After appearing, psoriasis in most patients does not disappear on its own, but only progresses and becomes more extensive, spreading through the skin.
However, with timely diagnosis, it is easier to treat and recovery is much faster.
The main thing here is to pay attention in time to the first signs of psoriasis and make an appointment with a dermatologist immediately.
Characteristic signs of psoriasis
Initial psoriasis can appear as small, red and scaly patches.
The location of these rashes appears directly depends on how the disease progresses.
In most cases, they can be seen:
- on the elbows and knees;
- on the head (in the hairy area);
- on the palms and feet;
- in the fold area (buttocks, armpits, areas under the breasts in women).
Primary eruptions (papules) are very small in size: their diameter does not exceed 4 millimeters.
However, as the disease progresses, they increase and fuse, forming unclear plaques.
Most often, the appearance of papules is not accompanied by pain or itching. The feeling of discomfort increases with the development of psoriasis and with the increase in the size of the affected areas of the skin.
The affected area starts to hurt and itch, and there is a strong burning sensation.
These signs of psoriasis are complemented by emotional inconveniences that can significantly increase the rate of spread of the disease.
It is inappropriate, when these rashes are found, to initiate self-treatment, since psoriasis in the early stages of development has similarities with other skin diseases.
Consequently, the wrong choice of drugs will not lead to positive results, but will only make the situation worse.
Cumulative symptoms
Scaly lichen belongs to the category of systemic pathologies.
This means that it manifests itself not only in the skin and nails, but can also affect the spine, joints and tendons, some systems of the body (for example, endocrine, immune and nervous).
There have been cases where the disease has affected the digestive (liver) and urinary (kidney) systems.
The first symptoms of psoriasis
- feeling of constant tiredness;
- weakness;
- a state of depression (even depression).
Due to the complex effect of the disease on the body, experts consider it appropriate to call it psoriatic disease.
But despite this, the main aspects of the disease are based on damage to the skin.
As mentioned above, the first call for the beginning of the development of the pathology are small papules in the range of colors between pale pink and red.
They differ in a symmetrical position on the skin surface (folds, lower back, area of the head covered with hair), sometimes - on the mucous membrane of the external genitals.
The size of the papules in the later course of the disease can exceed 10 centimeters.
Psoriatic eruptions, depending on their characteristics, are subdivided into:
- dotted (its size is no bigger than the head of a pin); teardrop-shaped
- (similar to a teardrop, equivalent in size to a grain of lentil); coin-shaped
- (plates 5 mm in diameter, with rounded edges);
- Rarely arched, annular or similar to a map.
Above, the papules are covered with scales, which are formed from keratinized cells of the epidermis and are removed without much effort. Initially, they appear in the center of the plate and gradually spread more and more.
Keratin cells have air gaps, which results in visual friability and light shade.
Sometimes the elements are surrounded by a pink ring, which acts as an area of plaque growth and inflammation. In that case, the state of the surrounding skin does not change.
Removing the plaque reveals a shiny, red surface based on capillaries, which in turn have very thin walls.
The presence of small diameter vessels is due to damage to the structure of the upper layers of the skin, the structure of which is disturbed by the incomplete maturation of epidermal cells (keratinocytes), which makes their correct differentiation impossible.
Symptoms of different forms of psoriasis
Common psoriasis has very specific symptoms, so it will not be difficult to diagnose.
Appears as scaly, rounded areas that protrude above normal skin and are pink or red.
Sometimes, in the early stages of the disease, there are no typical plaques: before they appear on the scalp and in the region of the joints (ankles, elbows and knees), small papules may be seen.
They are able to persist for a sufficiently long period of time and cause no discomfort to the patient: nothing itchy and painful or no pain, or practically not felt, the papules themselves are almost impossible to notice.
They do not chip, but when lightly scraped, the scales appear immediately. These pink seals can disappear or decrease significantly in summer, as exposure to the sun affects the skin.
The acute form of common psoriasis manifests itself in the form of several rashes with constant itching of colored papules and is the result of the influence of factors that activate the disease.
To avoid confusing it with an allergic reaction, it is necessary to scrape the surface of the plate just before the characteristic phenomenon appears.
Seborrheic psoriasis begins on the scalp (in the area covered with hair) and then spreads to the face and shoulders.
It is characterized by severe peeling of the skin from the corresponding area, which is most often considered by patients as dandruff, so they do not rush to a dermatologist.
This fact allows the disease to silently reach the stage of development when the forehead and areas behind the ears are peeled. And only after the plaques are formed.
Lesions of the folds of the skin with psoriatic disease (armpits, genitals and groin, under the breasts in women) are often confused with common irritation caused by friction or sweat.
This type of disease is characterized by smooth plaques that look like spots. No flaking is observed, but they often get wet. The rashes themselves are bright red, uniform and shiny.
In case of injury to the genitals, the characteristic signs of psoriasis may be incorrectly interpreted as balanoposthitis (lesions on the head of the penis, as well as on the foreskin on the inside) in men and vulvitis (skin rashes located on the labia minora)in women.
The palmoplantar form of the disease manifests itself in the form of compacted areas, similar to calluses, whose surface is covered with yellow scales that are difficult to remove.
The affected areas are cracked and painful. With this form of the disease, it is difficult to induce the appearance of a terminal film and dew with blood by scraping.
Nail psoriasis begins with psoriatic onychodystrophy, which is one of the main symptoms of this form of the disease and appears long before skin rashes.
In the early stages, the edge of the nail is covered by ridges and small depressions.
As the disease develops, they spread, reaching the root, from which changes in color are observed. The nail dulls and thickens. Due to failures in blood circulation, the manifestation of the disease increases.
Epidermal cells accumulate under the nail plate and are surrounded by reddish tissue on all sides, after which they can peel after a while.
This type of psoriasis is dangerous because it increases the sensitivity of tissues, which in turn increases the likelihood of infection. This disease is often mistaken for a fungus.
Moving bone joints (joints) are often affected. They are deformed, the joint capsule undergoes modifications of the dystrophic type.
Psoriatic arthritis begins with an increase in joint volume, which is accompanied by pain.
The fingers and toes are the most prone to this type of psoriasis.
In severe forms, the shoulder and elbow, hip and knee joints, as well as parts of the spine, are exposed to the disease.
Effect on the manifestation of symptoms of psoriasis stages
The symptoms of psoriasis are in direct proportion to the season and the stage at which the disease is.
Most of the time, in the spring-summer period, there is a noticeable decrease in disease activity, which is facilitated by ultraviolet rays.
Thus, in the autumn-winter period, due to the lack of sun, the disease is rapidly gaining strength. There are practically no patients with summer exacerbations.
There are three stages of psoriasis:
- Progressive- characterized by the continuous appearance of new skin rashes, an increase in the size of previously appeared plaques and their surroundings with pink edges, the affected area is very itchy and scaly;
- stationary- new eruptions no longer appear and old ones do not grow; the top layer of skin in the area of the plaques becomes wrinkled;
- regressive- the skin does not peel, the plates disappear, leaving behind highly pigmented areas.
Diagnosis of psoriasis
The diagnosis of psoriasis is made on the basis of the information obtained in the medical examination by interviewing the patient, as well as the symptoms inherent in one form or another of the disease.
The sooner a disease is detected, the faster the treatment process begins. Consequently, more tangible results will be obtained.
Because the condition is extremely specific, the diagnosis of psoriasis can be limited to a simple examination by a dermatologist.
However, in some cases, difficulties may arise due to the implication or absence of symptoms, which happens if the disease does not manifest itself in any way or appears atypical. This situation requires more research procedures.
A specific method is used to make the diagnosis, which consists of the gradual scraping of the papules along the layer.
As a result of this manipulation, it is possible to identify characteristic signs (psoriatic triad) to differentiate psoriasis from other diseases and make a final diagnosis:
- staining of
- with stearin; terminal film
- (pink epidermal cells);
- blood dew (droplets of blood appear on the surface of the plaque due to capillary rupture).
If necessary, the patient is tested as samples of affected tissues.
X-rays are taken if arthritis related to psoriasis is suspected.
If psoriasis is at an early stage, its diagnosis is not difficult: the picture of osteoporosis is clearly visible.
In later periods, there is narrowing of the joint space, erosion of the tissues that form the bones, osteosclerosis and periostitis.
If the disease is severe, the wrist and metatarsal joints are destroyed and, as a result, the joint completely loses mobility.
It should be noted that all tests performed are necessary not only for the final diagnosis, but also for differentiation with other diseases that, at first sight, are identical.
These diseases include: parapsoriasis, seborrheic eczema, lichen rosacea, atopic dermatitis, lupus erythematosus, rheumatoid arthritis and others.