For a person, the onset of psoriasis is the moment in life when he first noticed a rash. At first, it is inconspicuous, but after a short time it merges into large plaques, covered on top with dense silvery scales. Then a rash can appear on other areas of the skin and … the patient’s life turns into one continuous horror, and the body into a kind of painting painted by an avant-garde artist.
Psoriasis is a common condition with the same frequency as eczema. In clinics, the number of patients with psoriasis is about 6-8%. Psoriasis has no age and gender. In history, there are cases when the initial psoriasis was noted in newborns and in 90-100-year-olds. Most often, psoriasis occurs in women at the age of 27 and in men at 29. The incidence of psoriasis in both sexes is the same.
Typically, initial psoriasis appears on the legs, lower back, knees, elbows, and on the head. But papules can occur on the nails, groin, and mucous membranes. It is characteristic that in one patient there is only one type of this disease, although the possibility of further development of various forms of psoriasis is not excluded.
Psoriasis is characterized by a distinct genetic predisposition. One third of patients have ancestors and relatives with this disease. But psoriasis is not exclusively a hereditary disease. This is a multifactorial disease that occurs under the influence of many external and internal provoking factors.
Initial psoriasis can appear suddenly, immediately covering large areas of the skin, or, conversely, develop slowly and gradually. The rash can be localized in limited areas or spread to almost the entire body. But the main element of psoriatic eruptions are always papules, which are rather dense nodules of red-pink color with a scaly surface.
Disease “under the microscope”
If we consider the rashes characteristic of psoriasis under a microscope, then we can see that in the papules the skin is thicker and inflamed due to hyperkeratosis (a sharp thickening of the cells of the epidermis of the skin). This inflammatory process is caused by T-lymphocytes (a type of white blood cell) attacking the skin itself. The state of chronic inflammation causes a constant process of skin cell division, and the cell cycle begins to move up to 5 times faster than in healthy people. Skin cells build up and this leads to the formation of scales. Subsequently, new capillaries are formed in the dermis, feeding the papules, and they continue their active development. Due to newly formed blood vessels, the patient’s skin can remain red even after some improvement in its condition.
It is still not clear what is the reason for the activation of T-lymphocytes in psoriasis. It is upsetting that once started, this process lasts a lifetime. Finding a way to turn off or inactivate T-lymphocytes without harming the immune system and without causing side effects is one of the most important challenges facing immunology.
Initial psoriasis is a fairly serious chronic disease, and it is always useless to fight it on your own. In order not to harm yourself and not aggravate the situation even more, it is imperative to consult a specialist. The course of the disease is also impossible to predict today as it was 150 years ago. In each individual patient, remission and exacerbation of the disease proceed differently. Treatment, accordingly, should also be individual for each patient.
A new work schedule, creating a normal environment, moderate sedation , rest or a short hospital stay will help change the course of the disease and improve the patient’s condition.