Mycobacterium leprae).Psoriasis is not infectious.

Symptoms

The main symptom of psoriasis: the appearance of pink red spots on the skin, whose surface is covered with silver scales of the keratinizing layer of the skin (epidermis).

1. The symptom of the "Starin stain".This is a pathognomonic sign (that is, characteristic only for a given disease).Speaking (grant) of psoriatic points.It occurs with an opaque scalpel or object glass (not with a nail!).With a Honda League, the surface of the stain becomes white, as if it were covered with wax, this is a symptom of the "Starin stain".
2. "Psoria" symptom.Another pathognomonic symptom for psoriasis.With another scrap, carefully eliminates the scales of a psoriatic plaque, a bright surface is seen under the scales: the SO symptom of the psoriatic or terminal film.
3. The "Blood Dew Poltebnov" symptom (Auspitz symptom).Another pathognomonic symptom for psoriasis.With greater propagation (grottowing) of plates, that is, by eliminating the terminal film, the bleeding of points is manifested, which do not merge with each other.This is the symptom of "Rocío de Blood".
4. Pilnov symptom.Characteristic for the initial stage and the progression stage.A rounded pink stain without pelar, with clear limits.With the progression of the disease along the periphery, the spots (plates) marks the edge of the red skin, not yet covered with scales.
5. Kebner symptom.Psoriatic spotlights appear in the skin in places of injury, in places of scratches, scratches, in places of friction on clothing.
6. Kartamyshev symptom.When the fingers (palpates) plates are examined on the scalp (Acts), it feels a clear edge of plates with the fingers.Unlike seborrheic dermatitis, when there is no clear edge between spots and healthy skin on palpation.
7. Voronov's symptom is a symptom of regressive spots (which passes).For some time, wrinkled skin remains along the periphery of the psoriatic stain, clearer and brighter than healthy skin.
8. The symptom of the "thimble" on the nails is a sign of damage to the nails.The nail is in points, like a thimble.
9. The symptom of the "oil stain" on the nails: a yellow brown spot under the nail plate is also a sign of nail psoriasis.
10. Anicohogrifosis - Deformation of nail plate with nail psoriasis.The nail acquires ugly shapes, sometimes similar to a claw of birds.
11. Bo-Rile line.The longitudinal line that passes throughout the nail is a sign of rape of the nail plate.

Types of psoriasis and clinic

Psoriasis generalized pustulent (L40.1) and pustulosa palmar and plantar (L40.3)

These two forms of the disease differ only in the prevalence of the process.The pathogenesis mechanisms are the same.Pusture forms are found in 1% of patients with psoriasis.Vesicula (bubbles) and pustules (pustules) appear in the skin, which can fuse with each other, forming "purulent lakes."Around the skin can be present.It can be disturbed by itching in the skin.The skin around the pustules is red, inflamed, hot to the touch.

Improvement of body temperature.In the blood: an increase in leukocytes (leukocytosis).These are rare and severe types of psoriasis.But they require an immediate examination of the doctor and prescribing a complex treatment.And generalized pustular psoriasis requires treatment for hospitalized patients.In very rare cases, when bacterial infection joins, even sepsis and death cases are described in literature.

One of the varieties of pustular psoriasis is an exudative form.At the same time, there are no abscesses and bubbles on the skin, but there is a crying of affected skin, the formation of crusts and itching in the skin.

Acrodermatitis is a persistent allopo

MKB 10 code: L40.2.

In the skin of the fingers and legs, psoriatic pustular (pustular) and peeling changes appear.The process involves nail plates.The nails are deformed, exfoliated in places from the bed of the nail, have points recesses.

A clearer way is nail psoriasis without pustular changes, that is, without skin abscesses.

Psoriasis is rocky

MKB 10 Code: L40.4

Survatory haloid spots with a peeled pink size appear on the skin.There may be clear skin itch.Location: The whole body is in the body, in the arms and legs.Rarely, on the face.

Often, a drop -shaped shape appears after infectious diseases (tonsillitis, acute respiratory viral infections).

Psoriasis is artropathic

MKB 10 Code: L40.5

Other names are the psoriasis of the joints, the psoriatic arthropathy, the psoriatic arthritis.

It develops in 10% of patients with psoriasis.Articular surfaces and periarticular fabrics are affected: ligaments, tendons, joint bags.

Location: Any joint, but the small interfaceable joints of the fingers are mainly affected.However, there are cases, for example, psoriatic spondylitis - damage to intervertebral joints, or psoriatic coxarthrosis - damage to the hip joint.

Patient complaints: pain, stiffness in the joints.Swelling and skin redness appear in the joints.There are frequent cases in which patients do not bother anything at all, however, there are changes in the form of arthrosy on articular surfaces in radiographs.

The joint pain and the restriction of the movement in the joints lead to the disability of the patients.These patients should go to the UIT exam to determine the disability group.

Another psoriasis

MKB 10 Code: L40.8

This type includes psoriasis on the back (inverse, intertrigonic).

Location, on the contrary, not on extensor surfaces, but in flexion.The elbow doubles, popliteal wells, axillary cavities, inguinal folds, under the mammary glands.At the same time, there are no rashes in the rest of the body.

It develops in patients with obesity and diabetes.
Manifestation: Red spots appear on the skin, almost without peeling, slightly high on the surrounding skin.

Psoriasis is not adequate

MKB 10 Code: L40.9

All other species that, to one or the other, cannot be attributed to the previous species, are attributed to this group.

Seasonal forms of psoriasis

1. Winter form (photosensitive psoriasis).The rashes appear in the cold season.Well treated with ultraviolet radiation.
2. Summer form (phototoxic psoriasis).Exacerbations occur in the summer.UVNI prostration leads to an exacerbation of the disease.

Diagnosis

The diagnosis is made on the basis of clinical symptoms and complaints of the patient.

• The presence of certain symptoms of skin damage, nails, joints, etc., see above.
• In difficult cases: a biopsy of the skin for verification (installation of a precise diagnosis).At the same time, the infiltration of lymphocytes, neutrophils and macrophages, thickening of the skin capillaries, immature keratinocytes are found in the thickness of the skin.
• Joint radiography: Ideally, all patients should be done.But most of the time it is done according to indications, in the presence of complaints about the pain in the joints.
• A general blood analysis is more normal.Inflammatory changes are detected only in the severe course of the disease.
  Recently, it is common to diagnose blood tests under a microscope.This does not matter for the diagnosis of psoriasis!

The differential diagnosis of psoriasis is carried out with diseases:

• Licen red flat 
• Licen pink 
• Parapsorize,
• Atopic dermatitis
• Eczema
• Papular syphilid
• Seborrheic dermatitis in the head
• Dermatophytia in the head
• Reuters disease, rheumatoid arthritis, osteoarthritis
• Medicinal allergic dermatosis
• Urticaria

Psoriasis treatment

Remember: It is impossible to completely cure psoriasis.You can only achieve long -term remission.

Local treatment

ATTENTION: If the pustules appeared from the ointment, the ointment must be canceled and consult your doctor to correct the treatment!

1. Ointments and creams with vitamin D. For example, medications that contain substances synthesizing vitamin D.
2. Ointments and corticosteroid creams.These medications reduce the immune response in the skin, reduce inflammation activity.
3. Combinations in a composition of vitamin D and corticosteroid preparations.
4. Naftalanas based preparations.Lubricate the affected area of the skin 2-3 times a day-4 weeks.
5. Birch tar and drugs based on it.Berritin, birch tar.Lubricate the affected areas and give an extract for 15-30 minutes, then washed with warm water and soap.
6. Creams and ointments based on solidol.You can use solidol, but you must find the old Soviet solidol, and not the solidol that is now sold in car stores with different additives.Creams and ointments.Solidol and cream -based creams help in half cases with psoriasis.The itching decreases on the third day, peeling the leaves and the point itself gradually decreases.
7. Ointments and keratolithic creams (exfoliants).Used unstable!Just to eliminate excessive peeling.Often, in combination with corticosteroid preparations to reduce itching and inflammation.You can't use exudative psoriasis!Salicylic acid keratolithic agent.
8. Zinc drugs.  It reduces the irritation and redness of the skin, dry the skin.It does not contain hormones.
   Attention: Do not use tar and salicylic acid in "service plates"!The irritation of the plates in Dutas can cause the propagation of pathological eruptions in the skin.

Instrumental treatment methods

Photo cabinet for bullet therapy

We look at the video how PUVA therapy is carried out:

• Eximer laser.

Treatment with an eximer laser of scalp psoriasis:

• Plasmapheresis, we are organized - Purification of blood plasma in a special apparatus.At the same time, toxic immune complexes of the blood are produced, which lead to the infiltration of the skin with lymphocytes.The effectiveness of the procedure is high, especially in the severe course of the disease.But the procedure is expensive and is essentially aimed at eliminating the mechanisms of the development of the disease, and not its causes.According to patients, plasmapheresis is satisfactorily tolerated, the effect appears of several procedures.

Diet with psoriasis

Exclude:

Citrus fruits, tomatoes, pineapples and other fruits abroad, honey, sweets, sugar, cookies, spices, alcohol, spicy and salty dishes, coffee, white bread, smoked meats, products with dyes and sugar, replacements, potatoes and semolina.

Do not eat in excess!

Necessarily:

Gars (Saracen wheat, oatmeal), vegetable oils (sunflower, olive), fruits and vegetables: apples, carrots, beets, cabbage, cucumbers, boiled meat, fish, one day a week (usually on Saturday) - post (or even starvation).On this day, drink only water or coma gachas of sarracene wheat flooded with water.

Popular remedies

At home, you can use several popular remedies for psoriasis.But their effect is minimal or zero.

Remember: independent treatment in the home in half of the cases leads to the progression of the disease and the transition in a more serious way.

Popular remedies list of psoriasis used in patient reviews:

1. Solidol
2. Therapeutic mud of salty lakes.
3. Baths with sea salt.
4. Birch tar.
5. Naphtalan oil.
6. A decoction of a series: compress (applications) to the affected areas of the skin.
7. A decoction of Celandine's herbs.
8. An Ortigas decoction.
9. Aloe juice.
10. Gotos baths.
11. Hunger.
12. ASD 3 faction.
13. Linseed oil.
14. Milk thistle.
15. Good goods and drugs.Ineffective or with zero efficiency.In the best case, ordinary herbal extracts are contained, or even ordinary starch with vitamins and trace elements.Very expensive and provide good profits to manufacturers and scripts of dietary supplements.They are not a medicine, so you cannot expect help from them in the treatment of psoriasis.
16. Psoriasis ointment.In fact, the current remedy is solidol.At the same time, there are many more herbal extracts, bees products that can cause an allergic reaction and exacerbation of the disease.
17. Chinese lotionThe drug contains acids that can cause skin irritation and disease progression.

Types of exotic treatment

Ichthiotherapy.
In black Mru there is gara -ru fish.Pellizquen the dead areas of human skin and contribute to "rejuvenate" the skin.This effect is also used in the treatment of patients with psoriasis.

The effect of ichthiotherapy is positive only with an exhaustive observance of the technique and the choice of exactly the same fish.There are similar fish fish: scales with sharp teeth are started, therefore, damage the psoriatic plates.The effect of the exposure of the Chin-Chin fish is exactly the opposite: the propagation of plates by the type of Kebner phenomenon.

Failure to comply with hygiene in some spa gutters can lead to the appearance of fungal or viral lesions in the skin (mycosis, warts).

Registration prevention

• Exclude risk factors!
• Observe the regime of the day, the work and rest regime
• Adequate nutrition
• Timely treatment of infectious and endocrine diseases
• UFO and PUVA-TERAPY COURSES
• Complex vitamins
• Sanatorium resort treatment, swimming in the sea
• A healthy lifestyle!

It is psoriasis

No, not contradictory!This is a non -infectious disease.