Psoriasis is a chronic non-communicable disease that until recently was considered simply a skin disease. A characteristic of the inflammatory process in certain areas of the skin in patients with psoriasis is that the life cycle of normal skin cells is approximately 30-40 days, whereas, as in psoriasis, it is 4-5 days, that is, after4 days, the skin cells gradually die, forming plaques, dryness, flaking of the skin and so on.
The problem of treating this complex and difficult-to-treat disease today is urgent not only for dermatologists, many doctors of other specialties are often involved in determining the causes of psoriasis in a patient and are also directly involved in the complex treatment of this disease. Today, medicine considers psoriasis as a systemic failure of the body, and not just as an inflammatory process of the skin.
Even its name has changed, now it is a psoriatic disease. Why is psoriasis a systemic pathology? Because in patients, several different disorders in the functioning of the body as a whole are found at the same time - in the nervous, endocrine, immune system. In medicine there are several types of psoriasis, there are also a large number of reasons for the occurrence of this disease, mainly theories, since there is no convincing evidence of these alleged causes, we will analyze them in more detail.
Some facts:Psoriasis is not contagious, as it is believed to be caused by a malfunction of the human immune system, including hyperactive T lymphocytes in the skin. Psoriasis is classified as a hereditary disease, with psoriasis in one parent, the risk of developing psoriasis in a child is 25%, if both parents have 65%. In addition to the hereditary factor, the triggering mechanism for the appearance of psoriasis or relapse is the intake of antibiotics, NSAIDs, B vitamins, as well as stress, alcohol and skin lesions.
Viral theory of the cause of psoriasis
Several studies carried out among patients with psoriasis have found several changes in the peripheral lymph nodes, which may indicate the viral nature of the development of this disease. It is suspected that retroviruses, which are genetically transmitted by inheritance, may be one of the causes of psoriasis, but in order to prove the viral nature of the origin of psoriasis, it is necessary to identify the virus, isolate it and select the habitat, andso far nobody can do that.
The fact is that retroviruses have the ability to alter the host's genetic code, they, with the aid of the reverse transcriptase enzyme, have the ability to synthesize DNA, and a “false program” is formed in the cells that alters thehuman genome. However, it has been established that, even with blood transfusions from patients with psoriasis to healthy people, infection or disease transmission has never been observed. Therefore, the version on the viral cause of psoriasis has not yet been proven.
The immune cause of psoriasis
This is one of the generally accepted theories about the causes of psoriasis, since disorders of cellular immunity are considered the main triggering mechanism of the disease. It has long been found that in people with a genetic predisposition to psoriatic disease, chronic foci of infection - tonsillitis, sinusitis, which indicate impairment of immunity - are factors that provoke the onset of psoriasis.
When a primary outbreak of psoriasis occurs, medicine also suggests that damage to the epidermis is caused by autoimmune aggression. In several studies of psoriasis patients, abnormalities in the immune complexes, antibodies, immunoglobulins, which cause Munro's microabscesses, have been identified.
In the process of activating the inflammation of psoriasis, the skin's hypersensitivity increases markedly, therefore, in places of physical or chemical irritation, rashes characteristic of psoriasis appear. When examining the scales of the skin, antigenic components and autoantibodies against them were found in the blood, which are not found in healthy people, neither in the skin nor in the blood.
This fact allows us to state that the autoimmune process plays an important role in the cause of psoriasis. But any processes, even immunological reactions, occur in the body as an integral system; therefore, a combination of other factors, such as endocrine influence, hereditary factors, metabolic disorders, must be taken into account.
Infectious theory of the development of psoriasis
A hundred years ago, many researchers stubbornly searched for an infectious agent of psoriatic disease, and streptococci, spirochetes and epidermophytes were found guilty of its occurrence. However, none of these pathogenic microorganisms, fungi, after research, were found to be the cause of psoriasis.
However, infectious diseases, tonsillitis and ARVI influenza affect exacerbation or trigger the primary onset of psoriasis, especially in the cold season, when the immune system weakens and patients with psoriasis are often admitted to the hospital.
Some authors believe that the development of psoriasis in the context of acute and chronic infection is explained by the influx of impulses from the focus of the infection to the endocrine system and the vegetative section, which leads to a restructuring of the body's reactivity. Very often, particularly in 90% of cases, chronic tonsillitis accompanies psoriasis, which confirms the influence of infectious processes and reduced immunity on the development of psoriasis.
In addition, according to many experts, there is an infectious allergic cause of psoriasis. Proponents believe that psoriasis is an allergic tissue reaction to viruses, streptococci and their metabolic products. However, neither the viral nor the infectious theory has been confirmed.
Genetic cause
This cause is based on a familial manifestation of psoriasis between close and distant relatives. However, psoriasis should not be considered a strictly hereditary disease, as well as diabetes, cancer, ischemic heart disease, as psoriasis itself is not hereditary, but only a genetic predisposition to it. Yes, 60% of psoriasis patients have ancestors or close relatives who suffer from this disease and, if one parent is ill, according to theoretical probability, the child's risk of developing psoriasis increases by 25% and, if both parentsare sick, up to 75%.
However, not always in psoriasis, the cause is just a genetic factor. Recently, this disease has become very common in clinical practice and there is not always a direct relationship with the related predisposition. In psoriasis, the causes of occurrence are so multifactorial that it is impossible to unequivocally indicate a specific cause. Since pathogenic factors are violations of protein or carbohydrate metabolism, and changes in lipids, enzyme metabolism, a combination with foci of streptococcal infection or viral nature.
Metabolic disorders as factors in the development of psoriasis
If we consider the metabolic disorders in psoriasis, in many patients there is a slight decrease in body temperature, and this is one of the symptoms of a slow metabolism, an increase in cholesterol content is also observed, which indicates changes in lipid metabolism. Given the high level of cholesterol, many researchers consider psoriasis to be a dialysis of cholesterol, and consider its increase to be the initial manifestation of dermatosis, since a violation of lipid metabolism stimulates the formation of keratinization of the skin.
In addition, in psoriasis, the metabolism of vitamins is disturbed, especially vitamin C, A, B12, B6, while the vitamin C content in the skin is increased. In addition, changes in the content of iron, copper and zinc have been observed, which significantly reduces the adaptive properties of the human body. Almost 25% of patients with psoriasis also suffer from diabetes mellitus, however, some researchers consider this not as a cause of psoriasis, but, on the contrary, as a manifestation of psoriatic disease.
As the disease progresses, basal metabolism in patients with psoriasis is more often increased, and in those patients who have a decreased metabolism, symptoms of hypothyroidism, endocrine glands, gonads are often manifested in 60% of patients with psoriasis, the general metabolism of carbohydrates is disturbed. Low-calorie foods, or even moderate fasting, reduce body poisoning, so a psoriasis diet improves the patient's condition.
Factors that cause psoriasis
At the current stage of medical research in the field of determining the cause of psoriasis, we can say that it is a systemic disease of constant recurrence that appears in genetically predisposed people, with concomitant disturbance of various central nervous system metabolisms.
Stress
Both for the onset of psoriasis and for the exacerbation of existing chronic psoriasis, the main triggers are most often stress, psychological trauma, prolonged fatigue and nervous tension.
Stress triggers immunological and biochemical reactions that contribute to the development of psoriasis. However, sometimes negative emotions serve, on the contrary, to complete the clinical symptoms of psoriasis. According to a survey of patients with psoriasis, this provoking factor causes the onset of the disease in 49% of patients and in 41% it causes a relapse of psoriasis.
Infectious diseases, vaccination, chronic outbreaks of infection
Tonsillitis, sinusitis, STI, otitis media and so on, especially highly virulent streptococci, are often detected. For the exacerbation of the disease, this factor is relevant in 21% of the patients and, for the appearance of the development of psoriasis, the infection is a triggering mechanism in 15% of the patients.
Hormonal changes in women
During pregnancy, breastfeeding, menopause or adolescence - in 6% of the patients surveyed, this was also a provocative factor in the development of psoriasis.
Injuries, bites, burns
Any trauma to the skin - in 12-14% of patients, the onset of psoriasis is caused by physical trauma.
Prolonged hypothermia
It is the cause of psoriasis or its exacerbation in 5% of patients.
Medicines
Like any type of antibiotic, NSAID. Vitamin therapy - mainly vitamins C, B, beta-blockers, cytostatics, vaccination, use of herbal medicines in treatment - causes psoriasis in 6% of patients.
Food poisoning, abuse of certain foods
Chocolate, citrus fruits and other products - according to a survey of patients, this is the cause of psoriasis in 4% of patients.
Drinking alcohol
In addition, a provocative factor that causes generalization of the inflammatory process shortens the remission period and increases the risk of complications, this is indicated by 3% of respondents.
Climate change
High humidity, prolonged exposure to intense ultraviolet radiation, sudden changes in temperature and humidity - causes an exacerbation in 2% of patients.
The first symptoms of incipient psoriasis can occur regardless of age, with an equal frequency in babies and in people aged 20-40 years, even in old age, psoriasis can start to develop. Naturally, the sooner it appears, the more serious the consequences it causes to the patient. If psoriasis starts in a person after 30 years, it is usually accompanied by gastritis, liver disease, overweight, various neuroses, diabetes, arthritis and other diseases.