A characteristic feature of psoriasis is the preferred position of papules symmetrically on the skin of the extensor surface of the hands and feet and scalp.
Despite the fact that the leading role in the development of psoriasis is the presence of genetic predisposition (psoriasis refers to diseases that are inherited), the impetus for the emergence of the disease can serve a multitude of exogenous and endogenous factors (the development of psoriasis in the nervous system, endocrine disorders after infectious diseases and t.. d).
The etiological factors of the disease
The disease has no sex predisposition, therefore, the frequency of occurrence of psoriasis in men and women is no different. In 12 percent of patients with the disease first develops up to ten years. Twenty years before psoriasis develops into forty-six percent of patients, and up to thirty years at sixty percent.
In the development of psoriasis there are two age peaks:
- twenty-seven and fifty-four years for men;
- fifteen and fifty-four years in women.
Causes of psoriasis in adults
The exact cause of psoriasis is unknown. The leading role in the pathogenesis of the disease belongs to genetic predisposition. Also, a significant role is played by the occurrence of immunological instability, lipid disorders and if the patient foci of chronic infection.
In favor of genetic theories (inherited causes of psoriasis) is evidenced by the fact that the disease is always found not only the patient but also his relatives.
To identify a predisposition to psoriasis can be when conducting a classical analysis of the genome. These patients may be ten loci of the chromosomes responsible for genetic predisposition to the disease (PSORS 1 through 9, as well as HLA – B27, 17, etc.).
The main gene responsible for maximally expressed an innate tendency to develop the disease, think of PSORS1.
Also, in the pathogenesis of psoriasis play an important role of genetically determined disorders of metabolism of carbohydrates and lipids. In the majority of patients with psoriasis reveal severe hyperlipidemia and metabolic syndrome. In this regard, in patients with psoriasis, there is a high risk of severe early atherosclerotic vascular lesions and cardiovascular pathologies.
In addition to hyperlipidemia, noted the disturbed metabolism of fatty acids (fatty acids), increased production of free radical compounds that are involved in keratinization of the epidermis, etc.
In the study of psoriatic plaques revealed a large concentration of oxidized low-density lipoprotein.
The main markers that allow to evaluate the proliferation of keratinocytes in psoriasis outbreaks are protein Ki67 and keratin, six, sixteen and seventeen. These markers identified are responsible for the processes of hyperplasia, disorders of differentiation of cells and development of inflammatory reactions in the dermis.
Due to this, even with the onset of the stage of clinical recovery in psoriasis (disappearance of inflammation of the epidermis), can persist inflammatory process in the blood vessels of the dermis.
Also, in the development of inflammation in the outbreak of psoriasis play a role of activated T-lymphocytic cells, mediators of inflammatory reactions, inflammation in the microvasculature. In the study of the microflora of the skin in patients with psoriasis reveal streptococci, which provoke the development and exacerbation of guttate psoriasis.
Immunological basis of pathogenesis of psoriasis is the progression of immunocompetent cells, activated CD4+ T-lymphocyte cells and cytokines with anti-inflammatory action. In favor of this theory suggests that monoclonal antibody for psoriasis, which act against activated CD4+ T-lymphocyte cells have a significant therapeutic effect. Also, effective remedy for psoriasis are drugs aimed to inhibit the production of factors tumor necrosis.
Contagious psoriasis to others
No. Psoriasis is a genetic disease.
Whether psoriasis is passed from person to person
No. To get psoriasis from another person is impossible. Despite the fact that streptococcal infection can be a precipitating factor, a person without a genetic predisposition to the disease, psoriasis will not occur.
Whether psoriasis transmitted sexually
No. Psoriasis is not contagious and is not transmitted, neither airborne, any contact, either sexually or in any other way.
If passed, the psoriasis hereditary
For the development of psoriasis requires a genetic (hereditary) predisposition. Therefore, the disease is often found in close relatives. In the presence of psoriasis in the parents, there is a high risk of psoriasis and have a child.
However, some authors isolated psoriasis is the second type. It is assumed that this variant of psoriasis that develops in patients after forty years and which affects mainly the joints and the nail plate that is not associated with heredity.
Can you die from psoriasis
No. Psoriasis is not life threatening disease. The prognosis in these patients is favorable.
However, psoriasis can seriously impede the full life of the patient, causing him a lot of discomfort and reducing its social activity.
Also, it is worth noting that pustular psoriasis can occur is very difficult, accompanied by emptying and suppuration of the pustules, with a further falling away of the skin the type of "purulent lakes". In this case, perhaps the development of the erythroderma, secondary bacterial complications of joint damage and t.. D.
Triggering factors of psoriasis development
Aggravating factors contributing to exacerbations of psoriasis are:
- injuries of the skin;
- endocrine disorders;
- the emergence of metabolic disorders;
- the use of drugs, beta-blockers, anti-malarial CP-and t.. d;
- the presence of foci of chronic infection (particularly streptococcal infection);
- the abuse of alcohol;
- excess sun exposure;
- eating spicy, sweet, fatty food etc;
- acute infectious diseases;
- exacerbation of allergic diseases;
- stress, emotional overload (psoriasis nerves becomes aggravated more often).
The classification of psoriasis
Of the species isolated forms of psoriasis:
- vulgaris (common psoriasis);
- chronic Palmar-plantar;
The disease can wear the progressive, stationary.
On the extent of the lesion distinguish limited, common and generalized flow.
Also there may be a seasonality of exacerbations: winter, summer, and indeterminate (non-season) exacerbation of psoriasis.
Pictures, symptoms and treatment of psoriasis in adults
For psoriasis characterized by the appearance of pinkish-red or bright red papules, covered with silvery, white scales, loose consistency. Itchy skin may be missing. Many patients noted the appearance of a sensation of tightness of the skin.
Intense itching characteristic, as a rule, to psoriatic lesions of the scalp and the perineum.
The appearance of pain in the joints observed in the development of psoriatic arthritis.
The most typical manifestation of psoriasis is a triad of specific symptoms :
- the emergence of the phenomenon stearin spot (strengthening of peeling during the diagnosis of psoriatic papules, whereby it becomes similar to a drop of stearin);
- the appearance of the terminal films (the appearance of a thin transparent film which remains after when poskablivanii will be separated all the peeling);
- the appearance of blood dew or the appearance of pinpoint bleeding at the site of the rejection terminal of the films.
Psoriatic papules can wear isolated or merge. The size can vary from fine - to that covers a large surface of the skin. The most common localization of papules are the elbows, knees, head (scalp) and back.
In rare cases, plaque can affect the mucous membranes of the lips and oral cavity.
In children, elderly patients and individuals with diabetes may develop a folded form of the disease. In this case, the affected skin behind the ears, armpits, crotch, buttocks, around the navel and under the Breasts.
Patients with this psoriasis can be no peeling. Surface psoriatic lesions may be smooth and bright red. In some cases, it may cause maceration of the folds.
In some patients the only manifestation of the disease may be plaques on the skin and genital mucosa.
Usually psoriatic skin lesions are symmetrical in nature, but some patients may experience unilateral rash. You may also receive curly psoriatic lesions (annular, arcuate, geographical, etc.).
In patients with a long flowing disease long-existing plaques on the skin of the lumbar and gluteal region may be accompanied by the appearance of warty growths.
In addition, the reasons for the appearance of verrucous psoriasis can include:
- purulent infection of the skin;
- wrong external treatment (usually self);
- the excess body weight.
When warty forms of the disease, the scales begin to stick together among themselves, forming on the surface of the plaques yellow crust.
Some patients may occur in isolation occurring Palmar-plantar psoriasis. In this case, the patient concerned about painful cracks, pustules, papules, erythematous-squamous plaques on the palms and soles.
Frequent manifestation of psoriasis is the lesions of the nail plates. In most cases, the appearance of dotted recesses on the surface of the nail (dystrophy). Also can appear the deformation of the nail, longitudinal and transverse furrows, thickening of the nail plate, it is loosening and changing colors, bleeding under the nail plate.
In erythrodermic psoriasis, which usually develops on the background of excessive sun exposure or improper topical treatment is a pronounced swelling of the skin, redness, intense itching and flaking, fever, weakness, and loss of appetite. In severe, it may cause anemia, heart failure, and disorders of the kidney and liver, is dehydrating, alopecia areata.
Psoriasis and pregnancy is a threat to the child, especially
Psoriasis does not violate the reproductive function and are not contraindications to pregnancy. It is worth noting that many women during pregnancy, the disease is easier than normal. However, about twenty percent of women may be expressed exacerbation of the disease.
In General, psoriasis does not complicate pregnancy and threatens the life of a child. However, in patients with arthritis, by increasing the load on the joints, there could be significant deterioration. In generalized forms of pustular psoriasis, the possible emergence of secondary bacterial complications.
It should be noted that since psoriasis is not true for contagious diseases, the mother is allowed contact with the child and breast-feed it. The likelihood of developing psoriasis in the future is equal to about 15-20% if ill only one parent and approximately 50% when both parents are sick.
The main difficulty in the treatment of psoriasis in pregnant women is that they are contraindicated in most assigned medications. Therefore, when planning pregnancy should inform her doctor so he adjusted the treatment.
Self-medication is strictly prohibited and may cause significant harm to both mother and child (some drugs have toxic effects on the fetus).
Diagnosis of the disease
The diagnosis put on the basis of specific symptoms (psoriatic triad). And also, if necessary, the data of histological, immunological, and radiological studies.