In life, it is often found that many patients confuse some diseases, and after confusion, because they do not have the correct knowledge of the disease, resulting in deviations in treatment, which may lead to the symptoms of some diseases worsening, and take many “detours” in the treatment process, psoriasis is one of them.
Because psoriasis has another more resounding name “psoriasis”, many patients in life believe that psoriasis is a kind of “ringworm” and is a contagious skin disease, just like ringworm and ringworm of the hands. This is a particularly common “misconception” about psoriasis in our lives. In order to correctly understand psoriasis and get out of the many “misconceptions” of psoriasis, it is necessary to rely on a series of professional diagnoses in clinical practice to make professional identification and diagnosis of psoriasis.
1.Psoriasis diagnostic criteria
Rash characteristics
Patients with psoriasis usually have the typical “triad of signs”, namely white scales, film phenomenon, and punctate bleeding.
Typical “triad” signs
Patients with psoriasis have red patches of skin covered with silvery-white scales that can be easily scraped off. When these scales are scraped off, a transparent film-like substance can be seen, and if the film-like substance is scraped off, the patient will experience punctate bleeding.
In addition, due to the different types of psoriasis, patients may also have some other special clinical manifestations, such as arthritic psoriasis, in addition to the common symptoms of psoriasis, there will also be arthropathy, patients often show joint swelling, pain, restricted movement, and in serious cases, joint deformity may also occur. Patients with erythrodermic psoriasis may have systemic symptoms, including fever, swollen lymph nodes, and water and electrolyte disorders.
Medical history
Because of the persistence of psoriasis, patients may have a history of psoriasis from the beginning or from a previous history of psoriasis for some time, or even for years or decades.
Past and family history
Psoriasis is prone to recurrence, and if a patient is seen for a relapse, the presence of a past history of psoriasis can be clarified in the process. Since psoriasis is considered to have a certain relationship with heredity, some patients may also have a family history of psoriasis.
However, it is still not enough to confirm the diagnosis of psoriasis from the clinical symptoms and asking the patient’s medical history, and the clinical doctor usually needs to judge with the help of some auxiliary examinations.
2.Psoriasis diagnostic tests
Histopathological examination
Dermoscopic examination
If necessary, the patient may need to remove part of the skin of the lesion for pathological examination. The doctor will cut the skin of the patient’s lesion under local anesthesia and put it under a microscope for observation, so as to clarify the nature and type according to the pathological manifestation and exclude other diseases.
X-Ray Examination
X-Ray of joints
X-ray examination is usually used for patients with high suspicion of arthritic psoriasis. The bones of the patient can be examined by X-ray to clarify the presence of joint damage and further confirm the diagnosis.
Blood tests
When a doctor suspects that a patient has psoriatic arthritis complications, he or she will also request a blood test to check for the presence of rheumatoid factor and other relevant indicators in the patient’s blood, and to rule out other types of joint lesions if they are not present.
Blood tests
Do you have a feeling of “information overload” by now? With so many symptom characteristics and examination items, what kind of process is it in practice to life?
3.Clinical consultation process
(1) In life, patients usually visit the clinic because of psoriasis because they find that their skin has scaly patches, itching, dryness and other abnormal conditions.
(2) During the consultation process, the doctor will usually make inquiries first, asking the patient when the symptoms appeared; whether the lesions appeared suddenly or gradually; whether similar symptoms have appeared before; whether any relatives in the family have also had such symptoms; whether other skin diseases or systemic infections or surgeries have appeared before, etc.
(3) After asking the appropriate questions, the doctor will begin to examine the shape, color, and distribution of the lesions.
(4) After examination, if the doctor determines that further testing is necessary, he or she will recommend some ancillary tests to diagnose the disease, usually including histopathology, x-ray, and blood tests.
(5) Once the diagnosis is confirmed, the doctor will choose different treatment methods according to the severity and staging of the patient’s disease.
After these operations, the basic process of medical treatment is almost complete, but in this process, there are some details that patients are advised to pay attention to.
4.Other details
During special periods, such as during an epidemic, hospitals are required to carry out stricter control. During the visit, it is necessary to improve some measures according to the specific requirements of different hospitals, such as taking body temperature, wearing a good mask, and carrying a valid ID card to make a time-slotted appointment, staying away from others in line, and trying to maintain a 1-meter queuing distance. If the hospital has special requirements, patients are advised to know in advance whether they need to undergo nucleic acid tests in advance, etc.
Preparing in advance and being familiar with the consultation process can make the process smoother. Patients should also make sure that they do not follow blindly or panic, especially not to listen to some so-called biased prescriptions, but should trust more professional and regular hospitals and listen to professional doctors’ advice in order to minimize the harm of the disease.
References
[1] Huang Dan, Chen Kun. Advances in epidemiological investigations related to psoriasis [J]. Diagnosis Theory and Practice,2021,20(01):48-52.
[2]Cheng Longlong,Jiang Shukun,Du Yang,Liu Jihui. The pathogenesis of psoriasis and its research progress[J]. Medical Review,2019,25(02):227-232.