Difficult life with psoriasis

Proven content

It is not a disease that does not give any obvious symptoms. Changes on the skin are visible to the naked eye, which is the main burden for patients. Although psoriasis is treated with more and more modern methods, it is unfortunately chronic and recurrent.

Not only is it one of the most severe skin diseases, but also it occurs in all latitudes. Known for a long time – it was first described by Hippocrates. Its Latin name – psoriasis – comes from the Greek word psora, meaning itch. Psoriasis is a real nuisance for many people. Worldwide, it affects approximately 2-4 percent. population, in Poland is affected by approx. 800 thousand. people. Most often it is young people between 15 and 30 years of age.

So far, the exact causes of psoriasis have not been discovered, but it is undoubtedly genetic. The observations show that in the case of both parents suffering from psoriasis, the probability of their child developing psoriasis increases to approx. 70%.

Scales on the skin

How is psoriasis manifested? Increased proliferation, i.e. faster division of epidermal cells. This, in turn, leads to the formation of clearly visible, reddish-brown lumpy eruptions covered with silvery scales. The latter, as they develop, merge into larger patches that disappear without a trace (sometimes after treatment, paler areas remain in the area of ​​the scales, but they are of a temporary nature). In general, lesions appear on the elbows, knees, around the sacrum and buttocks, on the nails (it may then be mistaken for mycosis) and on the scalp. Medicine distinguishes, among others, Plain psoriasis, affecting about 90% of patients, pustular and articular (often confused with onychomycosis).

The choice of the treatment method is decided by the physician, who must take into account the patient’s clinical condition, the type of skin changes, the degree of their severity, etc. Regardless of these factors, it is important that psoriasis is not infected!

Stop the inflammatory process

Psoriasis is a chronic disease of varying severity. It is characterized by periods of remission, i.e. the disappearance of symptoms, and their sudden relapses.

The main treatment consists of external therapies that work on symptoms. However, they do not cause a permanent remission of the disease, because it is incurable. The treatment is carried out in two stages. First, exfoliating drugs are used to remove the scales, which greatly weaken or even prevent penetration into anti-psoriatic drugs. Appropriate ointments containing salicylic acid are then used.

Then, reducing agents are introduced into the treatment, directly affecting the excessive proliferation and inhibiting inflammation. Currently, ointments containing corticosteroids are very popular, but they should be recommended for use on a limited area of ​​the body. For example, they should not be used on the face and on extensive lesions, because there is a possibility of general complications related to their absorption, as well as possible skin steroid atrophy. This is especially true in the area of ​​folds and joint bends, where the drug remains and penetrates into the deeper layers of the skin. The severity of side effects largely depends on the type of steroid used.

Relatively recently, retinoids (tazarotene) and vitamin D3 derivatives, e.g. calcipotriol, have been introduced into external treatment.

In the case of scalp psoriasis, the same drugs are used (steroids, vitamin D3 derivatives), but in the form of lotions and shampoos. Due to the itching experienced by most patients and quite significant drying of the skin, it is advisable to use emollients and / or oiling baths.

In people with milder forms of psoriasis (up to 25% of the skin surface), local treatment is sufficient in most cases.

Irradiation and oral medications

Still other methods are used in the treatment of psoriasis. These include irradiation with UVA and UVB rays, i.e. PUVA therapy (orally P-psolarena and UVA), wide-spectrum UVB and narrow UVB (311 nm) phototherapy, as well as excimer laser irradiation (308 nm).

In general treatment, prescribed in more severe cases, oral synthetic retinoids, derivatives of vitamin A are administered. The indication is pustular, articular and ordinary psoriasis – resistant to external treatment and phototherapy.

In severe psoriasis – articular and erythrodermic psoriasis – methotrexate (a cytostatic drug) is also given. It is used more often than the more toxic and less effective hydroxycarbamide.

What helps and what harms?

It is already known that stress leads to relapses and exacerbation of lesions, therefore psychotherapy has a positive effect on the course of psoriasis in some cases. Such help is useful for patients whose skin changes cause mood disorders, depression and even attempting suicide. Angina or other infections or intra-body infections may contribute to the deterioration of the condition. Therefore, they must not be neglected. Regular visits to the dentist are also important.

Most patients recover or remission in summer due to the action of the sun (although in some people sunlight causes an increase and new seeding). Sunbathing by the sea and swimming in the sea (especially very salty) are particularly beneficial. It is also worth adding regular salt to your daily baths.

In the case of exacerbations of the disease, it is inadvisable to drink alcohol or smoke cigarettes.

It is also worth remembering that the use of certain medications recommended in other diseases makes the disease recur or prolongs treatment. This applies in particular to beta-blockers, antihypertensives (e.g. propranolol) and some antibiotics.

Text: Alina Więckiewicz

Consultation: Kamila Padlewska, MD, PhD, University of Cosmetics and Health Care

Source: Let’s live longer