Psoriasis is a skin disease that is widespread worldwide and, according to recent data, affects about 4% of the population. Its frequency among the white race and the population of the northern countries is higher. In the Eskimos and the indigenous population of North America, psoriasis occurs exceptionally.
The disease is chronic, systemic – it affects not only the skin but also its appendages – nails, hair, and the locomotory apparatus (joints). Periods of remission and subsequent recurrences are exacerbated. Clinical events may be mild, but it is possible and severe to run, which in some cases may also affect life expectancy.
With respect to the onset of the disease, heredity is also important, but the presence of genes for the disease does not necessarily mean a certainty. Risk factors that can provoke exposure may be infectious agents, some medications (antimalarials, beta blockers, cytostatics), stress, traumas (including surgical interventions).
Affects both men and women without statistically significant prevalence in one of the sexes. Psoriasis has two debut periods – the first one is about 20-30 years of age and second around 50 years of age. Rare, but not impossible, is the manifestation of the disease in young children or adults over 60-70 years of age.
The main symptoms are the appearance of typical plaques, most commonly on the skin of the elbows, the knees, the hair of the head, the ears. Plaque is characterized by the fact that the skin is red, prone to swelling – with fine gray-whitish scales. Gradually the plates become sealed and roughly embossed.
There are different forms of psoriasis – depending on the type and form of the plaques, as well as the sub-sites. The most severe form is generalized psoriasis, which covers the entire body skin or at least 80% of it.
The disease is systemic due to the possibility of affecting other organs. In 30 to 50% of cases of psoriasis there is also involvement of the joints . Initially, the involvement is expressed in inflammation of the joint and the surrounding tissue, followed by remodeling of the structure, resulting in deformation.
There are no exceptions to the pre-emergence of joint problems before skin changes. The disease can also be affected by nail damage – a change in its structure.
Essential for treatment is the permanent maintenance of the skin sufficiently hydrated. This is achieved by applying emollients. In the initial and lighter forms, begin with topical therapy – salicylic acid, urea, calciptotriol. In case of heavier and harder to receive local therapy systemic therapy (oral or intravenous) with corticosteroids, cytostatics, retinoids is being undertaken .
In the past 10-15 years, so-called biological treatment, which is aimed at blocking the autoimmune mechanisms of unlocking and maintaining the disease, is becoming increasingly convincing. Unfortunately, the therapy with them is still too expensive.
Phototherapy is a method based on the action of ultraviolet rays. They enter the so-called PUVA therapy , which is skin treatment with psoralen and subsequent irradiation with UV-A rays.
In terms of prophylaxis, it is advisable to avoid hot showers that further dry the skin, as well as avoiding irritants – such as those containing the wool. Chronic stress, as well as frequent infections, can cause more frequent and severe recurrences of the disease.