Psoriasis: what type of disease is it?

Although psoriasis is a common and long-known disease, it has not yet been fully studied.And most of the time patients do not know at all that psoriasis is not a bacterial infection or a fungus, but an abnormal reaction of the immune system, caused by unknown reasons.Information about the causes and symptoms of psoriasis will be very useful for patients, as it will help them overcome the disease.

What kind of disease is this?

Squamous lichen is another name for psoriasis and this name perfectly characterizes this disease.Psoriasis manifests itself in the formation of inflamed plaques of different sizes on the skin, which are densely covered with thick scales.

Surely almost everyone has heard of a disease like psoriasis.And this is not surprising, since squamous lichen is quite widespread.This disease is diagnosed between 4% and 10% of the world's population.In addition, statisticians who collect information on the prevalence of psoriasis claim that the number of patients is constantly growing.

Squamous lichen has been known to people since ancient times;Even healers of ancient Greece tried to treat this disease.The modern history of the study of psoriasis dates back about 150 years.But during this fairly significant period of time, researchers were not able to learn enough about the causes and treatment of psoriasis.

Widespread prevalence, uncertainty about the etiology (reasons for its occurrence), insufficiently effective treatment - all this characterizes psoriasis as one of the most difficult problems in dermatology.

Today, dermatologists consider psoriasis as a complex systemic disease associated with disturbances in the functioning of the immune system, with failures in metabolic processes and the emergence of trophic disorders.The result of these failures are specific changes in the skin.

Therefore, answering the question of what psoriasis is, a modern dermatologist will answer that these are disorders of trophism and metabolic processes in the skin caused by malfunctions in the functioning of the body's systems.Today, two theories about the etiology of psoriasis are considered most likely: genetic and viral.

• The genetic theory has many supporters, since psoriasis usually acts as a hereditary or familial dermatosis.A thorough examination of the patient's family history confirms by 60-80% the presence of psoriasis in one form or another in the patient's relatives.However, in some patients it is not possible to confirm the hereditary origin of psoriasis.This circumstance is the reason for separating these cases into a special group, in which the main cause is not genetic errors, but rather phenotypic ones.
• The viral theory that psoriasis develops as a result of infection has its supporters.Confirmation of information about the viral origin of psoriasis is the detection of antibodies in the blood of patients, as well as "elementary bodies" in the cells of the epidermis.According to this theory, psoriasis develops not only in case of infection with a virus, but also in the presence of certain conditions.

There are other theories that explain the appearance of psoriasis.For example, endocrine, neurogenic, metabolic, etc.Naturally, all these theories are not without foundation and their study allows us to obtain more important information about the disease of psoriasis.However, today it is already known for certain that the state of the endocrine and nervous systems, as well as the functioning of the gastrointestinal tract, do not cause psoriasis, but have a significant impact on the course of this disease.

For example, pathologies that affect the liver cause the quality of blood purification carried out by this organ to be considerably reduced.And this, in turn, can lead to the appearance of various skin lesions, including psoriasis.

Pathologies that affect the liver (hepatitis, primary cirrhosis, etc.) cause the degeneration of the tissues of this organ, that is, the liver is gradually replaced by connective tissue.As a result, the liver stops performing its purifying functions.Externally, this is manifested by yellowing of the mucous membranes and skin, and the development of skin diseases, including psoriasis, is also possible.

There is also an inverse relationship: psoriasis is usually accompanied by fatty degeneration that affects the liver.Therefore, in the treatment of this skin disease, it is important to follow a diet so as not to unnecessarily overload the liver.Patients are advised to limit fatty foods and eliminate alcohol completely.

Thus, despite numerous studies, it was not possible to obtain an exact answer to the question of what psoriasis is.However, the work continues, so there is a chance that the mystery of this mysterious disease will be solved and we will learn a lot about the skin disease, psoriasis.

Classification according to the international system

The disease of psoriasis manifests itself in various ways.To make it easier for specialists to navigate, a generally accepted classification of psoriasis is used.

Psoriasis is also included in the International Classification of Diseases (ICD) system.Today the tenth revision of the international registry of diseases is already in use, therefore the abbreviation ICD 10 is used. Work on the tenth revision of the international classification of diseases began in 1983 and ended in 1987.

At its core, the ICD 10 is the standard assessment tool used in medicine and healthcare management.The tenth revision of the reference book is used to monitor the prevalence of various diseases and other problems related to public health.

Using version 10 of the ICD, it is possible to compare data on morbidity and mortality in different countries, which makes it possible to obtain statistical data and systematize diagnostic information.As agreed by WHO members, ICD 10 is used to assign codes to various diseases.In version 10 of the classifier, alphanumeric codes are adopted, with which it is convenient to store information in electronic format.

All types of psoriasis are included in ICD 10 and each of them is assigned a specific code.In dermatology, the following forms and types of psoriasis are distinguished:

• common psoriasis(synonyms: vulgar, simple, plate-like).The disease was assigned a code according to ICD 10 – L-40.0.This is the most common form and is seen in 80-90% of patients.The main symptoms are the formation of plaques that rise above the surface of the skin without changes, covered with grayish-white skin scales.This form is characterized by slight peeling of the scales.After its removal, red inflamed skin is revealed, which is very easily injured and begins to bleed.As the inflammatory process progresses, plaques can increase significantly in size.
• Reverse psoriasis.This is a disease that affects the skin folds (flexing surfaces).For this form of the disease, the ICD 10 code is L83-4.Dermatosis appears with the formation of folds of smooth or minimally scaly spots on the skin.The condition worsens when the skin is injured by friction.The disease is often complicated by a streptococcal or associated fungal infection.
• Guttate psoriasis.This form of psoriasis is characterized by the formation on the skin of a large number of small red or violet spots, shaped like water droplets.According to the tenth version of the international classifier, this disease received the L4 code.Most often, guttate psoriasis affects the skin of the legs, but rashes can also appear on other parts of the body.At the same time, it is known that guttate psoriasis develops as a complication after streptococcal infections: pharyngitis, tonsillitis, etc.
• Pustular or exudative psoriasis– this is a severe cutaneous form, according to ICD 10 it is assigned the code L1-3 and L 40.82.Characterized by the formation of blisters or pustules.The skin on the lesions is swollen, red, inflamed and comes off easily.If fungi or bacteria penetrate the pustules, the contents of the pustules become purulent.Pustular psoriasis most often affects the distal parts of the extremities, but in more severe cases, a generalized process may develop in which the rash spreads throughout the body.
• Psoriatic arthritis or arthropathic psoriasis.According to the tenth version of the ICD, the pathology is coded L5.It is manifested by inflammation of the joints.Arthropathic psoriasis can affect all types of joints, but in most cases the joints of the phalanges of the fingers and toes become inflamed.The knee, hip or shoulder joints may be affected.Injuries can be so severe that they cause disability to the patient.Therefore, we should not think of psoriasis as if it were exclusively a skin disease.Severe types of psoriasis can cause systemic lesions, disability or even death of the patient.

• Erythrodermic psoriasis.A rare but serious type of psoriasis;according to ICD 10, this disease received the code L85.Erythrodermic psoriasis usually manifests itself generally;The affected area may include all or almost the entire surface of the skin.The disease is accompanied by severe itching, swelling and pain.
• Psoriatic onychodystrophy or nail psoriasis.According to ICD version 10, the disease is coded as L86.The pathology manifests itself as changes in the appearance of the fingernails and toenails.Nails may change color, become thicker, and begin to break.Possible complete loss of nails.

In psoriasis, the classification of the disease takes into account not only the types of disease, but also the severity of the symptoms:

• Limited psoriasis is a disease in which less than 20% of the skin is affected;
• generalized psoriasis affects more than 20% of the body surface;
• When almost the entire surface of the skin is affected, we speak of universal psoriasis.

If we consider all types of disease, generalized psoriasis is more common than other forms.

Flow stages

Limited or generalized psoriasis goes through three stages in its course: progressive, stable and regressive.

The progressive stage of psoriasis is characterized by the following:

• the appearance of new rashes;
• growth of existing plaques;
• the appearance of new rash elements at the site of skin lesions (scratches, abrasions);
• excessive peeling of existing plaques.

The following symptoms are characteristic of the stationary stage of psoriasis:

• lack of appearance of new elements;

• moderate stripping of elements;
• There are no signs of element growth.

The appearance of folds in the stratum corneum around the elements is a sign of the transition from a stationary stage to a regressive one.

The regression stage is characterized by the following types of symptoms:

• reduce the intensity of peeling;
• element resolution.

After resolution of psoriatic plaques, hypo- or hyperpigmented spots remain in place.

Squamous lichen is characterized by a long course with periodic exacerbations.The following types of psoriasis are distinguished:

• winter (with aggravation in autumn and winter);
• summer (with exacerbations in the warm period);
• Non-seasonal psoriasis is the most serious type, since there is no clear connection between relapses and the seasons of the year, periods of remission may be practically absent.

Diagnostic functions

If psoriasis has a typical clinical picture, the diagnosis will not be so difficult.However, this disease usually disguises itself as other pathologies.

For example, nail psoriasis is often confused with nail fungus, since the external manifestations in the early stages of these diseases are very similar.However, nail fungus and psoriasis have completely different natures, so the treatment should be different.

A non-specialist may confuse it with a fungus and with skin psoriasis.Since cutaneous mycoses (skin fungi) manifest themselves with similar symptoms: the formation of scaly plaques.Therefore, if you notice suspicious symptoms on the body or nails, there is no need to make a diagnosis yourself and start treating the fungus with folk or pharmaceutical remedies.

If the diagnosis is erroneous and, in fact, the cause of the symptoms is not a fungus, but psoriasis, then the treatment will not be beneficial, but, on the contrary, will aggravate the symptoms.

By contacting a dermatologist, a fungal test will be performed and a scraping will be taken from the nail or skin.The resulting material is then placed on nutrient media.If the fungus is present on the material, a large colony will grow on the test sample within a few days.By the appearance of the material, it will be possible to understand what kind of fungus caused the infection.

Sometimes psoriasis is complicated by the addition of secondary infections, which can be a bacterial or fungal infection.Therefore, patients who change the clinical picture (appearance of purulent discharge, change in plaque color, etc.)You will need to have regular tests for fungus and other infectious agents.

In the diagnostic process, a certain role is assigned to a set of phenomena called the psoriatic triad.The phenomena appear sequentially when an element of the rash is scraped.

The psoriatic triad manifests itself in the following way:

• when an element of the rash is scraped, the scales are removed in the form of "splinters";
• after removing the chips, a thin transparent polyethylene-like film is revealed;
• When the film is damaged, spot bleeding occurs.

A dermatologist diagnoses psoriasis, but if necessary, the doctor can refer the patient for consultations with other specialists: a rheumatologist, a gastroenterologist, a surgeon, etc.

Interesting facts about psoriasis

The disease psoriasis has been known since ancient times.Even the name of the disease came to our language from ancient Greek.During the prosperity of ancient Hellas, the word "psora" referred to all skin diseases that manifested themselves as peeling and itching.

The first person to write a detailed treatise on psoriasis was a Roman named Cornelius Celsus.In the fifth volume of his work “On Medicine” there is an extensive chapter dedicated to this disease.

They knew about psoriasis, but this disease was not evaluated unequivocally, since it was called "imperial" or "devil's" disease.

Of course, ancient healers knew very little about psoriasis.Until the 19th century, this disease was often confused with other skin ailments.Psoriasis was first identified as an independent nosological form in 1799. This was done by the English dermatologist Robert Willan, who identified psoriasis among a large group of skin diseases manifested by itching and peeling.

Not only ordinary people, but also prominent political figures knew about psoriasis firsthand.For example, Winston Churchill, who suffered from this disease, promised to erect a monument of pure gold to a person who could learn everything about psoriasis and offer effective treatment for this disease.

Modern ideas about illness.

It must be said that modern science does not know much about this mysterious disease.There are various theories about the origin, as well as the course and treatment of psoriasis.

Here are some facts about psoriasis that are beyond doubt among experts:

• Although the causes of the disease are not clear, we are able to understand the nature of psoriasis.This disease is autoimmune, that is, it is caused by a malfunction of the immune system;
• Another proven fact about psoriasis: the disease can be inherited.However, this is not always the case;Even if both parents are sick, the risk of their child developing the disease is 65%.At the same time, some patients develop psoriasis, even though none of their family members are sick;
• An interesting fact about psoriasis is that this disease is characterized by the Koebner phenomenon.This phenomenon manifests itself in the fact that elements of the rash form in places of skin damage: scratches, burns, frostbite.Sometimes psoriasis appears after a while, at the site of scars;
• An important observation that allows us to obtain more information about psoriasis is the connection of this disease with climatic factors.Exacerbations and relapses are often timed to coincide with the change of season;
• Patients have probably noticed the connection between exacerbations and stress in practice.All patients should know for sure that the disease reappears or worsens its course against a background of nervous tension and anxiety;
• A novelty about psoriasis is that the disease can appear at any age, although it was previously believed that pityriasis versicolor appears after 30;
• It is important for everyone to know that psoriasis is not a contagious disease.Even in close contact with a patient, there is no risk of infection;
• Almost everyone has heard about the incurability of psoriasis, and this is true, since no treatment has been found that guarantees defeating the disease.But patients should know that psoriasis can be controlled.Proper and timely treatment allows you to achieve long-term remission.

Modern methods of treatment

Speaking of the common disease psoriasis, we cannot stop talking about the treatment of this very common disease.It must be said that it is impossible to cure psoriasis with tablets or ointments alone.

To forget about the manifestations of psoriasis for a long time, the patient, in close cooperation with the doctor, will have to make efforts.It will be necessary to properly organize the food.Some experts say that it is possible to forget about psoriasis forever only with the help of a properly formulated diet and regular cleansing of the body.

The doctor will draw up a preliminary regimen according to which the treatment will be carried out.As a rule, external (ointments, creams) and systemic (tablets, injections) methods of therapy are used.In addition, physiotherapeutic methods will be used and treatment in tourist centers will be recommended.It is recommended to treat psoriasis with healing mud, mineral and thermal water.

Resorts may also offer non-traditional treatment methods.For example, with the help of fish that live in hot springs.These little healers effectively remove dead skin flakes and disinfect the skin, promoting faster healing.

Resorts may offer other methods of treating lichen planus.For example, leech therapy, healing baths and applications, sun treatments, etc.

You will need to be prepared for the fact that the treatment regimen will change periodically.Since not all methods are suitable for a specific patient.If the chosen treatment methods are not effective, they will need to be replaced.

Traditional methods of treating psoriasis are also widely advertised.In fact, some of them can help achieve remission.However, when choosing a method, you should remember common sense so as not to harm your health.If there are doubts about any recipe or recommendation, it is better not to use it.Consult your doctor before using any treatment method.

It is necessary to understand that it will be possible to forget about psoriasis forever only if the patient himself and his immediate environment are in a good mood.Only faith in success and an optimistic attitude will help defeat this mysterious and insidious disease.