Diagnosis of psoriasis: methods, tests, treatment

One of the most common skin diseases is "scaly lichen" or psoriasis. According to statistics, it occupies 15% of dermatological diseases. 3% of the world's population suffer from this disease, most often in regions with a cool climate. The tendency of development of severe forms of the disease is increasing. Recently, the diagnosis of psoriasis is becoming relevant not only for adults, the incidence of this diagnosis has increased in very young people, and even in children. Until now, all causes of this disease have not been revealed.

What is psoriasis

Psoriasis, a clinic and diagnosis of which is known to every dermatologist, is a chronic skin disease. Characterized by the presence of red outlined patches, which are covered with scaly silver scales. With time, the activity of the disease fades. The disease mainly affects the skin, although there are cases of illness of other organs, in particular joints and nails.

Although psoriasis is called "scaly lichen," unlike other types of lichen, the disease is not contagious. The triggering mechanism of the disease is a process that occurs in the epidermis. In the deep (basal) layers keratinocytes are formed, then from them keratin - a protein, from which nails, hair, skin are built, should be produced. Keratinocytes in normal development from the bottom to the upper layer move imperceptibly, for about a month.

In patients with psoriasis, keratinocytes multiply too quickly and move to the top layer in 4 days. The skin is not able to get rid of these cells so quickly, their number is constantly growing, and dry, condensed patches on the skin appear in the form of plaques. In this case, the lower layer of the dermis, where the blood and lymph vessels pass, nerves, inflames, swells. Diagnosis of psoriasis will help to correctly establish the type of disease.

Types and symptoms of the disease

Different types of disease can occur in different ways, follow one at a time or simultaneously. There are several types of psoriasis:

• Spotted. The most common type. It manifests as rashes on the skin, first it covers small areas, then grows, appears in the same places of the body from the opposite side. This type of disease is possible after a certain viral or streptococcal infection, after treatment with corticosteroids. Small spots, increasing, turn into plaques, unite in large areas. If damaged, minor hemorrhages are possible (Auspitz sign). Places of defeat: knees, elbows, legs (lower part), palms, hips, calves, waist. In 50% of patients psoriasis of the scalp is observed, plaques appear along the border of hair growth. Diagnosis of psoriasis in children is carried out mainly in the same ways as in adults.
• Teardrop-shaped . A rare form of ailment. Plaques appear suddenly on the legs, hands, on the head. They often disappear by themselves, but can again arise in stressful situations.
• Reverse . This form is difficult to treat. Inflamed, smooth areas appear in the folds of the body (under the chest, underarms, in the inguinal zone).
• Seborrheic . The spots are red scaly patches located above the scapula, behind the ears, under the armpits, in the groin and on the face. The treatment lends itself hardly. In the diagnosis of seborrheic psoriasis, attention is paid to the fact that, despite the long-term damage to the skin, there is no alopecia, hair thinning.
• P soriaz nails. With this type of legs and hands, the nail plates change color, exfoliate. Often this kind of psoriasis is associated with psoriatic arthritis. Usually, the diagnosis of psoriasis of the nails is carried out without difficulty. Sometimes a histological examination is performed.
• Psoriartritichesky arthritis. Inflammatory disease, which leads to inflammation and stiffness in the joints. It is divided into several types: symmetrical, asymmetric, mutilic.
• Psoriatic erythroderma . Heavy, rare form, in which almost the entire body is covered with a red scaly crust.
• Pustular. Pustules are formed on the legs and hands. This species can manifest itself, or be associated with another form of psoriasis. In the latter case, it is very dangerous.

Causes of the disease

Etiology, the clinic (diagnosis of psoriasis does not cause problems) have long been studied, but the reasons for which the disease occurs are still being investigated:

• Medicine claims that psoriasis occurs when there is a malfunction in the immune system, with various factors that are responsible for the correct division of skin cells. Invalid immune responses cause inflammation and a dramatically increased production of immature cells.
• Heredity plays a big role in this disease. 35% of patients have these problems genetically. The genetic factor is the leading cause of psoriasis.
• A big role is played during the disease by weather conditions. In dry, dry weather, an outbreak can occur. Some suffer photosensitivity and relief is experienced only in the winter, when the sun's rays are much smaller.
• Strong emotions, stress. Relapses of psoriasis occur with stress, emotional disorders, depression and anxiety.
• Infections. Some bacteria and viruses are capable of provoking the appearance of psoriasis, these can be streptococci, affecting the upper respiratory tract. Often, the transferred pharyngitis, tonsillitis, sinusitis in adolescence becomes the cause of drop-shaped psoriasis. It is associated with psoriasis and HIV, and in some cases HPV (human papillomavirus).
• Skin trauma. A similar reaction of the body is called the phenomenon of Kebner, when the skin is damaged in the form of red lines. In these places, the appearance of psoriasis. It can also develop in areas that have not been affected by trauma.
• Medicinal products are capable of provoking psoriasis, these are: ACE-preparations, beta-blockers, chloroquine, lithium, NSAIDs (indomethacin), hormone progesterone, various steroid ointments that cover large areas of the skin.

Methods for the diagnosis of psoriasis

The doctor who establishes the disease, takes into account:

• Clinical picture of the disease;
• Presence of the Kebner phenomenon;
• Symptomatology of the psoriatic triad.

Diagnosis of psoriasis relies on psoriatic triad - these are emerging phenomena when scraping plaque. It can be a phenomenon:

• Stearin stain, scraping the papule, you can observe the ecdysis, which looks like a mashed stearin;
• Point bleeding, after scraping the terminal film appear individual droplets of blood;
• Kebner, new rashes appear in places of irritation, especially in the acute phase of the disease.

Sometimes a histological examination is required for certain changes.

Blood tests

If the doctor is difficult to diagnose by external signs, a laboratory diagnosis of psoriasis is assigned, the following tests are included:

• The general analysis of blood , it does not include the leukocyte formula and ESR. Often, psoriasis is a companion of anemia and leukocytosis.
• Rheumatoid factor helps to detect a protein, the level of which increases with any inflammatory phenomena. In psoriasis, the result should be negative. This is its difference from rheumatoid arthritis, when this factor rises.
• ESR (sedimentation rate of erythrocytes). This indicator should be normal. Exceptions are cases of pustular psoriasis or psoriatic erythroderma.
• Uric acid . In psoriasis, this indicator increases. Psoriatic arthritis resembles gout, which is characterized by an overestimation of the concentration in the blood of uric acid. In this case, a complete diagnosis of psoriasis is necessary, the analyzes are one of the stages.
• Antibodies to HIV . This infection often causes sudden symptoms of psoriasis.

Psoriasis: differential diagnosis

In clinical practice, there are often situations where similar symptoms resemble different diseases. It is necessary to distinguish one condition from the like, this is helped by differential diagnosis of psoriasis. Externally similar in the first signs of psoriasis and red lichen. To assign adequate therapeutic measures, the doctor should clearly know the distinctive features. Performing an examination, the doctor sees typical papule aggregations, which are covered with white silver scales, they then form psoriatic plaques. Pathological elements bordered by a red corolla, which is called the rim of Pilnov, he indicates that there is a progression of psoriasis. Differential diagnosis allows us to identify this. It is not difficult to establish a diagnosis after carrying out a scraping (scraping), which make it possible to detect the phenomena that enter the psoriatic triad.

Disease severity

Psoriasis, diagnosed and treated in every dermatological clinic, has a different severity of the disease. Starting from one, two papules, psoriasis develops to a post-stage type, sometimes it represents a life threat. There are several degrees of severity of psoriasis:

• Mild psoriasis . Cases when the skin surface on the body is covered by 3%, most often affects only 2% of the skin.
• Moderate psoriasis . The skin is affected by 3-10%.
• Severe form of psoriasis . In this case, the disease affects 10 or more percent of the skin. Measures the severity of the effect of the disease on the patient's quality of life.

Another classification is also proposed, which assumes a two-tier system, according to which patients are divided into those who need systemic and local treatment.

Common and severe psoriasis is harder to treat. Some forms are very resistant to treatment, even if they do not belong to heavy ones. This includes:

• Psoriasis on soles and palms;
• In the folds of the skin (reverse psoriasis);
• Psoriatic arthritis;
• Psoriasis affecting the scalp.

Treatment of psoriasis

Treatment of severe and moderate forms of psoriasis includes such methods as light therapy, systemic drugs, combined and excimer laser therapy, which are often very effective.

TNF inhibitors reduce the activity of immunity factors, help with severe forms of psoriasis, but complications may occur in other infections.

"Ustekinumab". This agent contains monoclonal antibodies. It helps with severe and moderate forms of the disease. Studies of the drug are still being carried out, at the moment positive qualities are revealed.

There are newer drugs that are not yet fully understood. Preliminary studies indicate a positive trend. There are methods that are not approved. The use of various ointments, sprays, creams can alleviate the symptoms of psoriasis. The clinic, diagnosis, treatment of the disease are described by many medical scientists. They distinguish three main treatment options for the disease:

• Local remedies (creams, shampoos, ointments, sprays).
• Drug treatment. The drugs used (injections, tablets) affect not only the skin, but also the entire body.
• Phototherapy. Light is used for treatment.

For each person, treatment is selected separately, taking into account all the individual characteristics of the body, as well as the type and form of the disease.

Alternative methods

Those who suffer a protracted course of psoriasis, try to find some alternative, non-traditional methods of curing the disease. But it is worth remembering that this is not an ordinary skin pathology, although it resembles lichen. The reason is inside the body. The choice of treatment is best entrusted to the doctor.

For example, it was found that green tea slows the growth of skin cells, but studies have so far only been carried out on animals. What kind of reaction the human body will give, it is not yet known.

Non-traditional methods offer some herbal preparations for the treatment of psoriasis, but clinically confirmed data on their effectiveness is still not there.

It is not necessary to use on yourself again heard some national remedy, it is necessary to be convinced, having consulted with the doctor, that it will not cause your body even more harm.

Plant products, as well as dietary supplements are not controlled by the system, so the permission to sell them to manufacturers is not required. Do not forget that any substance of vegetable origin also has its side effects, in some cases can even cause damage to health.

Sometimes patients have real problems after using natural remedies.

The efficacy of agents containing zinc pyrithione is doubtful. In many countries, this connection is even forbidden to use, but, unfortunately, such means are available on the Internet.

Used to treat Gotu Cola in the form of a cream. If you use this herb inside, you may have many side effects. For pregnant women, it is also dangerous to interrupt pregnancy.

Prevention of disease

Despite the fact that there is an unequivocal opinion about the dangers of sunburn and sun rays, psoriasis is very useful. Regular intake of moderate sun baths develops positive dynamics, reduces anxiety and stress.

Between relapses of the disease and negative emotions, there is a relationship, so you can alleviate the symptoms by any anti-stress methods. A visit to the psychotherapist and psychologist greatly alleviates the symptoms.

If the skin is too dry, itching starts, you can try the following:

Within 15 minutes, take a warm bath. Then apply salicylic acid, which removes flakes from the skin. After that, use any softening cream - "Cetaphyl", Vaseline or "Eucerin". At night, you can wear moisturizing gloves.

From itching and irritation will help ointment "Capsaicin", where the active ingredient is the seeds of Chile pepper. It helps to remove psoriatic itching. First, a burning sensation is felt, but then it fades.

Power factors. Patients should consume enough folic acid. It is found in products such as asparagus, leafy greens, fruits, peas, dried beans, liver, yeast, orange juice.

It is necessary to include in the diet products containing Omega-3, to eat fish oil, which has an anti-inflammatory property, has a positive effect in autoimmune diseases.