a significant increase in the number of patients with disability as a ground for disease and disability, especially among young men.
According to various sources, the disease was from 2 to 7% of the population. In the structure of diseases of the skin psoriasis is 3-5%, and among patients with dermatological hospitals — up to 25%.
This data is for some reason incomplete: the difficulty of identifying the severe forms, such as, psoriatic arthritis, rare negotiability to medical institutions of patients with mild forms etc.
Despite the advantage of the local manifestations the skin in the majority of forms of the disease, its causes and the nature of the offences in the body of the disease is of a systemic nature.
In the course of the disease, the joints involved, the blood vessels, the kidneys, the liver. There is also a high risk of diabetes, obesity and hypertension in people with psoriasis, especially in women.
In 20-30% of patients later develop a syndrome of metabolic disorders with a high content of triglycerides in blood, obesity, especially in the abdomen, psoriatic arthritis.
Also in the last few years reveals a series of biological markers, that indicate a direct connection of psoriasis with crohn's disease, rheumatoid arthritis, cardiovascular diseases, angina, and increased mortality due to myocardial infarction.
For these and other reasons, a growing number of researchers are inclined to the system of definition Dermatosis as "psoriatic disease" and not just "psoriasis."
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Despite the large number of hypotheses and research carried out in the present day is still difficult, the answer to the question of whether psoriasis is transmitted by inheritance. However, it is generally accepted that the disease is genetically determined. In the absence of the disease, both parents that is found only in 4.7% of children. When the disease of the parents, the child's risk of Contracting is increased to 15-17%, both parents — to 41%.
The beginning of psoriatic disease can be at any age, but in the majority of cases, the peak observed in the ages of 16-25 years of age (type I psoriasis) and 50-60 years (type II psoriasis). Psoriasis of the ith type can be traced to hereditary disease, joint injuries and the prevalence of the lesions varicose veins. With type II disease have a more favorable course.
The main link in the pathogenesis (mechanism of development) disease that causes lesions on the skin, is the increase of mitotic (cell division) activity and the proliferation accelerated (growth) epidermalibus cells. The result of the cells of the epidermis, without having orogovet, expelled by the cells of the layers underlying the skin. This phenomenon is accompanied by excessive flaking and it is said Hyperkeratose.
Possible the free communication and contact with the patients, that is to say, can you get it? All the studies related to this disease, to refute this hypothesis. The disease did not spread to other people by droplets or by direct contact.
Implementation of a genetic predisposition to the disease (according to the theory of genetics of psoriasis) are possible in the case of the alterations of the regulatory mechanisms of the following systems:
Mental trauma plays an important (if not the main) role in the mechanism of the disease, and the frequency and duration of relapses. At the same time, the dermatosis causes an alteration of the functional state of the psyche. Endocrine.
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Immune. The mechanism of realization of genetic predisposition to PSORIASIS with involvement of the immune system that occurs through genes that control the immune response to cellular and immune cell interaction with the other (HLA system). Immune system in psoriasis is also either altered genetically or under the influence of internal or external factors, as evidenced by a violation of all the parts of the cutaneous immune regulation.
Genetically determined disorders of cell metabolism lead to the accelerated growth and proliferation of cells immature of the epidermis, which leads to the release of substances biologically active (BAS) lymphocytes, are the cells of the skin, activated keratinocytes and macrophages. These are mediatores, inflammation and the immune response.
These substances include protease, protein informational molecules called cytokines (tumor necrosis factor, interleukins, interferons, and various subtypes of lymphocytes), polyamines (hydrocarbon radical). Mediators, in turn, stimulate the growth of the defects of the cells of the epidermis, changes in the walls of small blood vessels and the appearance of the inflammation.
The whole process is accompanied by the accumulation in the epidermis and the papillary layer of the dermis of one - and multi-celled leukocyte. Predisposing and trigger factors Key pathological manifestation of psoriasis is the excessive growth of the defective cells of the epidermis. Therefore, fundamental to the elucidation of the mechanisms of the disease and decide how to treat psoriasis, is the establishment of game factors. Main:
Metabolic disorders in the body, the dysfunction of the digestive tract organs, especially the liver and exocrine function of the pancreas. Disease or dysfunction of the endocrine glands (hypothalamus, thyroid, parathyroid tissue and glands, the endocrine activity of the pancreas). Immune system (allergichekie reactions and immunological diseases).
The presence in the body of the chronic focus of infection (tonsillitis, rhinosinusitis, inflammationibus profuere, etc.). Pathogenic and conditionally pathogenic microorganisms, especially Staphylococcus aureus, streptococci and fermentum the fungus, its toxins, the skin cells damaged by these microorganisms, are powerful antigens, which can activate the immune system to aggression against them, modified, and healthy cells of the body.
Mechanical and chemical damage to the skin, the prolonged use of antibiotics or glucocorticoids for any disease, giperinsolyatsiya, Smoking and alcohol abuse, acute infectious diseases (respiratoriorum viral infection, influenza, angina, etc.).
The progression of the process in which precipitation of up to 1-2 mm appear in large quantities in new areas. It transformirovalsya in a typical psoriatic plaque.
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the symptom of "stearin spot" — strengthening peeling after a light poskablivanii, making the surface of the papules becomes similar to the fall oppressi stearin; this is due to parakeratosis (thickening of the epithelium), Hyperkeratose (thickening of the stratum corneum of the skin, i.e. the stratum scales), the accumulation of fat and sicut crassus, the components of the external layers of the epidermis; a symptom of the "terminal film" under remote scales appears slimy epidermis layer in the form of a thin, smooth, shiny, wet surfaces; the symptom of "blood dew", or the phenomenon Auspittsa-Polotebnova — not merging together of drops of blood in the form of dew, which act on the shiny surface after a light poskablivanii is due to an injury plenus blood vessels dermal papillae.
Favourite places of localization of the eruption pellis are part of the head, a symmetrical arrangement on extensoris indications of surfaces in the area of large joints — elbow, knee. The location of the plates can be very time has been limited to these areas. So they are called "guard" or "officium". Rarely affects the nails, the skin in the area of other joints, genitals, face, soles of the feet and hands, large folds.
Another characteristic symptom is the appearance of psoriatic lesions in areas of mechanical or chemical damage to the skin (the phenomenon Kebnera). These lesions can be scalpendi, cuts, chemical irritation by acids or alkalis.
Depending on the location of the elements and clinical course, psoriasis vulgaris is divided into several varieties:If on the face, back and chest rash has the character of red papules, which are covered squamea convolvens large plates of silver-white color, the ears are similar to the eruption of dermatitis, complicated by access infection.
The surface of the keratosis spots and papules of the ear sinks more bright and edematous, in comparison with other areas. It is covered with statera intentionally yellowish-white or gray-white color and serosum vehentem-purulent cortex (due to the macerari), which fits well to the skin. Almost always rash accompanied by severe itching.
