When first appeared, psoriasis in most patients does not go away on its own but only progresses and increasingly spreads and spreads on the skin.
However, with timely diagnosis, the treatment will become easier and the recovery takes place much faster.
The main thing here is to pay attention to the first signs of psoriasis promptly and make an appointment immediately with a dermatologist.
Characteristic signs of psoriasis
Psoriasis can initially manifest as small, red, scaly patches.
The location of such rashes is directly dependent on the form of the disease progressing.
In most cases they can be seen:
- at elbows and knees;
- on head (in bristly areas);
- on the palms of the hands and feet;
- in the area of the fold (buttocks, armpits, and under the breast in women)
Primary eruptions (papules) are of very small size: their diameter does not exceed 4 mm.
However, as the disease progresses, they enlarge and fuse to form pieces with no apparent shape.
Usually, the appearance of papules is not accompanied by pain or itching. Discomfort increases as psoriasis develops and increases the size of the affected areas.
The affected area begins to hurt and itch, and a burning sensation starts.
These signs of psoriasis supplemented by emotional discomfort can dramatically increase the rate of the disease's spread.
It is not appropriate to detect such rashes, initiate self-treatment because psoriasis at an early stage of development has similarities with other skin diseases.
Accordingly, choosing the wrong drug will not lead to positive results but only make the situation worse.
Cumulative symptoms
Scaly lichen is a generalized pathology.
This means that it not only manifests itself on the skin and nails, but can also affect the spine, joints and tendons, certain body systems (e. g. , endocrine, immune and psychoactive. business).
There have been cases that affect the digestive system (liver) and urinary system (kidney).
First Symptoms of Psoriasis
- constant feeling of fatigue;
- weaknesses;
- depressed state (up to depression).
Due to the complex effect of the disease on the body, experts believe it is suitable to call it psoriasis.
However, even so, the main aspects of the disease are based on the lesion of the skin.
As mentioned above, the first sign to begin to develop pathology are small papules that range in color from pale pink to red.
They differ in a symmetrical position on the surface of the skin (folds, lower back, hairy head area), sometimes - on the mucous membranes of the external genitalia.
The size of papules in more severe stages may exceed 10 cm.
Psoriasis eruptions, depending on their characteristics, are divided into:
- dot pattern (their size is not larger than the pin);
- teardrop-shaped (similar in shape to a teardrop, similar in size to a lentil seed);
- coin-shaped (plates 5 mm in diameter, with rounded edges);
- Rarely arcs, annular or map-like.
On the top of the papules are covered with scaly plaques, formed from the keratinized cells of the epidermis and removed with little effort. Initially, they appear in the center of the plaque and gradually spread further and further.
Horn cells have gaps of air, resulting in hard to see and shiny images.
Sometimes the elements are surrounded by a pink ring, which acts as an area for plaque growth and inflammation. In this case, the state of the surrounding skin does not change.
Removing plaque reveals a shiny, dark red surface based on the capillaries, so a very thin wall.
The presence of small vessels of such diameter is due to the damaged structure of the layers on the skin, which is disturbed by the incomplete maturation of the epidermal cells (keratinocytes), making them impossible to distinguish accurately.
Symptoms of different types of psoriasis
Psoriasis usually has quite specific symptoms, so it is not difficult to diagnose.
It appears as rounded, scaly areas that protrude over normal skin and are pink or red.
Sometimes, in the early stages of the disease, there are no typical plaques: before they appear on the scalp and in the joint area (ankles, elbows and knees), can be observedsmall papules.
They can last for a long enough time and do not cause any inconvenience to the patient: no itching and pain or no pain, or the fact that they are not felt, the papules themselves are barelycan notice.
They do not come off, but when lightly scraped, the scales will appear immediately. Such pink seals can disappear or significantly decrease in size in the summer, as the solar radiation affects the skin.
The acute form of psoriasis is usually manifested as a persistent itchy erythematous rash and is the result of the influence of the disease-triggering factors.
To avoid the mistake of an allergic reaction, you need to scrape the surface of the plaque a bit before any characteristic phenomenon occurs.
Seborrheic psoriasis begins on the scalp (where the hair is present) and then spreads to the face and shoulders.
Characterized by severe flaking of the skin in the respective area, patients often consider it to be dandruff, so they do not rush to a dermatologist.
This fact allows the disease to quietly go into the developmental stage when the forehead and areas behind the ears are flaky. And only after that array formed.
Lesions of skin folds with psoriasis (armpits, genitals and groin, under the breasts in women) are often mistaken for the common irritation caused by friction or sweat.
This type of disease is characterized by smooth patches that look like spots. No flaking was observed, but they are often wet. The papules themselves are bright red, they are uniform and shiny.
In the case of genital damage, the characteristic signs of psoriasis may be incorrectly interpreted as foreskin (lesions with a rash on the penis glans, as well as foreskin). head in the inner part) in men and vulvitis (a localized rash on the labia) in women.
Palm disease manifests as compressed areas similar to calluses, yellow scaly surfaces that are difficult to remove.
Affected areas are cracked and painful. With this disease, the scrape is difficult to cause sclera and blood mist.
Nail psoriasis begins with psoriatic nail dystrophy, which is one of the main symptoms of this form of the disease and manifests itself much earlier than a rash.
In the early stage, the nail margin has many grooves and small indentations.
With the development of the disease, they spread, all the way down to the root, then there are changes in color. Nails dull and thickened. Because blood circulation is not circulating, the manifestation of the disease increases.
The epidermal cells accumulate under the nail plate, and it is surrounded by red tissue on all sides, then it can peel off after a while.
This type of psoriasis is dangerous because it increases the sensitivity of the tissues, thereby increasing the likelihood of infection. Quite often, this disease is mistaken for a fungus.
The moving joints of the bones (joints) are often affected. They are deformed, covering the joints undergoing dystrophic changes.
Psoriatic arthritis begins with an increase in joint volume, accompanied by pain.
The fingers of both hands and feet are most susceptible to this type of psoriasis.
In severe form, the shoulder and elbow joints, hip and knee joints, as well as some parts of the spine, are in contact with the disease.
Affects the presentation of symptoms of psoriasis stages
The symptoms of psoriasis are proportional to the season of the year and the stage in which the disease occurs.
Most commonly during spring-summer, disease activity is significantly reduced, which is facilitated by ultraviolet rays.
Accordingly, in the autumn and winter period due to lack of sunlight, the disease develops rapidly. Practically no patient had a summer exacerbation.
There are three stages of psoriasis:
- progression- characterized by a constant appearance of new rashes, increasing the size of previously appearing plaques, and surrounding them with a pink border, the affected area is very itchy and flaky;
- static- new rashes no longer appear and old ones don't grow; the top layer of skin in the plaque area becomes wrinkled;
- regression- the skin does not flake, the plaques disappear, leaving areas of highly pigmented skin.
Diagnosis of psoriasis
Diagnosis of psoriasis is made on the basis of information obtained from a physical examination by interviewing the patient, as well as symptoms inherent in one form or another of the disease.
The earlier the disease is detected, the faster the treatment starts. Accordingly, more tangible results will be obtained.
Due to the very specific picture of the disease, the diagnosis of psoriasis can be limited to a simple examination by a dermatologist.
But in some cases, difficulty may arise due to the absence or absence of symptoms, which will happen if the disease does not manifest itself in any way or looks nonspecific. This situation requires further research processes.
A specific method used for diagnosis, including gradual curettage of papules along the layer.
By doing so, it is possible to identify the characteristic markers (psoriasis trio) that distinguish psoriasis from other diseases and make a final diagnosis:
- stearin traces; end membrane
- (pink epidermal cells);
- blood mist (drops of blood appear on the surface of plaque due to capillary rupture).
If necessary, the patient is tested as a sample of affected tissue.
X-rayif you suspect that arthritis is related to psoriasis.
If psoriasis is in an early stage, the diagnosis is not difficult: clearly visible osteoporosis.
In the later stage, joint space shrinks, erodes bone-forming patterns, fibrosis and inflammation around the bone.
If the disease is severe, the wrist joint and wrist joint will be destroyed, resulting in complete loss of mobility in the joint.
It should be noted that all tests performed are not only necessary for the final diagnosis but also to distinguish from other diseases, at first glance, they are identical.
Such diseases include: parapoid psoriasis, seborrheic eczema, lichen rosacea, atopic dermatitis, lupus erythematosus, rheumatoid arthritis and others.