Psoriasis, also known as psoriasis, is a common chronic erythematous scaly skin disease with an incompletely understood etiology related to genetic factors, infections, metabolic disorders, and immune dysfunction. Based on clinical features, there are four types: the common, erythrodermic, pustular, and arthritic types. The incidence is 0.12-1.9% in China, 0.2-1% in Japan, 2.6% in the United States, and 1-2% in Europe. The incidence is higher in Caucasians than in Yellows, and in Yellows than in Blacks. The chance of heredity is 10%-23% in China.
1. Causes of recurrence or aggravation of psoriasis
Local trauma, local irritation.
Infection (streptococcal pharyngitis, viral infection).
Cold and dryness.
Endocrine changes.
Physical and psychological stress reactions.
Abrupt withdrawal of systemic and/or potent topical steroids.
Alcohol consumption.
Mental stress.
Wrong treatment.
2. Common types of psoriasis and their clinical features
Psoriasis vulgaris
(1) It can occur in any part of the body and is symmetrically distributed.
(2) The rash is characterized by red papules at first, which can gradually expand or fuse into infiltrative plaques, with silvery white scales on the surface of the rash, and after scraping off the scales to reveal a lustrous light red film (called “film phenomenon”), and then scraping off the film to appear sieve-like bleeding (called punctate bleeding phenomenon).
(3) The hair on the scalp is distributed in bundles, but there is no hair breakage.
(4) In the progressive stage, psoriasis damage often occurs locally after skin trauma or needling (called psoriasis isomorphic reaction phenomenon).
5) Pathological changes are characterized by incomplete keratinization, small Munro abscesses composed of neutrophils within or under the stratum corneum, prolonged dermal protrusions, and thinning of the spinous layer above the top of the dermal papillae.
(6) The course of the disease is generally divided into a progressive phase (new rash constantly appears and expands), a quiescent phase (the disease is in a stationary stage, no new rash occurs) and a regressive phase (the rash gradually fades, leaving temporary hypopigmentation or hyperpigmentation spots). The disease is often recurrent and often recurs or worsens in winter.
Erythrodermic psoriasis
(1) History of improper treatment of psoriasis vulgaris, such as the application of irritating topical drugs during the progressive period; sudden discontinuation or rapid reduction of corticosteroid treatment after the application of a large amount of corticosteroids; and overheated bathing during the progressive period
or irritating hot spring baths, etc.
(2) The original skin lesion is aggravated, enlarged, and rapidly develops into a generalized red or purplish-red spot with a lot of flaking, and the mucous membrane of the mouth, nose, throat and conjunctiva of the eyes are congested and red.
3) Systemic symptoms such as fever, chills, headache, enlarged superficial lymph nodes, and increased white blood cell count appear.
4) It mostly occurs in adults and has a long disease duration.
Pustular psoriasis
1）Most of them have acute onset and often spread all over the body within a few weeks, with the flexors and folds of the limbs being the heaviest.
(2) The lesions are characterized by dense pinhead to corn-sized superficial sterile pustules on an erythematous basis.
The pustules dry up and become flaky. Due to external factors such as abrasion or sweat impregnation, it is often accompanied by oozing, erosion and crusting. The finger (toe) nail may be atrophied, dissolved or thickened and cloudy, and small pustules may appear in the nail bed.
(3) This type may develop from common psoriasis, or may show common psoriasis damage in the course of this type of lesion.
(4) It is often accompanied by systemic symptoms such as high fever, arthralgia, general malaise and increased leukocytes, and may also be complicated by liver and kidney damage.
(5) The pathology is characterized by the appearance of Kogoj spongy pustules in the upper part of the spinous layer on the basis of common psoriasis.
Arthritic psoriasis
(1) Often secondary to psoriasis, the lesions are often aggravated with exudation or pustular erythrodermic changes.
(2) The rheumatoid arthritis-like changes such as redness, swelling, pain and limitation of movement appear in large and small joints throughout the body, especially in the small joints of the fat (toe), and ankylosis appears over time, but the rheumatoid factor is negative.
3) With fever and increased blood sedimentation. The course of the disease is chronic.
3.Proper understanding of psoriasis
Understand and learn the scientific knowledge related to psoriasis to exclude unnecessary fear.
Psoriasis is not contagious, and family members living together in daily life do not need special protection.
Although the current medical science can not be eradicated, but the reasonable application of Chinese and Western medicine treatment under the guidance of doctors can completely reduce the disease and improve the quality of life.
Psoriasis may accompany you for the rest of your life, so you should treat it correctly and treat it scientifically.
The psoriatic skin loses a lot of proteins due to the large amount of flaking, and excessive avoidance of food can lead to malnutrition (such as hypoproteinemia).
Diet should pay attention to a balanced mix of staple foods, eggs, milk, meat and vegetables, but wine, spicy and other irritants should be avoided.
Do not believe in “secret recipes”, “complete eradication”, “never relapse”, “refundable” and other propaganda. Stay away from unsafe and non-scientific treatments.
Consult your doctor frequently when you encounter confusing problems.