Psoriasis – what type of disease is it?

Despite the fact that psoriasis is a common disease and has been known for a long time, it has not been fully researched.And patients are often unaware that psoriasis is not a bacterial or fungal infection but a dysfunctional response of the immune system, caused by unknown causes.Information about the causes and symptoms of psoriasis will be very useful for the patient because it will help overcome the disease.

What kind of disease is this?

Lichen sclerosus is another name for psoriasis and it describes the disease perfectly.Psoriasis is manifested by the formation of inflammatory plaques of various sizes on the skin, densely covered with thick scales.

Surely almost everyone has heard of a disease like psoriasis.And this is not surprising, because scaly lichens are quite common.This disease is diagnosed in 4-10% of the world's population.Furthermore, statisticians who collect information on the incidence of psoriasis claim that the number of patients is steadily increasing.

Scaled lichens have been known to humans since ancient times;even ancient Greek healers tried to treat this disease.The modern history of psoriasis research dates back about 150 years.But during this critical time, researchers have not been able to fully understand the causes and treatments of psoriasis.

Wide prevalence, uncertainty about etiology (reason for appearance), ineffective treatment - all this characterizes psoriasis as one of the most difficult problems of dermatology.

Today, dermatologists consider psoriasis a complex systemic disease associated with dysfunction of the immune system, with failure of metabolism and the appearance of nutritional disorders.The result of these failures are specific changes in the skin.

Therefore, when answering the question of what psoriasis is, modern dermatologists will answer that these are disorders of nutrition and skin metabolism due to malfunctions in the functioning of body systems.Today, two hypotheses about the cause of psoriasis are considered the most likely: genetic and viral.

• The genetic theory is supported by many, as psoriasis often behaves as a genetic or familial skin disease.A thorough examination of the patient's family history will confirm 60-80% of the presence of psoriasis in one form or another in the patient's relatives.However, in some patients the actual genetic origin of psoriasis cannot be confirmed.This circumstance is the reason for separating these cases into a special group, in which the main cause is not genetic but rather a phenotypic error.
• The viral theory, according to which psoriasis develops due to infection, has its supporters.Confirmation of information about the viral origin of psoriasis is the detection of antibodies in the patient's blood, as well as "primary bodies" in the cells of the epidermis.According to this theory, psoriasis develops not only in case of viral infections but also in the presence of certain conditions.

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

For example, pathologies affecting the liver lead to a huge decrease in the quality of blood filtration performed by this organ.And this can cause the appearance of various skin lesions, including psoriasis.

Pathologies that affect the liver (hepatitis, primary cirrhosis...) lead to the degeneration of this organ's tissues, meaning the liver is gradually replaced by connective tissue.As a result, the liver stops performing its cleansing 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 often accompanied by fatty degeneration that affects the liver.Therefore, in the treatment of this skin disease, it is important to follow a diet that does not unnecessarily burden the liver.Patients are advised to limit fatty foods and completely eliminate alcohol.

Therefore, despite a lot of research, it is still impossible to get an exact answer to the question of what psoriasis is.However, work continues so it is possible that the mystery of this mysterious disease will be solved and we will learn a lot about cutaneous psoriasis.

Classification according to the international system

Psoriasis manifests in many different forms.To make it easier for professionals to navigate, a widely accepted classification of psoriasis will be used.

Psoriasis is also included in the International Classification of Diseases (ICD) system.Today, the 10th revision of the international disease registry is in use, which is why the abbreviation ICD 10 is used.Work on the 10th revision of the International Classification of Diseases began in 1983 and was completed in 1987.

In essence, ICD 10 is a standard assessment tool used in medical and healthcare management.The 10th revised reference book is used to monitor the incidence 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 allows obtaining statistical data and systematizing diagnostic information.By agreement of WHO members, ICD 10 is used to assign codes to many different diseases.In version 10 of the classifier, alphanumeric codes are used, which make it convenient to store information in electronic form.

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

• psoriasis common(synonym: vulgar, simple, plaque-like).The disease is coded according to ICD 10 – L-40.0.This is the most common form, it is observed in 80-90% of patients.The main symptoms are the formation of raised patches on the surface of the skin that are unchanged, covered with gray-white skin scales.This form is characterized by slight peeling of the scales.After removing them, the red, inflamed skin will be exposed, which can be easily injured and begin to bleed.As inflammation progresses, plaques can increase significantly in size.
• Inverse psoriasis.This is a disease that affects the folds of the skin (curved surfaces).For this form of the disease, the ICD 10 code is L83-4.Dermatosis appears with the formation of smooth or less flaky folds on the skin.The condition gets worse when the skin is damaged by friction.The disease is often complicated by streptococcal or fungal infection.
• Guttate psoriasis.This form of psoriasis is characterized by the formation on the skin of a large number of small red or purple spots shaped like water droplets.According to the 10th edition of the international classification, this disease receives code L4.Most often, guttate psoriasis affects the skin of the feet, but the rash can also occur on other parts of the body.At the same time, it is known that guttate psoriasis develops as a complication after streptococcal infection - pharyngitis, tonsillitis, etc.
• Purulent or exudative psoriasis– This is a form of severe skin damage, according to ICD 10 codes L1-3 and L 40.82.Characterized by the formation of blisters or pustules.The damaged skin area is swollen, red, inflamed, and peels easily.If fungi or bacteria enter a pustule, the substance inside the pustule will contain pus.Pustular psoriasis usually affects the distal parts of the extremities, but in the most severe cases, a systemic process can develop with a rash spreading throughout the body.
• Psoriatic arthritis or psoriatic arthritis.According to the 10th edition of the ICD, the pathology is coded L5.Manifested by arthritis.Psoriatic arthritis can affect all types of joints, but in most cases, the joints on the toes and hands become inflamed.The knee, hip or shoulder joints may be affected.The injuries can be so severe that they lead to disability in the patient.Therefore, you should not think of psoriasis as just a skin disease.Severe types of psoriasis can lead to systemic damage, disability, or even death for the patient.

• Erythrodermic psoriasis.As a rare but severe type of psoriasis, according to ICD 10 this disease receives code L85.Erythrodermic psoriasis often presents in a generalized manner;The affected area may include all or nearly the entire skin surface.The disease is accompanied by intense itching, swelling and pain.
• Psoriatic psoriasis or nail psoriasis.According to version 10 of the ICD, the disease has code L86.The pathology is manifested by changes in the appearance of the nails on the toes and fingers.Nails may change color, become thicker, and begin to break.Complete loss of nails is possible.

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

• Limited psoriasis is a disease in which less than 20% of the skin is affected;
• Extensive psoriasis affecting more than 20% of the body surface;
• When almost the entire surface of the skin is affected, we are talking about systemic psoriasis.

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

Stages of flow

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

The advanced stages of psoriasis are characterized by the following:

• the appearance of a new rash;
• growth of existing plaque;
• the appearance of new rash elements at the site of skin damage (scratches, scratches);
• Excessive peeling of existing plaque.

The following symptoms are characteristic of the stable phase of psoriasis:

• lack of appearance of new elements;

• moderate peeling of elements;
• There are no signs of elemental growth.

The appearance of folds in the stratum corneum around the particles is a sign of the transition from the stationary phase to the regressive phase.

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

• reduces the intensity of peeling;
• element resolution

After resolution of psoriatic plaques, hyperpigmented or hypopigmented spots remain in their place.

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

• winter (aggravated in autumn and winter);
• summer (with exacerbations during warm periods);
• Non-seasonal psoriasis is the most severe type, because there is no clear connection between relapses and the seasons, so periods of remission may be practically absent.

Diagnostic features

If psoriasis has a typical clinical picture, diagnosis will not be too difficult.However, this disease is often disguised as other diseases.

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 must also be different.

A layperson may mistake it for fungal and skin psoriasis.Because mycosis (skin fungus) manifests itself with similar symptoms - the formation of peeling patches.Therefore, if you notice suspicious symptoms on your body or nails, you do not need to self-diagnose and start treating the fungus with pharmaceuticals or folk remedies.

If the diagnosis is wrong and in fact the cause of the symptoms is not fungus but psoriasis, treatment will not be beneficial and will on the contrary worsen the symptoms.

When a dermatologist is contacted, a fungal test will be performed and a scrape sample taken from the nail or skin.The resulting material is then placed in a nutrient medium.If fungi are present in the material, after a few days a large colony will develop in the test sample.Based on the appearance of the material, it is possible to understand which fungus caused the infection.

Sometimes psoriasis is complicated by secondary infections, which can be bacterial or fungal.Therefore, patients with altered clinical manifestations (appearance of pus, change in plaque color, etc.)You will have to be tested periodically for fungus and other infectious agents.

During the diagnostic process, a certain role is assigned to a set of phenomena known as the psoriasis triad.The symptoms appear sequentially when part of the rash is scraped off.

The psoriasis triad manifests as follows:

• When scraping a portion of the rash, the scales are removed in the form of “chips”;
• After removing the chips, a thin transparent film similar to polyethylene is exposed;
• When the membrane is damaged, bleeding will occur.

A dermatologist diagnoses psoriasis, but if necessary, the doctor can refer the patient for consultation with other specialists - rheumatologists, gastroenterologists, surgeons, etc.

Interesting facts about psoriasis

People have known about psoriasis since ancient times.Even the name of this disease appeared in our language from ancient Greek.During the prosperity of ancient Greece, the word “psora” meant all skin diseases that manifested 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 “De medicina” there is an extensive chapter devoted to this disease.

They knew about psoriasis, but the disease was not clearly evaluated, as it was called the “royal” or “devil” disease.

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

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

Modern concepts about this disease

It must be said that modern science does not know much about this mysterious disease.There are many different theories about the origin, progression and treatment of psoriasis.

Here are some facts about psoriasis that experts cannot doubt:

• Although the cause of the disease is still unclear, we have figured out the nature of psoriasis.This disease is autoimmune, meaning it occurs due to a malfunction of the immune system;
• Another fact about psoriasis: it can be hereditary.However, this is not always the case;Even if both parents have the disease, their child's risk is 65%.At the same time, some patients develop psoriasis, even though none of their relatives have the disease;
• An interesting fact about psoriasis is that the disease is characterized by the Koebner phenomenon.This phenomenon manifests itself in the fact that elements of a rash form in places of skin damage - scratches, burns, frostbite.Sometimes psoriasis appears after a while, at the site of the scar;
• An important observation that allows us to gain more information about psoriasis is the relationship of this disease to climatic factors.Exacerbations and relapses are often timed to coincide with the change of seasons;
• Patients have probably noticed in practice the connection between exacerbations and stress.All patients should be certain that the disease relapses or worsens due to nervous tension and anxiety;
• A new reality about psoriasis is that it can begin at any age, although it was previously believed that psoriasis appears after age 30;
• It is important for everyone to know that psoriasis is not a contagious disease.Even in close contact with the patient there is no risk of infection;
• Most people have heard about psoriasis being incurable, and this is true because no treatment has yet been found that can guarantee defeating the disease.But patients should know that psoriasis can be controlled.Adequate and timely treatment allows you to achieve lasting remission.

Modern treatment methods

When talking about common psoriasis, we cannot help but talk about treatment methods for this common disease.It must be said that psoriasis cannot be cured with pills or ointments alone.

To forget the symptoms of psoriasis for a long time, the patient needs to make efforts in close cooperation with the doctor.It will be necessary to organize food properly.Some experts say that you can forget about psoriasis forever only with the help of a proper diet and regular body hygiene.

The doctor will outline a preliminary regimen for treatment.As a rule, external (ointments, creams) and systemic (pills, injections) treatments are used.In addition, physical therapy methods will be used and encouraged at the resorts.Psoriasis should be treated with healing mud, mineral water and hot water.

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

Resorts may offer other treatments for lichen planus.Examples include leech therapy, baths and healing applications, sun therapy, etc.

You will need to be prepared for the fact that the treatment regimen will change periodically.Because not all methods are suitable for a particular patient.If the chosen treatments do not work, they will need to be replaced.

Traditional psoriasis treatments are also widely advertised.Indeed, some of them can help achieve remission.However, when choosing a method, you need to pay common attention so as not to harm your health.If in doubt of any formula or recommendation, it is better not to use it.Consult your doctor before using any treatment.

You need to understand that it is possible to forget about psoriasis forever only if the patient himself and his surroundings are in a positive mood.Only faith in success and an optimistic attitude will help defeat this mysterious and insidious disease.