Treatment of psoriasis. Symptoms, signs of disease and effective treatments

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

  • genetic predisposition;
  • metabolic disorders;
  • immune disorders;
  • focal chronic infection.

Several interrelated factors underlie the development of the disease. Often, even in people with a genetic predisposition to psoriasis, it may not be felt for many years. Incentives for disease development can be:

  • severe or prolonged stress
  • alcohol;
  • hormonal disorders;
  • metabolic disorders;
  • taking certain medications;
  • infections;
  • skin damage (burns, cuts, injuries);
  • other factors.

In response to negative factors, foci of inflammation are formed in the skin, and the processes of cell division and maturation are disturbed. The cells begin to actively divide, the skin thickens at the sites of inflammation, forming light pink papules (nodules), which merge into so-called psoriatic plaques covered with scales. If left untreated, a significant area of skin is gradually affected, the inflammation spreading to the nails and joints.

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

All external factors (environment, stress, trauma) only worsen the course of the disease, but cannot act as a single cause.

elbow psoriasis

Types of diseases

There are many classifications of psoriasis, which are based on the severity of the condition, the nature of the rash, the location of the lesion, etc. The following types of diseases are most often distinguished:

  • Plaque psoriasis (vulgar) makes up most of all types of psoriasis. It is characterized by the appearance of traditional plaques covered with white-gray scales.
  • Guttate psoriasis is manifested by numerous and rather small rashes with scales all over the body after a cold or sore throat.
  • The pustular variant is characterized by the formation of plaques with purulent inflammation.
  • Seborrhea - is characterized by the presence of oily scales in the area of hair growth, nasolabial folds, chest and back. It differs from seborrhea by clearer plaque borders.
  • In palmar-plantar psoriasis, the elements are located in the corresponding areas of the skin.
  • The exudative variant is characterized by the fact that the shells are saturated with a yellowish liquid - exudate. This makes them look stuck and change color. It is often seen in obesity.
  • Psoriatic erythroderma is a severe form of the disease, because almost the entire skin surface is affected and systemic reactions occur (fever, weakness, weakness, swollen lymph nodes, impaired liver and kidney function).
  • Arthropathic type causes joint damage, is observed in 3-5% of all patients with psoriasis, often leads to disability.

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

Characteristic signs and symptoms of psoriasis

In psoriasis, pink-red plaques covered with grayish or white scales (psoriatic plaques) most often appear on the skin surface. This name is associated with another name for the disease - scaly lichen.

The size of the rash can be different. The primary elements are considered small papules (nodules) from pink to bright red or dark red. 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. The doctor discovers this triad with a special diagnostic test - plaque scraping:

  1. Stearin stain - characterized by peeling when the plaque is scraped and separating the gray-white scales, which look like candle chips.
  2. If you continue to scrape the surface of the plaque, then after removing all the shells, a thin glossy film will appear, called the terminal.
  3. The dew symptom can be detected by removing the terminal film. At the same time, tiny drops of blood appear on the surface.

The rash can be found on different parts of the skin, but the most common are:

  • on the extensor surfaces of the limbs (elbows, knees);
  • along the hairline (so-called "psoriatic crown");
  • in the region of the sacrum.

Also, the symptoms of psoriasis can get worse and disappear depending on the season. For example, in the autumn-winter period, in most patients, the disease passes into the acute phase, while in the summer the symptoms decrease.

diagnosis of psoriasis

How to diagnose psoriasis?

Symptoms, stages and types of psoriasis

There are several stages in the course of the disease:

  • Progressive. It is characterized by an active increase in psoriasis symptoms, proliferation of lesions, thickening of skin plaques, increased redness around them, as well as severe itching and flaking of the skin.
  • Stationary. At this stage, the papules stop growing, the formation of new psoriatic plaques stops, while the redness around them decreases, the itching persists, and the peeling of the plaque intensifies.
  • Regressive. The activity of the disease subsides, which is accompanied by a reduction in itching, psoriatic plaques, in their place there are areas of skin with damaged pigmentation. As a rule, even without worsening, a person suffering from psoriasis has 1-2 plaques that never disappear - these are the so-called "duty plaques".

When diagnosing psoriasis, the doctor necessarily determines the stage, because the choice of treatment depends on it.

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

  • Plaques form on the scalp, which rise slightly above the main surface. From above they are covered with small scales, visually similar to dandruff. The hair structure remains intact. Apart from the fact that plaques are located in the scalp, often with the progression of the disease, they also go beyond its borders, affecting the skin of the forehead, neck and the area behind the earlobe.
  • On the skin of the feet and palms psoriasis is manifested by noticeable thickening, the skin becomes rough, the thickness increases. Cracks and ulcers often form at the sites of the lesion and are visible on external examination. This characteristic is explained by the fact that the cells of the epidermis divide with great intensity, the skin simply does not have time to get rid of dead particles, because they accumulate and compress, remaining on the surface.
  • On the nail plate, psoriatic lesions manifest in a completely different way. Options are possible here: the surface of the nail is covered with small shallow pits - the nails get the so-called "thimble" look. Or another option - there is a thickening of the nail plate, its color changes, it begins to peel in some places. At the same time, characteristic papules with red edges can be seen through the nail. Sometimes this form is confused with a fungal nail infection.

Recommendations for eliminating the symptoms of the disease

Effective treatment of psoriasis is possible only with an integrated approach. Adherence to maximum precautions is of great importance to reduce the risk of disease exacerbation. Therefore, it is recommended:

  • avoid skin injuries;
  • avoid hypothermia;
  • reject bad habits;
  • avoid stressful situations;
  • timely treatment of infections and concomitant diseases;
  • avoid prolonged exposure to direct sunlight.

Patients with psoriasis must take special care to comply with the requirements of personal hygiene. If you are showering or bathing, then:

  • use colorless and odorless products;
  • choose a mild shampoo;
  • avoid the use of coarse cloths, creams, gels with abrasive particles;
  • Avoid hard soaps as they dry out the skin.
  • adjust the water temperature so that it is warm;
  • stay in the water no longer than 10-15 minutes;
  • use a soft towel, do not rub or comb the skin.

After showering and bathing, it is recommended to use special moisturizing body creams. Try to comb your hair as little as possible so as not to irritate the scalp once again. The same goes for blow-drying. If you can’t do without it, choose a hot or cold jet.

Choose light clothes, made of natural fabrics, free cut, so that they do not hinder movement and do not rub.

Don't sunbathe for too long in the summer. 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 approach and method for the treatment of psoriasis.

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

A chronic course with numerous relapses throughout life forces the patient and his physician to seek prevention methods that can prolong periods of remission and improve the patient’s quality of life.

Basic approaches to treating psoriasis

Treatment of a disease such as psoriasis should begin by determining the cause of the disease's worsening. If you systematically eliminate the factors that contribute to the worsening of this pathology, it will be possible to keep the course of the disease under control. Methods of treating psoriasis are selected taking into account several aspects:

  • complexity of the disease course;
  • 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 method of treating psoriasis, doctors are guided by the solution of the following tasks:

  • maximum possible cleansing of the skin from lesions;
  • achieving results in the shortest possible time;
  • alleviation of the main symptoms of the disease;
  • reducing the likelihood of recurrence or worsening of the course of the disease.

General scheme of therapy

Usually patients with this pathology are prescribed the following treatments for psoriasis:

  • Glucocorticosteroids - give a good effect, help stop exacerbations, but have many contraindications. With improper use, there may be a decrease in the effectiveness of the drug, skin atrophy, so-called "abstinence dermatitis".
  • Vitamin D3 analogues - such drugs are used to control psoriasis in remission and exacerbation, however, can not be used for extensive skin lesions, are contraindicated in children under 18 years and over 65 years, and are not recommended for patients withby calcium exchange.
  • Means with salicylic acid - provide exfoliating and anti-inflammatory effect, are recommended for use in the stationary phase of the disease and in severe peeling. Particularly impressive treatment results can be achieved with a combination of salicylic acid and corticosteroids.
  • Birch tar - despite the abundance 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.
  • Psoriasis treatments containing activated zinc pyrithione. They are included in modern clinical guidelines for the treatment of psoriasis and are prescribed to accelerate the regression of the rash.

Experts generally recommend the use of several drugs at once. This approach helps to achieve a pronounced effect and keep the disease under control.

Systemic treatment

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

External treatment

Special attention in the treatment of psoriasis is paid to the choice of external drugs, because among the patients, people with a mild and moderate course of the disease, which is characterized mainly by cutaneous manifestations, predominate.

These medications are designed to deal with skin symptoms:

  • reduce and eliminate itching;
  • relieve inflammation;
  • reduce the volume of lesions;
  • promote plaque regression;
  • reduce flaking of the skin;
  • moisten dry areas.

Activated zinc pyrithione in the treatment of psoriasis

Zinc pyrithione is a complex compound of zinc with sulfur and oxygen. It is used in the treatment of various skin diseases, including psoriasis.

Recently, preparations based on activated zinc pyrithione have been especially in demand. The relevance of its use is due to the fact that it helps fight the worsening of psoriasis, in some cases it is an alternative to external drugs that contain hormones for the treatment of skin diseases. Activated zinc pyrithione molecule is 50 times more stable than standard zinc pyrithione.

Advantages of using zinc pyrothione activated in the treatment of psoriasis:

  • Pathogenetically substantiated treatment of skin psoriasis, because 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)
  • Without restrictions in the localization of lesions, it can be used to treat psoriasis on the face, scalp and anogenital region

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 this area, they can stay on the hair and not reach the surface of the skin. The way out of the situation can be the use of preparations based on activated zinc pyrithione.

Mild shampoo designed especially for patients with psoriasis. Apply to damp hair with light massage movements, rinse, then shampoo again and leave for five minutes to act the active ingredients, then rinse with warm water. The shampoo has a light unobtrusive aroma, the substances contained in it fight inflammation, preventing skin irritation. And the menthol in the composition cools the scalp and helps reduce itching. For medical purposes, shampoo is used 2-3 times a week, and for preventive purposes - 1-2 times a week.

In addition to severe damage to the scalp, an aerosol can be used with the shampoo. It is convenient to apply on the scalp with a special nozzle.

If the disease has spread to smooth skin, psoriatic plaques have appeared behind the ears, on the neck or other parts of the body, then a cream or aerosol based on activated zinc pyrithione can be applied to the affected areas. Do this twice a day for four to six weeks.

Glucocorticosteroids are usually prescribed to patients with severe psoriasis. Preparations based on activated zinc pyrithione are recommended as the second phase of treatment. When it is possible to reduce the severity of the process, they can be used to further control psoriasis.

Risk factors that provoke the development of the disease

In the medical environment, there are usually several characteristic factors that can trigger the process. Moreover, the risk of developing the disease increases if there is a combination of several provoking factors at once. This includes:

  • genetic predisposition. Scientists have theorized that the carriers of the disease are certain types of genes that affect the functioning of the immune system and immune cells of T-lymphocytes. For this reason, parents suffering from psoriasis are more likely to have a child who will also be susceptible to this disease.
  • Dry, thin skin. Numerous studies have established a link between skin characteristics and the risk of developing psoriasis. It turns out that people with thin and dry skin suffer from this disease more often. The reason, according to researchers, lies in the insufficient production of sebum, which acts as a natural moisturizer on the surface of the body, as well as in the structural characteristics of epidermal cells.
  • Influence of the external environment. The use of various cosmetic products, household chemicals, which often contain alcohols, solvents, surfactants and other aggressive components, can play a significant role in increasing the number of people suffering from this disease. These substances disrupt the natural functions of the skin, can cause irritation and worsen psoriasis.
  • Excessive body hygiene. Pathological obsession with cleanliness also plays a cruel joke on people. The more actively, intensively and often you clean your skin, the more damage it can do. Due to the frequent use of soap when bathing or showering, the protective lipid layer of the skin is destroyed, which leads to the creation of micro-damage on the surface, which can cause worsening or worsening of the course of psoriasis.
  • Unhealthy lifestyle. Alcohol, smoking, constant stress, poor and unbalanced diet, lack of normal rest and sleep - all this inevitably affects people's health. It has been noticed that certain foods, such as tomatoes and eggplant, as well as alcohol and smoking, can worsen psoriasis.
  • Immunodeficiency. Decreased immunity, especially in HIV-positive patients, causes skin problems and worsens the symptoms of psoriasis.
  • Medical therapy. Taking certain medications can cause the development of the disease. Beta-blockers, antidepressants, as well as anti-malarial and anti-seizure drugs should be used with extreme caution.
  • related infections. Numerous cases have been described in medical practice when signs of psoriasis develop in patients after fungal skin damage or as a result of streptococcal infection.
  • Changing normal living conditions. Climate change, changes in time zones, seasons have a negative impact on the general well-being of people. In the period of changing living conditions, environment, the organism weakens, which opens the way for the development of various diseases.
  • Impact of stress. Emotional and nervous tension, physical activity, violation of the regime of work and rest are among the factors that cause the appearance of the first symptoms of psoriasis.
  • Skin injury. Prolonged scratching, friction, pressure on the skin can cause microdamages and injuries. In certain situations, they can transform into characteristic psoriatic plaques.

Is it possible to get psoriasis from another person?

If we consider a disease such as psoriasis, what is it, what treatments and medications to use to alleviate the symptoms, a related question is often asked - is psoriasis contagious and is it possible to get this disease from another person? How safe is it for relatives, close people to stay or live near the patient? Is it possible to get psoriasis through household contact, personal belongings, touch or blood?

Scientists unequivocally claim that psoriasis is not contagious to others. It is not a virus or bacterium that can be transmitted from person to person in a variety of ways. Psoriasis is not transmitted from person to person, it is an autoimmune disease that occurs as a result of an improper response of the immune system to external factors (the body attacks itself).

The other thing is when it comes to inheritance. Therefore, if there is psoriasis in the family or close relatives, in such a situation, the condition of the skin should be controlled and an attempt should be made to exclude or minimize the factors that can cause the appearance of the disease.

Table. How to distinguish psoriasis from dermatitis

Redness of the skin at the site of inflammation

Lichenification (skin thickening)

Diagnostic criteria

contact dermatitis

Atopic dermatitis

Seborrheic dermatitis

Psoriasis

Typical signs

Inflammation requires skin contact with an irritating agent.

How itchy

Exfoliation of the skin with the formation of scales in the localization of sebaceous glands

The presence of characteristic psoriatic plaques, as a rule, there is a duty plaque that never completely disappears

Dry skin

Allergen association

Flow

Acute / chronic flow

Chronic course with relapses

Chronic course with relapses

chronic progressive flow

Localization

Any localization at the site of skin contact with the irritant

Depends on age:

- face

- elbows, knees

- flexion, extensor surfaces of limbs

- scalp

- folds

- face

- upper chest

- scalp

- neck

- axillary region

- sacral region

The nature of the rash

For acute flow:

It depends on the stage of the rash and the age of the patient

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

Red-pink plaques covered with silvery scales (psoriatic plaques)

Hyperemia (severe redness with increasing temperature of the skin area)

Papules (raised skin) / vesicles (skin blisters up to 5 mm)

Edem

Edem

Pain in the affected area

Thickening

Peeling occurs later

Redness

For chronic flow:

congestive hyperemia

Peel / wet

hyperpigmentation

Scratch marks