Psoriasis stages are defined time intervals during which the disease takes on its characteristic features. Many psoriatics mistakenly call the stage a severe or mild form of the disease, but in medical records the term is used with a completely different meaning.
What are the stages of psoriasis?
Psoriasis is recognized as a recurrent skin disease, in which the genetics is to blame. According to dermatologists, at least 2% of the world population suffers from the disease, which means that the problem is very urgent. During psoriasis, 2 conditions are clearly distinguished:
- Relapse.This term refers to the deterioration of the skin. In case of recurrence, the patient experiences itching, pain, burning, profuse skin rashes, irritation and discomfort. The victim's situation is aggravated by insomnia, neurosis and anxiety.
- Remission.This word is used to mean improving the appearance of the skin. In remission, the skin regains its normal color, the redness disappears and the area of psoriatic plaques is reduced.
The stages of psoriasis partially duplicate the description of remission and relapse, so many dermatologists use these words interchangeably. In clinical practice, 3 stages of psoriasis are described:
- progress stage;
- stationary; regression stage
- .
Considering that it is a cyclical process, the stages flow sequentially among themselves and form a continuous course of the disease.
Fact!The progress stage is considered the most difficult to feel.
What is the progress of psoriasis?
The progress stage is triggered by several factors, such as the cold season or stress. In some cases, even an experienced dermatologist cannot identify the trigger unambiguously. During the progressive stage, the following happens:
- Psoriatic nodules develop quickly, affect the skin and interconnect in so-called plaques, which peel and itch. A plaque is an arbitrarily shaped point, usually round or oval, sometimes with an irregular border.
- Papules, that is, individual nodules from a psoriatic rash, are lumps on the skin. The edges of the papules do not come off and the central part is highlighted. As a large number of dead scales accumulate, plaques begin to rise above the skin's surface. The swelling gives them an even more convex and irregular appearance.
- This stage of the pathology is characterized by an isomorphic reaction, which consists of the exacerbation of skin rashes in the event of skin lesions, scratches, injections, cuts, microtrauma. This phenomenon takes the name of Köbner.
A delayed reaction is characteristic of the progressive stage of psoriasis. In some cases, rashes appear about 9 days after exposure to a trigger (such as a food allergen). Typically, a psoriatic rash appears within 24 hours after exposure to adverse factors.
Interesting!95% of psoriatics have some type of food intolerance that can trigger a relapse. To avoid exacerbation, you need to keep a food diary and watch the reaction to different types of food.
Stationary and recessive stages
The stationary stage is the period in the course of psoriasis during which the victim's condition is relatively stabilized. At the stationary stage:
- Psoriatic plaques have a smooth outline. The entire surface of the plate is covered by a thick layer of scales that easily peel off. Itching and discomfort are moderate. There is no bright red inflamed border around the papules.
- In skin microtraumas, the Koebner phenomenon is not observed, that is, scratching or cutting healthy skin no longer becomes a psoriatic plaque.
The regressive or recessive stage is characterized by massive lesions in psoriasis. First, a pseudo-atrophic border can be seen around the papules, and then patients notice a rapid cessation of skin peeling, with the formation of hyperpigmentation plaques at the site.
Severity of pathology
An additional diagnostic criterion is the assessment of the area of psoriatic lesions. The term "gravity" is used to describe it. Dermatologists distinguish 3 degrees of severity from skin disease:
- Easy.Psoriatic plaques occupy 1 to 3% of the total body area. The small size of the affected areas does not mean that the patient is well. In psoriasis of the head or face, even some plaques are sufficient to cause discomfort and distress to a person.
- Medium.The volume of psoriatic eruptions occupies 3 to 10% of the total body area. In this case, the back, chest and outer surfaces of the joints, scalp, palms and feet are affected. This prevalence leads to severe poisoning and severe pain. The patient may lose all or part of the ability to work, the mental state and the state of the nervous system deteriorate.
- Heavy.The disease covers more than 10-15% of the skin's surface. According to approximate estimates, if psoriasis occupies more than a quarter of the total body area, the likelihood of kidney or liver failure increases significantly. Uncompensated damage to internal organs can cause death from psoriasis.
To comprehensively assess the severity of psoriasis, a special scale called PASI is used. The scale takes into account:
- percentage of healthy and diseased skin;
- stage of pathology;
- patient's response to drug therapy;
- individual tolerance to psoriasis (mental state, complications of the nervous system and psyche);
- objective data from laboratory tests in dynamics (for example, the volume of uric acid in a blood test).
The diagnosis takes into account all symptoms that affect the condition of a person with psoriasis. The intensity is reflected in the medical record:
- itchy skin processes; redness
- ;
- swelling; hyperemia
- ;
- thickening of the skin;
- exfoliation;
- blood flow;
- edema;
- infections; pain syndrome
- .
On the PASI scale, the volume of skin lesions is described by numbers, from 0 to 72, where 0 is the absence of cutaneous symptoms and 72 is the maximum possible spread of the disease on a large scale.
Warning!It is important that the patient, first of all, knows and monitors the signs of exacerbation. If unfavorable symptoms appear, you should immediately consult a dermatologist, as psoriasis does not always enter a steady state. A relapse can last for decades.
Psoriasis treatment depends on the stage
For each stage of the disease, a set of therapeutic measures has been developed, so the first thing a dermatologist determines is whether psoriasis is progressing, stabilizing or regressing.
How the progressive stage is treated
Every psoriasis patient guesses that remission is coming to an end due to their own feelings. If the itch gets worse, the skin gets worse and psoriasis is obviously spreading over the body surface, treatment should be started. Therapy for the advanced stage has the following features:
- The patient is committed to preventing further deterioration, strictly follows the diet, abstains from triggers of the pathological process (stress, smoking, alcohol).
- For severe itching, antihistamines can be used; an additional benefit of this class of drugs is the removal of swelling in the area of psoriatic plaques.
- The dermatologist prescribes a wide variety of topical treatments to heal, soften and thin the skin. By doctor's decision, creams, ointments or sprays are selected. Tar soap and solid oil compresses provide positive dynamics. You can also apply compresses or apply cosmetics with Dead Sea mud.
The main task at this stage is to stop the exacerbation before the disease enters a prolonged relapse. According to the indications, the doctor selects corticosteroids in injections or in the form of ointments.
Warning!Corticosteroids should be used in a short, intensive course under the supervision of a dermatologist. You can give yourself injections or apply antihistamine ointments.
Stationary and regressive stage therapy
The dermatologist's future actions depend on the organism's response to the selected treatment. The following scenarios are possible:
- The medication has a positive effect. Within 1-2 weeks, psoriasis passes from the stationary stage, regresses and remission occurs.
- Medicines have no effect. If, after 2-4 weeks from the time the medication course is prescribed, the results are still not visible, it is a reason to change the medication list or the attending physician.
- The medication gets worse. This dynamic is also possible, especially if the dose or frequency of administration is not sufficient. Relapse is delayed, psoriatic plaques cover a large area of the body, the person needs hospitalization.
In a medical institution, a more powerful therapy is used, for example, hardware blood purification. With a favorable reaction, psoriasis enters the stationary phase, which can last from several days to several months.
Interesting!More than 80% of patients notice the seasonal nature of exacerbations. This makes the disease predictable and allows you to prepare for the onset of a relapse.
The list of drugs for the stationary and regressive stages is exactly the same, but the doses and frequency of administration are lower than for the progressive stage.
10-15 year remission
A competent dermatologist proposes the following task - to choose such medications and physiotherapeutic agents that provide psoriasis patients with the longest possible improvement. At the same time, the patient himself must do everything possible to promote treatment, avoid triggers and take medication responsibly. If the alliance between the patient and the doctor has developed successfully, the duration of the remission is unlimited. Stable well-being can last for 15 years or more.