WHAT IS PSORIASIS?
Psoriasis is a chronic inflammatory hereditary skin disease, which can be provoked by internal and external triggers. In addition to the nails, the joints may also be affected. Vessels, heart, liver and metabolic processes can also be affected. A major problem is also the psychosomatic complaints and the impairment of the patients’ quality of life. Psoriasis is not contagious.
More than half of those affected contracted psoriasis (type 1 psoriasis) for the first time before the age of 40. The rarer late-type (type 2 psoriasis) does not break out until the fifth to sixth decade of life. In childhood, psoriasis is – compared to atopic dermatitis – quite rare, but they exist.
- Infections (especially streptococci, such as tonsillitis in children and adolescents, otitis media, chronic dental, paranasal sinus or gastrointestinal infections, venereal diseases and HIV infection, infection of the scalp with yeasts …)
– Injuries, tattoos, sunburn, severe scratching, persistent mechanical skin irritation (for example due to tight clothing, belts, bra)
– metabolic disorders and hormonal fluctuations (for example, during pregnancy
– Certain medications (for example, beta blockers, ACE inhibitors, lithium salts, interferons, chloroquine, and certain nonsteroidal anti-inflammatory drugs, such as indomethacin.
The cells of the uppermost skin layer (epidermis) “migrate” to the skin surface seven times faster than in healthy people. Normally, the upper skin is renewed within 28 days. This takes only three to four days for psoriatics.
The result: shiny, silvery-white scales form on sharply defined, strongly perfused and inflamed red skin areas. It affects the scalp, but also the buttocks, chest and back, sometimes also eyebrows, armpits, abdominal or sexual organs, or the anus area (buttocks)
There is also a form with a preferential infestation of the large fold regions such as armpits, groin, navel and folds, hand and foot inner surfaces. In severe cases, the whole skin (erythroderma) can be infected. This is life-threatening.
Special forms of psoriasis
- Psoriatic arthritis
About one in five psoriasis patients who are in treatment also has psoriasis arthritis. In this case, sufferers also suffer from joint and vision problems as a symptom of the disease. There are four different joint forms, which can lead to very different deformations. However, the usual skin changes do not always have to occur additionally or simultaneously in the case of psoriasis arthritis.
- Psoriasis pustulosa
In this form, purulent but germ-free pustules occur, in particular, on the soles of the feet and palms of the hand.In addition, fever, fatigue, and a severe feeling of illness are also common. According to an Institute, this severe variant affects less than five percent of all psoriasis patients.
The doctor usually makes the diagnosis after a thorough examination of the skin. Sometimes, certain features that are typical of psoriasis help him: If he scrapes a scales carefully, a thin cuticle (“last cuticle”) remains. If it also solves this, the site bleeds easily and punctiformly (“bloody dew” or “sharpening phenomenon”).
Because a causative cure is not possible, therapies are always aimed at relieving and curing the symptoms, shortening the acute phase of the disease, and avoiding new relapses. For this, a whole range of options available that of nourishing creams to strong, the immune system rich retardant (immunosuppressive) drugs. Changing the therapy form after a certain time can be helpful.
- External treatment
Most topical drugs are applied in the form of creams, ointments and lotions. In addition, bath products and shampoos are available.
. The time required for an external treatment is between 10 and 45 minutes per day depending on the extent of the skin changes.
Dithranol inhibits excessive cell growth and inflammatory processes. Common side effects of dithranol therapy include skin irritation and discolouration, including bedding and clothing. In the meantime, there is the so-called Minutentherapie, which is easy and not so time-consuming.
- Internal treatment in severe case
In case of severe progression or if the external application is not successful, medicines are administered for ingestion. Prerequisite for such internal treatment of psoriasis, which is usually in combination with topical and/or phototherapy, is a certain severity of the disease.
- Photo and climate therapies
Sun or the irradiation with artificial UV light, tuned to specific wavelengths, alleviates the symptoms in many psoriasis patients. But be careful: Avoid sunglasses, as this can lead to an explosive spread of the psoric herd. The high salt content of the water dissolves the scales and the ultraviolet radiation causes a normalization of cell division.
- laser therapy
However, this laser therapy is much more expensive and expensive than conventional phototherapy. It is particularly suitable for persistent psoriasis foci, for example on knees or elbows.