The term "psoriasis" refers to a recurrent chronic dermatosis of non-infectious nature. Another name for the pathology is scaly lichen. The ailment has several forms, each of which is characterized by specific clinical manifestations. The causes of the disease, the medical classification of psoriasis and its symptoms, as well as the features of the treatment of the disease are described below.
Etiology
Currently, the pathogenesis of pathology is not fully understood. However, it is known that the following factors are provoking:
- Impaired immune system.
- Genetic predisposition.
- Impaired functioning of the nervous system.
- Staying long under stress.
- Dry and thin skin.
- Excessive enthusiasm for water procedures (frequent washing is as harmful as ignoring hygiene rules).
- Smoking
- The use of alcohol-containing drinks.
- Taking some medications.
- Infectious diseases.
According to numerous studies, psoriasis is not a contagious disease. The presence in the family of several persons suffering from an ailment is due to heredity.
Types
There are several classifications of psoriasis. Initially, the disease is usually divided into 2 large groups.
Medical classification of psoriasis by type:
- Pustular. It is considered the most dangerous, is extremely rare.
- Unappealing. Diagnosed most often.
This is the main classification of psoriasis by type. The first group includes: herpetiform empedigo, Tsumbush disease, Allopo acrodermatitis, palmoplant psoriasis. This also includes psoriasis, which proceeds as a ring-shaped centrifugal erythema.
The non-pulmonary type encompasses erythroderma and the traditional form of the disease, characterized by both early and late onset.
Forms
The clinical manifestations of the disease depend not only on its type. According to the generally accepted classification, the form of psoriasis (photo of the affected skin is presented below) has the following:
- Plaque-like. Diagnosed most often. This is a simple form of psoriasis, which accounts for up to 90% of cases. It is characterized by the formation of foci of inflammation slightly elevated above the skin. They are hot to the touch, have a reddish tint. In addition, plaques are covered with easily peeling gray or white scales. The skin under them is extremely sensitive and bleeds due to the large number of vessels in the focus of the pathology. Over time, plaques increase in size and merge with each other, forming the so-called "paraffin lakes."
- Reverse psoriasis. For this form of the disease, the formation of inflamed spots is characteristic. They are smooth and do not protrude above the surface of the skin. Most often they are localized in folds. The spots practically do not peel off. This form of the disease is dangerous because the foci of the pathology are often injured by friction. In addition, streptococcal pyoderma and fungal infection often occur.
- Teardrop-shaped. In this case, the patient can detect small red or purple elements that slightly rise above the surface of the skin. The foci of pathology are extremely dry and in appearance resemble drops, due to which the form of the ailment got its name. As a rule, the disease appears after sore throat and pharyngitis, which were caused by streptococcus.
- Exudative. In the classification of psoriasis, this form is of particular importance. This is due to the fact that it is the most difficult. A characteristic sign of the disease is blisters filled with exudate. Both the bubbles and the skin around them are hot to the touch. The latter is easily peeled off. The skin swells, thickens and becomes inflamed. Often there is a secondary infection. In this case, the bubbles are filled with purulent contents. In the most difficult situations, psoriasis takes on a generalized form in which bubbles form on the surface of the whole body and coalesce over time, forming huge foci of pathology.
- Onychidystrophy. In this case, psoriasis affects the nails on both the arms and legs. In this case, the plates become yellow, gray or white. Under the nails, you can often notice black dots or lines. The skin around the plates thickens. Over time, the nails become very brittle, they exfoliate and crumble.
- Arthropatic. This form of the disease is characterized by inflammation of the connective tissue and joints. As a rule, the structures of the toes and hands are affected. In most cases, they swell against this background. In this situation, the fingers look like sausages. Somewhat less often, lesions of large joints are diagnosed. But this condition is considered one of the most dangerous. It leads not only to disability, but in some cases to death.
- Psoriatic erythroderma. The main symptom of the disease is exfoliation of the skin. The process can be both widespread and generalized. Exfoliation is accompanied by severe itching, swelling and pain. In the absence of proper treatment, this form of psoriasis can be fatal. This is due to the fact that against the background of exfoliation of the skin and severe inflammation, the process of thermoregulation of the body is disrupted, the barrier function is lost, and therefore, patients with sepsis are often diagnosed.
The clinical classification of psoriasis in children is identical to that described above. The diagnoses for both small and adult patients are the same.
Another form of psoriasis should be noted. It is not in the classification, but doctors are increasingly mentioning it. This is a winter form, which is characterized by the occurrence of exacerbation from December to February. Often, inflamed areas begin to form already in late autumn.
Forms not included in the main classification
Psoriasis is a pathology whose clinical manifestations are very diverse. In ICD-10, a separate group is identified, including unspecified types of ailment. They are characterized by the presence of a large number of symptoms that are specific to the forms included in the main classification of psoriasis. In this case, the doctor reveals the dominant clinical manifestations.
Examples of diagnoses from the classification of unspecified psoriasis: seborrheic-like and induced forms, Napkin's disease.
ICD-10 codes
Currently, doctors use the International Classification of Diseases of the 10th revision in practice. It is designed to encode medical diagnoses.
According to ICD-10, the classification of psoriasis is as follows:
- L40.0 - plaque-like form of the disease.
- L40.83-4 - Reverse psoriasis.
- L40.4 - teardrop shape.
- L40.1-3 - exudative form.
- L40.86 - Onychodystrophy.
- L40.5 - arthropathic form.
- L40.85 - Erythroderma.
In the classification of psoriasis according to ICD-10 there is also a code L40.9. It is assigned to unspecified forms of the disease.
Stages of flow
Psoriasis is classified by severity. The following stages of the disease:
- Progressive. It is characterized by an increase in the number of rashes, which in a short time increase in size and merge with each other. The final stage of the inflammatory process is peeling. But at the same time, the foci of pathology grow faster. Thanks to this, the spots are bordered with red rims.
- Stationary. New elements of psoriasis do not appear. Old spots also do not increase in size. This stage is characterized by moderate uniform peeling.
- Regressive. At this stage, a stratum corneum, called the Voronov rim, is formed around the foci of pathology. The inflammatory process gradually stops, redness and peeling disappear. At the site of rashes, age spots remain.
During the examination, the doctor determines the stage of the disease and its form according to the above classifications of psoriasis. Treatment at different stages involves various therapeutic measures.
Localization
In some cases, it is the location of plaques, blisters and rashes that can accurately determine the shape of the ailment. Most often, psoriasis affects:
- Limbs. The classic form of the disease is characterized by lesions of the elbow bends. Sometimes plaques appear on the palms of their hands, which is why the latter become very rough. In the atypical form, the flexion surfaces of the joints are affected, and therefore psoriasis is sometimes confused with atopic dermatitis. If rashes appear on the hands, over time they will occur on the legs.
- Torso. Plaques on the body often indicate that the generalization process has started. Most often, rashes form on the back, less often on the stomach.
- Face. As a rule, rashes are localized around the eyes, eyebrows and in the area of the nasolabial folds. The defeat of the face indicates an atypical form of the disease.
- Head. In this case, psoriatic plaques have the appearance of scales. In this regard, they are often confused with seborrheic dermatitis. Such a localization of rashes is quite common.
Complications
Treatment of pathology should be competent and timely. Ignoring the classic form of the disease leads to the fact that the disease takes on a more severe form (for example, exudative, mentioned in the above classification of psoriasis). A complication of this nature is most likely. It is important to remember that some forms in the absence of treatment lead to disability and even death.
In addition, psoriasis negatively affects the condition of internal organs. Possible complications:
- Disruption of the cardiovascular system (hypertension, mitral valve disease, myocardial infarction, stroke, diabetes mellitus, Crohn's disease, dyslipidemia.
- Failure in the functioning of the kidneys.
- Visual impairment.
- Inflammation of the bladder.
- Depression.
Not every person has complications. But it is important to know that the risk of their occurrence is extremely high. In order to avoid the development of negative consequences, it is necessary to consult a competent doctor in a timely manner and strictly follow all his recommendations.
Principles of Traditional Treatment
The choice of treatment regimen depends on the stage of development of the disease. In addition, the doctor must take into account the gender and age of the person, the individual characteristics of his health, as well as the type of professional activity.
The classical treatment regimen includes local treatment with medicines containing glucocorticoids, photochemotherapy, as well as a stay in a spa.
In mild forms of the disease, as a rule, it is enough to smear the foci of pathology with drugs that do not contain hormones. With psoriasis, the following agents are effective:
- Anthralin.
- "Salicylic ointment."
- "Calcipotriol."
- "Naftalan ointment."
- Skin Cap.
- "Sulfur-tar ointment."
If, against the background of treatment, the dynamics do not change in a positive direction, the doctor prescribes hormonal drugs. Therapy is started using drugs that have a minimal list of side effects. If they prove to be ineffective, the doctor decides on the advisability of prescribing stronger drugs. Examples of such funds: Flumetazone, Triamcinolone, Hydrocortisone.
In severe forms of pathology, systemic drug therapy is indicated. It includes the introduction of cytostatics, glucocorticoids and synthetic retinoids.
Photochemotherapy has been shown to be highly effective against psoriasis. This is a treatment method, the essence of which is the simultaneous administration of drugs that increase the degree of sensitivity to light, and the effect of UV radiation on the body. Thanks to this, the natural process of melanin production is launched.
Photochemotherapy is carried out, on average, three times a week. The course of treatment is 25 procedures. Therapy is contraindicated for persons suffering from pathologies of a chronic nature, oncology, diabetes mellitus and diseases of the kidneys, liver and heart.
An ideal option is one in which the patient undergoes spa treatment. Mud baths, mineral waters, physiotherapy - this is only an incomplete list of what the patient's body can expose. In addition, a warm climate has a powerful healing effect. There are several sanatoriums in Russia that specialize in the treatment of psoriasis. These are Anapa, Sochi and Gelendzhik.
Finally
The term "psoriasis" refers to a chronic disease of a dermatological nature, prone to frequent relapses. Currently, the etiology of the disease is unknown, however, the launch of its development can occur under the influence of many provoking factors. There are several classifications of psoriasis. The disease has several types, forms, stages of the course. Moreover, each of these points has its own clinical manifestations. The treatment of psoriasis involves the external use of medications, the conduct of photochemotherapy and a stay in a spa.