Psoriasis is one of the most common chronic diseases of the skin
Unfortunately, there is no accurate information about the spread of disease in Georgia, but its share of dermatos is 3,0-3,5% with an analysis conducted by the National Center for Diseases and Treatment of 2007-2017. 2% of the population in the US is suffering from psoriasis. It is equally common between men and women and manifested in the age of 10 to 40 years, but its initial detection may be at any age.
The cause of the disease is unknown, but there is the opinion of the scientists that it is caused by the inherited factor (genetic mood). Due to the positive effects of immunosuppressive drugs, the primary pathogenetic factor of the disease may be immune. Environmental factors can provoke or aggravate psoriasis. For example, it can develop in the trauma site (coberner phenomenon) such as wound, trauma or surgery after wound, burn, as well as viral infection, medicinal allergic reaction, some local and systemic medications (eg antimicarial preparations, lithium, beta blockers, Interferon-alpha). After using systemic corticosteroids. Some patients (especially children) psoriasis rash may be after transplantation of upper respiratory tract streptococcal infections. Other factors that can stimulate psoriasis include stress, constant emotional tension, alcoholism.
The disease is characterized by different clinical forms. Most commonly hemorrhagic psoriasis. Typical psoriasis buckle is a circular or oval infiltrated hypermemic rash that is covered with a wither-white shaft.
It is localized in the area (behind the back), on the surfaces (especially on the knees and knees), the buttocks, the gap in the area and the pencil letter. May be damaged in nails, eyebrows, wounds, umbilis and anogenitis. Sometimes the disease experiences generalization. Itching is not characteristic.
Nail injuries are 30-50% of patients and clinically resembles fungal infections. Nail injuries are often preceded by skin rash and can be represented by nasal cleansing on the nail plate, nail nickel, nail hyperkeratosis, bruising, bleeding, and so on.
Other clinical forms are important psoriasis arthritis, which is 5-10% of patients and can be expressed with one or several joint inflammation.
In case of erythrodermic psoriasis (exfoliative psoriasis dermatitis) the entire surface of the skin is red and covered with gentle stalks. Typical psoriasis rash may not be. It may be accompanied by general weakness and require a hospital treatment.
Psychulous psoriasis is characterized by sterile pushes on the hands and feet of the heart (barber psoriasis), or the entire body (vampire type), typical psoriasis rash.
Psoriasis of wrinkles damage the intracellular areas including liver, wound, and breast feeding. It is usually found in the elderly patients.
Psoriasis of the hand and foot hall is relevant localization and is expressed with hyperkeratosis or can be made from local groups of push. Diarrhea psoriasis occurs at a young age, develops acutely, especially after acute streptococcal infection. It is localized in the form of small papules on the body and scattered around the limbs.
In a typical case diagnosis is easy to see. Skin biopsy does not give a specific convincing conclusion. Diagnosis helps diagnose psoriasis triads, presence of family history and a positive reaction to Cobner during trauma. Damaged brackets should be checked for attached fungal infections.
Treatment of psoriasis should be done in accordance with the severity of the disease.
Lactic cases are local corticosteroid ointments, keratolytic preparations (5-10% salicylic acid), topical Vitamin D derivatives (calcypotriol), anthrailine. Sea and sunlight lighting is good, but sunburn may cause exacerbation of the disease.
In severe cases, cytostatics (methotrexate, cyclosporine-A) are used. Systemic corticosteroids are contraindicated because its use can cause severe exacerbation or pustular rash. Showing PUVA-therapy (Psorrill + UV rays – 330-360 nm length). Combination of phototherapy can be combined with the above local therapy. Local glucocorticoids are used as a lotion in salts, salicylic acid and shampoos containing soda and sulfur. In severe and fatal cases (pustular and hypercaratose hand and foot psoriasis), etretinitis and isotretinin are used only by the teratogenic effects of these drugs. Generally, the treatment of psoriasis is strictly individual. The patient should be told that the disease is chronic and it is going on with alternatives and remediation. The physicians have been diagnosed with radical action to cure the disease can cause recurrence and aggravation of the disease, which, unfortunately, is rarely found in our population.
Doctor of Medicine, Associate Professor, Doctor Dermato-Venereologist,