Psoriasis: In a War with Your Own Skin
Department of Gynecology, Yaroslavl Regional Perinatal Centre, Yaroslavl, Russia
*Corresponding Author: Afa Bayramova, Department of Gynecology, Yaroslavl Regional Perinatal Centre, Yaroslavl, Russia, Tel: +79610220184, Email: firstname.lastname@example.org
Journal of Health Education Research & Development
One hundred twenty-five million people worldwide, among them around 2% to 3% of the total population is having Psoriasis, according to the World Psoriasis Day consortium. It is a genetic disease in which scaly, raised plaques appear on the skin. Psoriasis has been known since biblical times, and since then it is a mystery disease. Now we know many molecular and immune mechanisms for the development of psoriasis, but we still cannot fully understand what is considered the cause and what the effect is. In this article, we will give a general description of the disease, touch on its pathogenesis and tell the history of the study and treatment of psoriasis.
Psoriasis; Dermatology; Genetic disease; Pathogenesis
Plaques On The Skin
Psoriasis is a chronic non-infectious disease in which thickened flaky plaques appear on the skin, towering above its surface. This is due to excessive reproduction of epidermal cells and disruption of their keratinization processes. Such pathological changes are accompanied by an inflammatory reaction.
Psoriasis is the most prevalent autoimmune disease in the U.S. According to current studies, as many as 7.5 million Americans-approximately 2.2 percent of the population-have psoriasis.
Almost 2/3 of patients fall ill before the age of 30 years. Nevertheless, there are two peaks in incidence. The first peak in women falls on average by 15.5 years, and in men-by 27.5. The second peak is observed at the age of about 54 years, regardless of gender. Both early and late onset of the disease is associated with a genetic predisposition, but in these two cases different genes may be to blame .
The most common form of psoriasis (80-90% of cases) is normal or vulgar. When it appears, red spots appear on the skin, gradually turning into plaques elevated above the skin. Plaques are usually symmetrical and, as a rule, are located on the elbows and knees, on the back and on the scalp. They grow and merge into larger foci, then their growth stops, and the plaques gradually decrease in size. New plaques may occur on the periphery of existing lesions or in places where the skin has been damaged and rubbed (this effect is called Kebner's phenomenon). Scales appear on the surface of the plaques that are easily peeled off. At the same time, psoriasis is not contagious and does not pose a danger to others .
There are some more rare forms of psoriasis
Psoriasis of the palms and soles: It occurs most often in people engaged in physical labor or often in contact with irritating substances, such as aggressive detergents. When this form of plaque formed on the palms and soles, the skin on them becomes red, cracks may appear. In some cases, the nails are also affected: pinpoint indentations appear on them, longitudinal grooves, the nail plate itself thickens.
When it appears on the skin multiple small plaques are visible. Usually, shortly before the manifestation of this form of psoriasis, the patient suffers from a sore throat or another disease caused by streptococcus. Probably, streptococcal infection activates a certain type of lymphocytes, provoking skin damage .
In one third of patients with psoriasis, skin rashes can be complicated by joint damage.
Pustular psoriasis of von Zumbush, described by dermatologist Leo von Zumbush in 1910. The skin of these patients is red, and on the plaques and on the unchanged skin bubbles with fluid (pustules) form, pain and burning appear. Skin rashes are accompanied by a pronounced immune response: fever and inflammatory changes in the blood. Often these problems are associated with secondary infection of the skin due to scratching of the pustules.
The classic method for the differential diagnosis of psoriasis is by scraping the surface of a plaque with a glass slide or scalpel. Initially, whitish horny scales easily fly off the surface of the plaque. In dermatology, this is called the phenomenon of stearic stain. After peeling off all the horny scales, the surface of the plaque becomes wet and shiny (the phenomenon of the terminal film). Upon further scraping, small droplets of blood protrude from damaged capillaries on the surface of the plaque. This phenomenon is called the Auspitz symptom, or the bloody dew phenomenon. The combination of these three phenomena is called the psoriatic triad and is a reliable diagnostic sign of the disease .
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