psoriasis

Psoriasis is a multifactorial chronic inflammatory disease affecting the skin and nails, often accompanied by lesions of the musculoskeletal system.If you're concerned about red, dry, scaly, and itchy patches of varying shapes and sizes on your skin, make an appointment with a dermatologist.Our doctors use a comprehensive approach to the treatment of psoriasis - using pharmacological treatments (ointments, gels, aerosols, tablets and medicated injections) as well as the well-proven excimer light therapy using Italian laser equipment.

causes of psoriasis

Doctors list several causes of psoriasis:

• Genetic predisposition – Scientists have described a number of genes whose presence predisposes to the development of disease;
• endocrine, immune, and nervous system dysfunction;
• negative effects of certain environmental factors.

There are also triggering factors, including:

• Chronic infectious diseases (most commonly caused by streptococci);
• Alcoholism, chronic alcoholism;
• Weather conditions (dry or cold climates);
• Skin trauma (scratches, insect bites, sunburn);
• often emotionally stressed;
• taking certain medications (e. g. , lithium, adrenergic blockers, oral contraceptives, antimalarials);
• Abrupt discontinuation of systemic hormonal medications.

You shouldn't believe the myth that dry skin and excessive hygiene can cause psoriasis - it's absolutely not true!

stages of psoriasis

Currently, doctors divide the disease into three stages:

• Progressive - characterized by an increase in the number of rash components, fusion of papules, and the appearance of new components at the injured site. The patches are bright pink and covered with scales. The cell division rate of new lesions increases 10-fold;
• Quiescent - no fresh elements are observed, the plaques are stagnant red, there is little peeling, the itching is hardly bothersome;
• Regression - the intensity of the color of the rash decreases, the components of the rash are pale, no new rash appears, no peeling, no subjective signs are noted. A white pseudoatrophic rim forms around the plaque, and healthy skin appears in the center of the large plaque. Colorless spots remain at the rash site.

In some cases, elements in different stages of development coexist on a patient's skin.

disease symptoms

Dermatology and venereology specialists are first concerned about the presence of the psoriasis triad. These are symptoms of needle hemorrhages, terminal membranes, and stearic stains.When you scratch the plaque, "stearin spots" appear - you can observe an increase in flaking, and the surface of the pimple becomes similar to crushed stearin droplets.If the scales are completely removed, the so-called terminal film will be visible - a wet, thin, shiny film will appear on the surface.Pinpoint hemorrhage (Ospitz syndrome) - exposure to skin after removal of scales.Dermatologists also highlight Kobner's phenomenon - the appearance of a psoriatic rash at the site of skin trauma (scratch, injury).The symptoms of psoriasis depend on its type, but have some common features:

• Rashes - they always appear in one form or another;
• The skin in the psoriasis area feels tight;
• Varying degrees of itching.

Plaques of psoriasis appear in many places, but there are also some areas with typical localization:

• Scalp (with this arrangement of plaques we are talking about seborrheic psoriasis);
• knees and elbows;
• skin folds and flexor surfaces - elbow joints, knees, groin, axillary area, under the breast (this positioning allows us to talk about inverse psoriasis);
• lumbar spine, sacrum;
• Palms and feet - with palmoplantar psoriasis, respectively;
• Nail psoriasis – Dimples on the nail plate, subungual bleeding, and separation of the nail from the nail bed (onycholysis).

In addition to skin manifestations, psoriasis can cause other symptoms. For example, in the form of arthrosis, there is pain and swelling in the joints (these manifestations are usually concentrated in the feet, hands, ankles, and knees).

Types of psoriasis

Dermatologists distinguish several types of disease:vulgar(plaque, common) is the most common, accounting for 90% of all psoriasis cases. In this type of disease, reddish-pink flat inflammatory elements (papules) protrude above the surface of the skin and have clear borders.They tend to coalesce, forming patches of varying sizes that are covered with silvery scales. In appearance, it resembles a wreath or a geographical map.The psoriatic component is found primarily on the scalp, the extensor surfaces of the elbows and knees, and the skin of the lower back and sacrum, but may also occur elsewhere.Elbow psoriasis is considered a special condition (permanent plaques on the elbow that begin to worsen when injured).exudative– Most commonly occurs in patients with endocrine diseases (obesity, diabetes, etc. ). There is exudation in the lesions and yellow-gray scabs.teardrop shape– As the name suggests, a large number of bright red drop-shaped papules appear on the skin, with mild peeling and infiltration. It occurs mainly in children and adolescents after streptococcal infection. In some cases, guttate psoriasis can degenerate into regular psoriasis.seborrheicIts localization varies - elements are present behind the ears and in the nasolabial folds, on the chest, interscapular area and scalp. The scales are light yellow in color and sometimes spread to the forehead skin, forming a "psoriasis crown".Pustular type– Manifests as a limited (palms and soles) or widespread rash represented by superficial pustules.Baber's palmoplantar psoriasis is also prominent in the pustular form, in which pustules cover the soles of the feet and palms of the hands. It is characterized by severe itching, coalescence of pustules and formation of crusts. This disease also often affects the nails.Pustules are also seen in systemic Tsumbusch psoriasis. This type of disease is characterized by the appearance of bright erythema (redness) and superficial pustules. There is burning and pain in the rash area. The lesions grow rapidly, coalesce, and cover larger areas of skin. In Tsumbusha psoriasis, the epidermis (the upper layer of skin) sloughs off and forms what is called a "pus lake. "Patients will experience general malaise, with fever, burning, and tingling sensations in the affected areas.

psoriasis erythroderma

Doctors are particularly concerned about this type of psoriasis, known as psoriatic erythroderma. In this case, the pathological inflammatory process involves all or almost all of the skin. It becomes rough, tight, covered with flaky ingredients, and the skin becomes red.Many of our patients complain of fever rising to subfebrile levels and feeling unwell. Increased peripheral lymph nodes. Erythroderma can be caused by improper treatment of psoriasis (bathing, excessive tanning, use of high-concentration ointments, etc. ). In other cases, the condition occurs in healthy people if psoriasis has just begun and progresses rapidly.If psoriatic erythroderma persists for a long time, patients may experience nail damage and hair loss.

psoriatic arthritis

This pathology is also known as arthrotic psoriasis. Joint damage may occur at the same time as the rash, or even earlier in some cases, and is a precursor to psoriasis.It mainly affects the small joints of the feet and hands, but sometimes the wrist and ankle joints are also involved in the inflammatory process. Patients worry about joint pain, swelling, deformation, and limited mobility.

diagnosis

The main task of diagnosis is to determine the percentage of skin lesions throughout the body. This is necessary in order to assess the effectiveness of treatment in specific patients.There's a school of thought that to make a diagnosis, you need a lot of tests. But in most cases, this is not the case and a thorough examination of the rash by a dermatology and venereology specialist is sufficient. Psoriasis has characteristic manifestations, so visual diagnosis is not difficult.In the classic case, this is the psoriatic triad: pinpoint hemorrhages, terminal membrane symptoms, and stearic staining. Many times, patients suffer from varying degrees of itching. Having a relative with psoriasis is also important. However, skin symptoms should be differentiated when diagnosing the disease. A similar situation can be observed for papular syphilis, for example. In this case, the doctor will perform a differential diagnosis, including serological studies.Scalp psoriasis is sometimes confused with seborrheic dermatitis. With psoriasis, doctors identify papules on the skin -- compactions that are above the level of the skin and covered with scales.For the arthropathic form of psoriasis (without a rash), the dermatologist needs to be sure that this is psoriasis and not rheumatoid polyarthritis.Psoriasis often occurs with other conditions, and doctors will talk about co-morbidities. For example, psoriasis can be combined with coronary heart disease, diabetes, depression, or gastrointestinal disease.If a dermatologist diagnoses psoriasis, he will always refer the patient for consultation with a gastroenterologist, cardiologist, rheumatologist, and endocrinologist. These specialists will perform extensive tests (there is a standard list of tests for each disease, especially blood tests).The diagnostic basis of modern clinics is represented by the most modern instruments and equipment. This will allow you to conduct a comprehensive examination of various diseases.Perform laboratory research using modern biochemistry and hematology analyzers. Diagnostic sonographers use advanced ultrasound machines to examine patients.In the radiology department equipped with the latest medical technology, you can have radiographs and mammograms. At the clinic, you can also have an MRI or CT scan of any organ.Doctors in the Department of Functional Diagnostics have the opportunity to perform all necessary studies: electrocardiogram, electroencephalogram, echocephalography, daily ECG monitoring, daily blood pressure monitoring, determination of external respiratory function and other vital indicators.Our clinic offers the widest range of diagnostic tests, allowing doctors to identify diseases at virtually any stage of development.

treat

The main goal of treatment is to control the disease and bring it into remission (a decrease or disappearance of symptoms). When treating psoriasis, doctors use a combination of methods: medications (ointments and other topical forms, as well as tablets for systemic treatment) and phototherapy using excimer light.Topical treatments include creams, ointments, gels, lotions and sprays containing hormonal medications. Glucocorticoids suppress the immune system and reduce inflammation. They are available in a variety of dosage forms; depending on each specific case, your doctor will choose an individual treatment plan for you.To reduce itchy and dry skin, use moisturizers and emollients.To relieve the symptoms of psoriasis on the scalp, special shampoos are prescribed.Calcipotriol (an analogue of vitamin D) may also be used for topical treatment.In systemic treatment, doctors prescribe immunosuppressive drugs. These drugs are usually given in small doses (once a week) to treat common types of psoriasis that are difficult to treat. A similar treatment regimen is used for patients with rheumatoid arthritis. Administration is oral, intravenous, intramuscular or subcutaneous.Doctors may also prescribe retinoids (drugs with similar biological properties to vitamin A).Systemic corticosteroids are rarely used and only in particularly difficult situations.As the process wears off, topical and oral medications are used less frequently.Please note that some drugs have negative effects on fetal development (e. g. selective immunosuppressants) and are therefore contraindicated in pregnant women.No alternative treatment can lead to positive results. You should not try and trust traditional healers and unproven methods for your health.Our doctors urge you not to self-medicate or stop (prescribe) various medications on your own as this will only aggravate the condition and lead to increased rashes!

Using laser devices to treat psoriasis

The Center for Dermatology and Venereology offers you effective treatments for this disease using excimer laser systems. This is the primary physical treatment for psoriasis and some other skin conditions and has been shown to be effective.Excimer lamps use xenon-chlorine compounds and emit light in the ultraviolet range. Only rays of a certain length can penetrate the skin and reduce skin inflammation. The thickness of the plaque is reduced. The rays only affect "diseased" cells, not healthy skin. This treatment reduces the number of T lymphocytes in the area of skin covered by the plaque. This achieves stable remission, and in many cases treatment with excimer light makes it possible to abandon hormonal drugs.This approach can help you forget about the torment seasonal exacerbations bring to psoriasis sufferers.Dermatology and venereology specialists first determine the indications and contraindications for monochromatic excimer light phototherapy.Indications include:

• psoriasis;
• Vitiligo;
• Atopic dermatitis;
• Patchy alopecia (hair loss);
• Change in scar color;
• eczema.

There are few contraindications to this procedure and include:

• Pregnant;
• neoplastic diseases;
• The general condition is serious.

Why we should pay attention to systemic treatment

Dermatologists note that excimer light therapy has many undeniable advantages:

• The effects are localized, targeting only the psoriasis plaques, and the rays do not affect the entire body;
• In mild cases, stable remission can be achieved with only phototherapy and photosensitizers;
• Suitable for patients of any age (from 3 years old);
• Laser system treatment does not require hospitalization and can be easily adapted to any work schedule;
• Effective against many forms of psoriasis;
• Minimum limit.

How does the treatment process work?

At your first appointment, your doctor will perform a test on you, during which he will determine your skin photopattern and determine the minimum dose of UV radiation.The next day, you come in for an appointment and your doctor will determine the most appropriate test results. This means that your doctor will individually select the radiation power that is suitable for your skin.There are no restrictions during treatment; you are only advised to limit spicy and greasy foods and drink plenty of fluids.The effects of light therapy take just a few surgeries to show, and for stable relief you will need approximately 5-10 surgeries (in some cases 15).The duration of one surgery is 10-20 minutes, depending on the area treated and the number of areas affected.

psychological aid

We always encourage you to remember that psoriasis is not contagious! However, patients are often concerned not with the discomfort of the rash but with how others will react. This is especially painful for women and children.Children may behave cruelly toward sick children. Therefore, prompt treatment is very important, including consultation with a psychologist or even a psychotherapist.

Benefits of treating psoriasis in the clinic

Patients choose to treat psoriasis for a variety of reasons:

• Experienced, qualified dermatologists and beauticians;
• Eliminates skin and cosmetic problems simultaneously;
• Innovative treatment methods, especially the use of laser systems;
• The most modern diagnostic methods;
• Opportunity to consult with doctors from various specialties.

If you are concerned about patches, itching and flaking of your skin, please contact the clinic. You can always get qualified medical care.

Prevent psoriasis

The main task of a dermatology and venereologist is to prevent the progression of psoriasis. To this end, they proposed preventive measures:

• Prevent stress;
• Prevent colds;
• Control chronic infection lesions;
• Refuse to wear rough, tight clothes that can damage your skin.

Thanks to preventive measures and timely treatment of psoriasis, doctors are able to quickly reduce the severity of the disease and achieve the disappearance of many symptoms of the disease.

What happens if the disease is not treated?

If left untreated, the rash can spread and fill more and more of the skin. Conversion to the erythrodermic form is possible, but much more difficult to treat.