As you know, the development of medicine does not stand still. Every day new discoveries of medicines occur. However, it has not been possible to completely eliminate some ailments so far. An example is psoriasis. This pathology is characterized by a systemic lesion of the skin, its dryness and the appearance of hard plaques. To recognize the presence of the disease, specific symptoms help - the psoriatic triad. This phenomenon has been known for many years. It is the main diagnostic criterion for the disease and an indication for treatment.
Psoriatic Triad: Description of the Phenomenon
Psoriasis has several clinical forms. Therefore, the signs of pathology do not have to be the same in different patients. However, there are a number of symptoms that are characteristic of all varieties of the disease. These include the psoriatic triad. What is it and how to recognize it? Identify the specific signs of the disease can only be a doctor dermatovenerologist after the examination. To see such symptoms, the doctor should carefully examine the skin during the exacerbation and produce a scraping of the plaque. The psoriatic triad includes the following components:
- The presence of stearin spot syndrome.
- The appearance of pinpoint hemorrhages on the skin during scraping.
- The presence of a terminal film.
Stearin is a type of fat. This substance is not related to psoriasis. However, one of the signs of the triad was called "stearin spot syndrome." This happened due to the fact that when exfoliating the upper layers of the affected skin, large white areas of the epidermis are separated. Outwardly, they resemble stearin.
The next characteristic sign of psoriasis is spot hemorrhage. They appear when the scales are separated. Another name for this phenomenon is bloody dew syndrome. The last component of the triad is the presence of a terminal film on the skin. It is located under psoriatic plaques. The film has a smooth shiny surface. Only by removing it, you can see the point hemorrhage.
Experienced doctors immediately recognize the phenomena of the psoriatic triad. However, removing the flakes on their own to make sure the diagnosis is not worth it. This can lead to damage to the skin and the spread of damage.
Causes of Psoriasis
Psoriasis is a chronic pathological process that doctors have been struggling with for centuries. It was not possible to find a medicine that could completely eliminate this disease. This is due to the fact that doctors still have not figured out the exact etiology of the disease. There are several hypotheses regarding the cause of psoriasis. The main one is genetic theory. After all, the disease is often observed in members of the same family. This hypothesis is more applicable to early cases of psoriasis. If the disease occurs in adulthood and there is no burdened hereditary history, then the disease is associated with other causes. Among them is the viral and bacterial theory. In addition, almost all patients have immunological disorders.
Based on this, we can say that psoriasis refers to polyetiological diseases, that is, it develops under the influence of several reasons and has a complex pathogenesis. Among the factors that are predisposing for this pathology, there are:
- Burdened by heredity.
- Acceptance of toxic drugs.
- Thin and dry skin.
- Exposure to chemical and physical irritants.
- Stressful effects.
- Chronic pathological processes affecting the skin.
The disease is being actively studied not only by dermatologists, but also by specialists such as immunologists and allergists. After all, finding out the cause and pathogenesis of the pathology will allow you to find the optimal treatment method.
Symptom development mechanism
Diagnosis can be by such a sign as the presence of a psoriatic triad. Each of the main symptoms has a specific development mechanism. Stearin spot syndrome is the result of exfoliation of the upper layer of the epidermis. The skin loses moisture and becomes dry. As a result, flakes form. With the accumulation of several layers of dry epidermis, the skin begins to peel off. As a result, psoriatic plaques appear in the affected areas. When scraping, the damaged epidermis resembles stearin.
The primary element of psoriasis is papule. It occurs on the skin due to an inflammatory process. The appearance of papules is also due to the rapid division of epidermal cells. This leads to the fact that the upper layer of the skin does not have time to fully form and, as it were, is “pushed” to the surface, forming a rash. This is characterized by the histopathology of the psoriatic triad. The papule is covered with a thin layer of terminal film. Outwardly, it resembles polyethylene. The appearance of "bloody dew" is due to damage to small vessels that penetrate the thickness of the skin.
Classification of Psoriatic Elements
There are several varieties of psoriasis that differ in the location of the lesion and skin elements. Classical rashes include plaques. They are pinkish-red papules of small size, covered with scales. In affected areas, skin temperature is higher than in healthy neighboring tissues. This is due to the inflammatory nature of the disease. On the surface of the papule, the epidermis is flaky and has a dry structure. As a result, whitish-silver flakes appear. With the progression of pathology, plaques enlarge and merge, forming "paraffin lakes."
The next type of disease is psoriasis of the flexor surfaces. It is characterized by the appearance of pink-red inflammatory spots on the folds of the skin. The localization of the lesion is the axillary and inguinal region, the inner thighs. In women, spots can appear on the stomach and under the mammary glands. Similar psoriatic elements are not covered by scales, therefore, they are easily damaged.
Rare rashes include acne, similar to drops or coins. An unfavorable type of skin rash is pustule. It is a blister filled with exudate. On the surface of the pustule there is a dry peeling layer of the epidermis. Even with minor injuries, the blisters open, forming erosion. Pustules tend to merge and become infected. A separate kind of disease is considered to be psoriasis of the nails.
Characteristic clinical manifestations
A feature of the disease is that it is not transmitted by contact. Therefore, psoriasis is not dangerous to others. However, the genetic nature of the pathology should be considered. In children whose parents suffer from psoriasis, the likelihood of developing the disease is much higher. In addition to skin lesions, joint inflammation and pathologies of the endocrine, skeletal and nervous systems are often observed. For this reason, psoriasis should be attributed to systemic diseases. The disease has a wave-like chronic course. In addition to the psoriatic triad, the characteristic features of the disease include: the presence of a rim around the plaques, the dense structure of the skin elements and the appearance of papules when the epidermis is damaged. If these symptoms are detected, it is worth examining.
Diagnosis of the psoriatic triad
Diagnosis of the disease begins with a dermatological examination. The doctor scrapes the skin at the site of the plaques and detects signs of the psoriatic triad. Stearin stain is the first diagnostic criterion. Skin scraping does not cause the patient pain. Dry epidermis peels off easily with a spatula. After removing all the flakes, a thin terminal film is detected. It is also easy to separate from the papule. If you continue to scrape the skin, the third sign of the disease is diagnosed - point hemorrhage.
In addition to dermatological studies, perform:
- X-ray of bones and chest.
- Arthroscopy
- MRI
- Bacteriological examination of the skin.
- General and biochemical analysis of blood.
Diagnosis should be comprehensive, since with psoriasis, damage to various structures is possible. Depending on the clinical manifestations, the doctor selects an individual examination complex for each patient.
Differential diagnosis
A differential diagnosis is carried out with other diseases of the skin. Most often, it is required for atypical forms of psoriasis. For example, if there are pustular skin rashes or nail damage. The psoriatic triad allows you to confidently make a diagnosis.
Features of the treatment of the disease
The pathogenetic treatment of psoriasis includes the use of glucocorticosteroid-based ointments. Hormonal drugs help relieve inflammatory syndrome and slow down the progression of the disease. However, long-term steroid treatment leads to the development of side effects. To safer drugs include ointments with keratolytic action. They soften the scales and moisturize the skin. Also, antihistamines are used.
Baths with anti-inflammatory herbs (calendula, chamomile) and applications with clay help improve skin condition. Also, you should constantly use creams.
Drug therapy for psoriasis
In the period of exacerbation of psoriasis, hormones are prescribed. These include ointments such as Flucinar, Triamcinolone and Hydrocortisone. To prevent itching and the spread of rashes, antihistamines are prescribed. "Salicylic" ointment has keratolytic effect. It destroys dry skin forming plaques. Sinalar and Dermoveit are also used. Additional funds include ointments containing zinc, tar and ichthyol.
Preventive measures for psoriasis
To increase the duration of remissions, it is recommended to avoid physical and chemical effects on the skin. It is not recommended to sunbathe a lot. Improving the condition of the skin contributes to the continuous use of ointments and creams. Positive dynamics are found after spa treatment and climate change.