Psoriasis is a chronic non-communicable disease, namely skin disease, which mainly affects the skin. The autoimmune nature of this disease is currently hypothesized. Psoriasis usually causes excessive dryness, redness, and swelling of the skin. However, some patients with psoriasis do not have any visible skin damage. The spots caused by psoriasis are called plaques. These spots are essentially sites of chronic inflammation and excessive proliferation of lymphocytes, macrophages, and skin keratinocytes, as well as sites of excessive formation of new small capillaries in the underlying skin layer.
What causes psoriasis?
The cause of psoriasis is not yet fully understood. Currently, there are two main hypotheses regarding the nature of the process leading to the development of this disease.
According to the first hypothesis, psoriasis is a primary skin disease in which the normal maturation and differentiation of skin cells are disrupted, and these cells overgrow and proliferate. At the same time, proponents of this hypothesis believe that the psoriasis problem violates the function of the epidermis and its keratinocytes.
The autoimmune attack of T lymphocytes and macrophages on skin cells, their intrusion into the skin thickness and excessive skin proliferation are considered secondary because of the body’s response to "wrong", immature, pathologically altered keratinocyte proliferation. This hypothesis is supported by the positive effects of drugs that inhibit the proliferation of keratinocytes and/or accelerate their maturation and differentiation in the treatment of psoriasis, while having no or negligible systemic immunomodulatory properties-retinoids (vitamin ASynthetic analogues), vitamin D, especially its active form, fumarate.
The second hypothesis suggests that psoriasis is an immune-mediated, immunopathological or autoimmune disease, in which skin cells overgrowth and proliferate, especially keratinocytes secondary to various inflammations produced by immune system cellsFactors and/or, and autoimmune cells damage the skin to cause secondary regeneration reactions.
What will happen to the skin and how to care for it?
Damage to the barrier function of the skin (especially mechanical damage or irritation, skin friction and pressure, abuse of soaps and detergents, contact with solvents, household chemicals, alcohol-containing solutions, skin or skin infections, allergies, immunoglobulin deficiency, Excessive dry skin) also plays a role in the development of psoriasis.
Dry skin infections can cause dry (non-exudative) chronic inflammation, which can lead to psoriasis-like symptoms such as itching and increased skin cell proliferation. Due to the increase in inflammation and skin cell proliferation, and due to the fact that infectious organisms consume water, this in turn leads to a further increase in skin dryness, otherwise the water will play a role in moisturizing the skin. In order to avoid excessive dryness of the skin and reduce the symptoms of psoriasis, it is not recommended for psoriasis patients to use towels and scrubs, especially hard ones, because they will not only damage the skin, leave tiny scratches, but also scrape the upper to protect the skin stratum corneumAnd sebum, which usually protects the skin from dryness and microbial penetration. It is also recommended to use talcum powder or baby powder after washing or bathing to absorb excess moisture on the skin, otherwise the moisture will "enter" the source of infection. In addition, it is recommended to use products that moisturize and nourish the skin, and lotions that improve the function of the sebaceous glands. It is not recommended to abuse soap and detergent. You should try to avoid skin contact with solvents and household chemicals.
Is psoriasis inherited?
Genetic components play an important role in the development of psoriasis. Many genes related to or directly involved in the development of psoriasis are known, but it is not clear how these genes interact during the development of the disease. Most of the currently known genes related to psoriasis affect the function of the immune system in one way or another.
It is believed that if a healthy parent has a child with psoriasis, the probability of the next child being sick is 17%, and if one of the parents has psoriasis, the child's probability of being sick will beIncrease to 25% (diseases with both parents-up to 60-70%).
Since it is impossible to determine the genetic transmission of skin diseases in most patients with psoriasis, it is believed that psoriasis itself is not inherited, but a tendency of inheritance. In some cases, such genetic factors andThe complex interaction of adverse environmental impacts.
What does psoriasis look like?
Excessive proliferation of keratinocytes (skin cells) in psoriatic plaques and infiltration of lymphocytes and macrophages into the skin can quickly lead to thickening of the skin at the affected area, higher than the surface of healthy skin, and forming a characteristic pale, gray or silver lookSpots on hardened wax or paraffin wax ("Paraffin Lake"). Psoriasis plaques most often first appear on areas subject to friction and pressure-the curved surfaces of the elbows and knees, the hips. However, psoriatic plaques can occur and are located on any part of the skin, including the scalp (scalp), the palm surface of the hand, the plantar surface of the foot, and the external genitalia. Compared with eczema rash, eczema rash usually affects the inner flexor surface of the knee and elbow joints, and psoriatic plaques are more often located on the extensor surface of the joint.
What is needed to diagnose psoriasis?
This is usually much more difficult in children than in adults: in children, psoriasis is usually in an atypical form, which can make diagnosis difficult. The earlier the diagnosis is made, the greater the chance of fighting the disease.
There are no diagnostic procedures or blood tests specifically for psoriasis. However, for active, progressive psoriasis or its severe course, abnormal blood tests may be detected to confirm the existence of active inflammation, autoimmunity, rheumatic processes (increased rheumatoid factor titer, acute phase protein, white blood cellIncrease, ESR increase, etc. ), and endocrine and biochemical disorders. Sometimes a skin biopsy is required to rule out other skin diseases and confirm the diagnosis of psoriasis histologically.
How is psoriasis treated?
It is worthwhile to start treating the child for psoriasis as early as possible and to monitor the child so that he follows all the doctor’s recommendations. The baby's immune system is very sensitive. With the right method, she can deal with psoriasis, and if it is allowed to develop, the skin will be more and more affected.
If your child has symptoms of disease-plaques, itching, redness, peeling on the skin, you need to start treatment immediately, strictly in accordance with all the doctor's recommendations, he will recommend you to apply a special cream on the skin.
During the progressive stages and common forms of illness, it is best to hospitalize your child. Prescribe desensitizers and tranquilizers in a teaspoon, dessert or spoon of 5% calcium gluconate solution or 10% calcium chloride solution, 3 times a day. 10% calcium gluconate solution is injected intramuscularly, 3-5-8 ml (depending on age) every other day, 10-15 times per course of treatment. When itching is severe, oral antihistamines are needed for 7-10 days. For older children who are in a progressive stage, emotionally excited, and have poor sleep, small doses of hypnotics and small town tranquilizers can sometimes produce good results.
Application of vitamins: ascorbic acid 0. 05-0. 1 g, 3 times a day; pyridoxine-2. 5-5% solution, 1 ml every other day, 15-20 injections per course of treatment. Vitamin B12 is especially suitable for common exudative psoriasis-30-100 mcg, twice a week, combined with folic acid and ascorbic acid, twice a week for 172-2 months. The dose of vitamin A is 10, 000-30, 000 ME, once a day for 1-2 months. Patients with summer psoriasis, especially those with severe itching, will have niacin in their bodies. For psoriatic erythroderma, it is recommended: intramuscular injection of riboflavin mononucleotide, oral vitamin B15 or suppository (double dose), potassium orotate. Vitamin D2 should be used with caution in all forms of psoriasis.
In order to stimulate protection and adaptation mechanisms, pyrogenic drugs are prescribed to normalize vascular permeability and inhibit the mitotic activity of the epidermis. According to the results obtained, multiple blood, plasma, and multiple infusions per week can produce good therapeutic effects. For children with persistent (exudative and erythroderma) psoriasis, it is sometimes impossible to get a positive impact from these funds. Then, oral glucocorticoid, 0. 5-1 mg per kilogram of body weight per day for 2-3 weeks, and then gradually reduce the drug dose until it is cancelled. Due to their toxicity, cytostatics are not recommended for children of all ages. In the stationary and degenerative stages of the disease, a more aggressive treatment is prescribed-UFO, which is generally bathed for 10-15 minutes at a temperature of 35-37°C after 1 day.
Topical treatment of psoriasis.
Salicylic acid (1-2%), sulfur tar (2-3%) ointment; glucocorticoid ointment. These ointments take the form of occlusive dressings to quickly locate the palm and plantar psoriasis plaques and have a direct effect. For children with major scalp lesions, the recently used phosphodiesterase inhibitors in the form of lubricants or occlusive dressings with ointments can be recommended.
It is necessary to emphasize the importance of hygiene for local infections (respiratory diseases, ear, nose, and throat diseases, worm invasion, etc. ). Children with psoriasis can undergo tonsillectomy and glandectomy after 3 years of age. In 90% of cases, these surgical interventions have a beneficial effect on the entire process, and in 10% of patients, especially those with extensive exudative psoriasis, the condition will continue to worsen. Follow-up examinations after 7-10 years showed that 2/3 of patients after tonsillectomy did not relapse, while the remaining 1/3 had a small number of children with exacerbated rash and prolonged remission; in patients with psoriasis and chronic tonsillitisAmong non-surgical children, the deterioration of skin disease is more frequent.
Our long-term observation of children shows that in most cases, psoriasis relapses with age is less frequent and less obvious, and the trend of changing from a common form of skin disease to a limited form can be clearly seen. However, in some patients, the process is still common, with serious processes.
Is psoriasis a lifetime diagnosis?
If you start the right treatment in time, it won't be. The development of psoriasis in children does not mean that as an adult, he will also suffer from this disease. Of course, psoriasis is a chronic disease, and it is almost impossible to cure 100%. But the quiet period can be maximized. The treatment of psoriasis in children is the same as that of adults, with one treatment being switched to another every three months.
Children should be mentally prepared in advance for physical defects. Unlike adults, psoriasis in children usually affects not the body but the face (30% of cases). The rash may appear on the forehead, cheeks, and eyelids. Psychologically, this is quite unbearable. In addition, in one-third of children with childhood psoriasis, nails are affected. Therefore, it is quite difficult to hide the disease.
In addition to physical unpleasant feelings, psoriasis may also be a severe test of a child's mental state. Parents should not let him solve problems alone. Any activity should be encouraged: sports, games. However, it is worth remembering the caveats. For example, you can stretch the skin of certain parts of the body (for example, when riding a bicycle for a long time). This can cause psoriasis. Although the skin condition looks unsightly, the child can go swimming! If there are chemicals in the water, please remove
Why is there no complete cure for psoriasis?
This disease is called mystery disease for a reason. The nature of the disease is still unclear. Some psoriasis affects the face, some have limbs, and some have joints! Why marriage occurs in the cells of our body is unclear. As an oncology, psoriasis cannot be treated with pills. Interesting developments are happening in our country now. They tried to treat children with ointments made from natural ingredients. The forecast is favorable, but the ointment has not yet been put into production. At the same time, my advice to parents is not to trust scammers and pseudo-therapists. If your child shows signs of psoriasis, please contact a professional-a pediatric dermatologist.