The stages of psoriasis are defined time intervals during which the disease acquires its characteristic features. Many psoriasis mistakenly call the stage a severe or mild form of the disease, but in medical records the term is used with an entirely different meaning.
What are the stages of psoriasis?
Psoriasis is recognized as a recurrent skin disease, the fault of which is genetics. According to dermatologists, at least 2% of the world's population suffers from this disease, which means that the problem is very urgent. During psoriasis, 2 conditions are clearly distinguished:
- Relapse.This term refers to the deterioration of the skin. In case of relapse, the patient suffers from itching, pain, burning, profuse skin rashes, irritation and discomfort. The victim's situation is aggravated by insomnia, neurosis, and anxiety.
- Referral.This word is used to refer to improving the appearance of the skin. With remission, the skin returns to its normal color, the redness disappears, and the area of psoriatic plaques is reduced.
The stages of psoriasis partially duplicate the description of remissions and relapses, which is why many dermatologists use these words interchangeably. In clinical practice, 3 stages of psoriasis are described:
- progress stage;
- stationary;
- regression stage.
Taking into account that we are talking about a cyclical process, the stages flow sequentially with each other and form a continuous course of the disease.
Done!The progress stage is considered the hardest to feel.
What is the progress of psoriasis?
The progress stage is triggered by a series of triggers, such as the cold season or stress. In some cases, even an experienced dermatologist cannot determine the trigger unambiguously. During the progressive stage, the following happens:
- Psoriatic nodules develop rapidly, affect the skin, interconnect in so-called plaques, which peel and itch. A plaque is a spot of arbitrary shape, most often round or oval, sometimes with a ragged edge.
- Papules, the individual nodules of a psoriatic rash, are bumps on the skin. The edges of the papules do not peel off and the central part peels off. As a large number of dead scales accumulate, the plaques begin to rise above the surface of the skin. The swelling gives them an even more convex and uneven appearance.
- This stage of the pathology is characterized by an isomorphic reaction, which consists of an exacerbation of eruptions with skin lesions, scrapes, injections, cuts, microtrauma. This phenomenon bears the name of Köbner.
A delayed reaction is characteristic of the progressive stage of psoriasis. In some cases, skin rashes appear about 9 days after exposure to a trigger (such as a food allergen). Typically, a psoriatic rash appears within 24 hours of exposure to adverse factors.
Interesting!95% of psoriatic patients have some type of food intolerance that can trigger a relapse. To avoid an exacerbation, you need to keep a food diary and observe the reaction to different types of food.
Stationary and recessive stages
The stationary stage is the period in the course of psoriasis during which the sufferer's condition is relatively stabilized. In the stationary stage:
- Psoriatic plaques have a smooth outline. The entire surface of the plate is covered with a thick layer of flakes that are easily detached. The itching and discomfort are moderate. There is no bright red, inflamed border around the papules.
- With skin microtrauma, Koebner phenomenon is not observed, that is, scratching or cutting healthy skin no longer turns into psoriatic plaque.
The regressive or recessive stage is characterized by massive lesions in psoriasis. First, a pseudoatrophic border can be seen around the papules, and then patients notice a rapid cessation of peeling of the skin, with the formation of hyperpigmentation plaques at the site.
Severity of the pathology
An additional diagnostic criterion is the evaluation of the area of psoriatic lesions. The term "gravity" is used to describe it. Dermatologists distinguish 3 degrees of severity of skin disease:
- Easy.Psoriatic plaques occupy 1 to 3% of the total body area. The small size of the affected areas does not mean that the patient is well. With psoriasis of the head or face, even a couple of plaques will be enough to cause a person discomfort and distress.
- Medium.The volume of psoriatic eruptions occupies 3 to 10% of the total body area. In this case, the back, chest, and outer surfaces of the joints, scalp, palms, and feet are affected. This prevalence leads to severe poisoning and severe pain. The patient may partially or totally lose his ability to work, the mental state and the state of the nervous system deteriorate.
- Heavy.The disease covers more than 10-15% of the surface of the skin. According to rough estimates, if psoriasis occupies more than a quarter of the total body area, the probability of liver or kidney failure increases many times. Unbalanced damage to internal organs can cause death from psoriasis.
To comprehensively assess the severity of psoriasis, a special scale called PASI is used. The scale takes into account:
- percentage of healthy and diseased skin;
- stage of pathology;
- patient's response to drug therapy;
- individual tolerance to psoriasis (mental state, complications of the nervous system and psyche);
- objective data from laboratory tests in dynamics (for example, uric acid volume in a blood test).
The diagnosis takes into account all the symptoms that affect the condition of a person with psoriasis. The intensity is reflected in the medical history:
- itchy skin processes;
- redness;
- swelling;
- hyperemia;
- thickening of the skin;
- exfoliation;
- blood flow;
- swelling;
- infections;
- pain syndrome.
On the PASI scale, the volume of skin lesions is described by numbers, from 0 to 72, where 0 is the absence of skin symptoms and 72 is the maximum possible spread of the disease on a large scale.
Attention!First, it is important for the patient to know and monitor the signs of an exacerbation. If unfavorable symptoms appear, you should immediately visit a dermatologist, because psoriasis does not always enter the stationary stage. A relapse can last for decades.
Treatment of psoriasis depends on the stage
For each stage of the disease, a set of therapeutic measures has been developed, so the first thing a dermatologist determines is whether the psoriasis is progressing, stabilizing or regressing.
How is the progressive stage treated?
Every psoriasis sufferer guesses that remission is coming to an end because of her own feelings. If the itching worsens, the skin looks worse, and the psoriasis is obviously spreading over the surface of the body, treatment should be started. The therapy for the advanced stage has the following characteristics:
- The patient is engaged in the prevention of further deterioration of the condition, strictly adheres to the diet, abstains from the triggers of the pathological process (stress, smoking, alcohol).
- For severe itching, antihistamines can be used; An additional benefit of this class of drugs is the elimination of swelling in the area of psoriatic plaques.
- The dermatologist prescribes a wide variety of topical treatments to heal, smooth and thin the skin. By decision of the doctor, creams, ointments or sprays are selected. Tar soap and solid oil compresses give a positive dynamic. You can also apply compresses or apply cosmetics with Dead Sea mud.
The main task at this stage is to stop the exacerbation before the disease enters a prolonged relapse. Depending on the indications, the doctor selects corticosteroids in injections or in the form of ointments.
Attention!Corticosteroids should be used in a short, intensive course under the supervision of a dermatologist. You can give yourself injections or spread antihistamine ointments.
Stationary and Regressive Stage Therapy
Further actions of the dermatologist depend on the body's response to the selected treatment. The following scenarios are possible:
- Medication has a positive effect. In 1-2 weeks, psoriasis goes into the stationary stage, regresses, and remission occurs.
- Medicines have no effect. If after 2-4 weeks from the time of prescribing the course of drugs, the results are still not visible, this is a reason to change the list of drugs or the attending physician.
- Medication aggravates. This dynamic is also possible, especially if the dose or frequency of administration is not sufficient. Relapse is delayed, psoriatic plaques cover a large area of the body, the person needs hospitalization.
In a medical institution, a more powerful therapy is used, for example, hardware blood purification. With a favorable reaction, psoriasis enters the stationary stage, which can last from several days to several months.
Interesting!More than 80% of patients note the seasonal nature of exacerbations. This makes the disease predictable and allows you to prepare for the onset of a relapse.
The drug list for the stationary and regressive stages is exactly the same, but the dose and frequency of administration are lower than for the progressive stage.
Remission of 10 to 15 years
A competent dermatologist sets himself the following task: choosing the drugs and physiotherapeutic agents that will provide psoriatic patients with the longest possible improvement. At the same time, the patient himself should do everything possible to promote treatment, avoid triggers, and take medications responsibly. If the alliance between the patient and the doctor has been developed successfully, the duration of the remission is unlimited. Stable wellness can last 15 years or more.