Psoriasis - is persistent, chronic, to this day remains an incurable skin disease.It is a common permanent skin disease characterized by the appearance on the body of round red or pink areas of dry and flaky skin.They can occur anywhere, but mostly in the knees and elbows, and sometimes on the skin of the head and the upper part of the forehead.
common name of this disease comes from the Greek word psora, meaning "skin disease, scabs."Skin manifestations of psoriasis very typical: on the scalp, knees and elbows, lower back and in areas of skin folds are formed dense foci of inflamed scaly reddish, itchy.Dermatologists refer to these entities as "papular infiltrative elements reddish scaly plaques, peeling krupnoplastinchatoe, silver-polished."Sometimes these effects are so small that their patients do not notice, but a significant part of the skin is often affected.
In biblical times, the disease was considered a kind of leprosy.However, it is a disease of healthy people - it is not life-threatenin
Enhanced exfoliation of the skin in the affected areas occurs continuously or intermittently.Usually new scales are constantly produced in the deeper layers of the skin.From there, they rise to the surface layer - the epidermis, -where replace dead cells of the surface layer.This process usually takes about 28 days.However, in areas affected by psoriasis, new skin cells reach just four days, and excess accumulation of these cells leads to the appearance of the characteristic scales.
lesions may grow slowly or psoriasis attacks can be separated by periods when the disease recedes.The first attacks usually begin between the ages of 10 to 30 years.Sometimes psoriasis can cover the entire surface of the skin;In this case you should immediately consult a dermatologist for the purpose of treatment.Although most cases of psoriasis can be easily controlled with appropriate treatment and does not represent a serious threat to health, the disease can not be cured completely and itchy, and sometimes painful, the skin is preserved for life.
Psoriasis refers to skin diseases, skin manifestations since come to the fore.However, this is a systemic disease.When psoriasis affects not only the skin, but mucous membranes, skin appendages (hair and nails), musculoskeletal system.Violated function of internal organs and systems.
Do not try to immediately get rid of the disturbing elements of your skin, in any case do not try to "cure" their own.Seek qualified aid to specialist dermatologists.Modern medicine allows you to choose an adequate effective treatment even in the most severe forms of the disease.
infected by a patient with psoriasis can not be: the disease is not transmitted by contact.But the hereditary factor is not to be denied.It has long been observed that psoriasis frequently occurs in people whose relatives suffer from this disease.
Psoriasis is characterized by a chronic relapsing course.Relapses (exacerbations) of the disease usually appear in autumn and winter, with a lack of sunlight and dry skin.
disease, in which the observed peeling of the skin, was known in ancient times.According to A. Piasecki (1901), even in the Bible contained data on 10 cutaneous diseases (tuberosity, cheshuevatost, spotting, horny, inflammation, etc.).In the ancient Indian literature there is mention of the disease, similar to psoriasis.The ancient Greeks in the era of Hippocrates found rich dermatological terminology, but psoriasis is due to the variety of clinical options included in the different groups of diseases and designated as alphos, leichen, lepra and psora.Alphos term used in those cases where there were discolored patches of different origins: white patches in leprosy, scleroderma, psoriatic leucoderma.The term leichen (shingles) Hippocrates applied when dermatosis with an uneven surface of the skin and peeling, like the parasitic vegetation, vstrechayushimsya plants.The concept of lepra in ancient Greek medicine is not consistent with leprosy.This term is used to describe the disease characterized by thickening of the skin, peeling, itching.The term psora is closest to the current name of the disease.By this word the ancient Greeks understood pruritic dermatoses.
The ancient Greeks did not have a clear description of the clinical picture of psoriasis.And later among doctors terminological confusion existed for a long time.Celsus mention alphos (psoriasis) nails.Wilson called psoriasis alfozisom, and the term "psoriasis" refers to a form of scaly eczema.But in the presentation of clinical psoriasis is considered a pioneer of the Roman Celsus.
period errors when psoriasis was mixed with leprosy and other skin diseases, ppodolzhalsya until the XIX century.The classic description of the disease belongs to the Englishman R. Willan (1801), the founder of the English school of dermatology.It was first accurately described the symptoms of the disease, presenting the chapter on psoriasis scaly dermatoses, I spent the differential diagnosis between leprosy and psoriasis, as well as raised the term psoriasis, do not drink from the time of Galen.Willan distinguish two separate forms: discoid psoriasis and figured, described "chronic forms."Thanks to him, psoriasis took an independent position in the general classification of skin diseases.But he's kind of been a prisoner of terminological confusion of ancient authors.Many of his contemporaries continued to be confused with psoriasis, leprosy, squamous eczema and other diseases.
Only in 1841, Ferdinand Hebra (Hebra) combined two forms of psoriasis in a clinical and gave a clear description of the disease, which has not lost its value today.
most common form of the disease begins with small reddish rash on the skin, which are increasing and merging, covered with scales.In the process of peeling the surface flakes easily exfoliated, are denser, located at depth.When removing deep-seated scales bare skin starts to bleed.These initially small eruptions continue to proliferate, sometimes occupying a significant portion of the skin.
Psoriasis most often affects the outer surfaces of the elbows and knees, groin and genitals, scalp and nails.Lesions are often located on the body symmetrically.
Nails affected by psoriasis, have a characteristic point of the recess.Nail plate are loosened, thinner, beginning to crumble, and difficult to treat.
Psoriatic lesions are often located in the folds of skin groin and buttocks, armpits, genitals and under the breasts.
However, there are many forms of the disease.They vary in severity, duration, location, and appearance in the form of rashes.
Thus, in children and young adults often develop guttate psoriasis, where the skin after colds appear numerous small teardrop-shaped rashes and reddish color.Sometimes the rash spontaneously disappear within a few weeks or months.
Approximately 7% of patients develop psoriatic arthritis, in most cases having a heavy flow.Severity of arthritis in some patients depends directly on the degree of skin lesions, and for improving a decrease in cutaneous manifestations.
psoriasis suffers 1.5-2% of the world population.It meets as often as diabetes.The number of reported cases of psoriasis developed in Europe ranges from 1.4 to 2.8%.In dermatological clinics number of patients with this disorder is an average of 6-8% of the total patients.The prevalence of psoriasis play the role of geographic and ethnic factors.In tropical and subtropical climates psoriasis occurs much less frequently than in northern latitudes.People are sick of the white race of the cup, the yellow race - less frequently, the black race - rare, but people with red skin (Eskimo, South American Indians) psoriasis practically does not occur.Probably, this is different susceptibility to the disease is genetic.The disease can begin at any age, although its manifestations in infants and elderly people are rare.In adults, often psoriasis occurs equally in both men and women.
calculated the so-called "cumulative" score disease psoriasis, that is, the risk of developing the disease throughout their lives.In Russia, the "cumulative" score was 2.25% for men and 2.15% for women.
In recent years, there was a trend to an increase in the number of young patients with advanced, complicated, often continuously relapsing forms of psoriasis, requiring hospital treatment 5-6 times a year for many years.Many cases of the psoriasis resistant to conventional treatment regimens, and interrecurrent periods are much shorter.
true nature of the disease is still unknown.One possible reason could be a violation of the function of white blood cells and, as a consequence, inflammation of the skin.As a result, the skin cells begin to divide very quickly - every 3-4 days.And that is why - is still in question.Try to understand what is it that is important for the occurrence of this disease.
Familial occurrence of psoriasis clearly indicates that hereditary factors are significant in the manifestation of the disease.According to epidemiological studies, the overall probability of the disease psoriasis children from their parents without psoriasis is 12%.If one parent is sick with psoriasis, it rises to 20% if both parents are sick - 50%.If one of the identical twins sick with psoriasis, the risk of disease in the second 90%.
In his book "Journey to the Maclay Coast" NN Maclay describes the most common skin diseases among the Papuans, including psoriasis and family, who met in those regions often enough."Since this disease is inherited, it can be seen sometimes in infants over the years ... it rather quickly spreads throughout the body.Psoriasis is almost not considered a disease, men, patients with psoriasis, choose their wives are often affected by the same disease, and it is natural, therefore, that the majority of infants are traces of the same disease. "
But some nationalities in Nigeria and the Eskimos, the northern and southern American Indian psoriasis is rare, which is also, apparently, due to genetic factors.
But as psoriasis do not necessarily appear in children of parents with psoriasis, it is not so simple to heredity.Doctors speak of a "multifactorial" or "polygenic" heredity of psoriasis.This means that for the manifestation of the disease should not only the combination of different genes, but also the influence of some environmental factors.
intensity of endogenous skin ready for psoriatic reactions, endogenous impetus to the rash depends on the temporal fluctuations.There are three different stages in the development of psoriasis vulgaris.
genotypic or latent (hidden) psoriasis.The individual probably carries a polygenic associated psoriatic reaction (psoriatic diathesis and disposition), which, however, is not clinically manifested.The possibilities for diagnosis do not exist.
Genofenotipny preclinical or psoriasis.Special methods can be used to establish changes in clinically normal skin, which indicate pre-clinical disease, such as epidermal posleranevaya giperregeneratsiya, increased glycolysis in the epidermis, changes perspiration, or accumulation of lipids on the skin surface, or an increase in macrophages in the dermis.The clinical manifestations of the disease is not present.
phenotypic or symptomatic psoriasis.In these cases, there is overt clinical psoriasis.Here, modern techniques allow us to establish changes on clinically normal skin in comparison with the norm.Psoriasis treatment can be targeted at the disease translation from its phenotypic to genotypic phase of psoriasis.The final recovery is impossible, so it is clear that after the disappearance of cutaneous manifestations of psoriasis are new elements constantly emerge in the future.The appearance and number of elements depends on endogenous shock to the rash for a particular patient, and from exogenous (or endogenous) precipitating factors.
When inheriting psoriasis are particularly important age at initial appearance of the disease and the association with molecules of the major histocompatibility complex (HLA-antigens).Since the onset of the disease is possible at any age, disease age shows a bimodal distribution with a maximum frequency of the disease in women from 16 to 60 years for men - from 22 to 58 years.Patients with psoriasis have significantly increased the availability of antigens HLA-A2, B1 3, B27, Bw57, Cw2, Cw6, DR7.According to the correlation of age diseases and HLA type nepustuleznogo psoriasis are two types of psoriasis.
Psoriasis type I with early onset (before age 40) is associated with HLA- antigens Cw6, B13, Bw57, DR7, as well as a reduced number of Cw2 and A30.Psoriasis type I vetrechaetsya in 2/3 patients (75%) and shows the frequency of the family: 10% astonished siblings, or 15% of the children.If one parent has a type of HLA-A2 antigen, B13, Cw6 or HLA- A2, Bw57 and Cw6, psoriasis sick even more than 30% of children.The course of disease in psoriasis type I in most cases more severe than in type II.
Psoriasis type II with late onset (over 40 years).There HLA association is weak (Cw2 - 27%, B27 - 26%, Bw6 - 31,8%).The family rate is not the disease.In contrast to the first type of nail infections occur bowl and joints.
primary manifestations of psoriasis after acute infectious diseases or after vaccination are described often enough.Upper respiratory tract infections (acute tonsillitis, bronchitis) with betagemoliticheskimi streptococci type A (as well as the groups and the G), are often primary factors provoking psoriasis in children.The existing psoriasis may worsen infection of the upper respiratory tract.
Various drugs (antimalarials, lithium, beta blockers) and allergic reactions to drugs can trigger psoriasis, enough for this application, even the beta-blocker in the form of eye drops.Cancel systemic glucocorticoid therapy may also lead to a deterioration of psoriasis.
not exclude the possibility of influence of infectious virus in the genetic apparatus of human cells with subsequent breach of the code of hereditary information - the creation of new genomes of transformed cells with modified hereditary properties that can assume viral and genetic origin of the disease.
can be assumed that the amplified epidermopoez due to the influence of the virus in the genetic apparatus of cells, causing impaired genetic control of biochemical processes that occur enzimopatii that cause latent (hidden) course of the disease.
However, changes in the cell genetic apparatus still does not entail the development process, and creates a predisposition to psoriatic disease.Under certain conditions, under the influence of provoking factors of the disease becomes the manifest.
not only the cause but also the sequence of the development of pathological changes in the human diseased psoriatic skin and in his body has not yet been fully elucidated.It is possible that under the name of "psoriasis" is hiding a group of diseases.
At present, the following picture of events.For some unknown reason, is superficial epithelial skin cells begin to divide at a tremendous speed.The cell cycle, that is, the process of maturation of epithelial cells decreased from 311 to 36 hours!As a result, keratinocytes produced approximately 20-30 times greater than normal.Than it can be caused by?The most likely trigger factor is considered to be an inflammatory reaction of the skin and acceding immune disorders (proof of this is a very rapid onset of remission in the treatment of immunosuppressants).