Psoriasis is a chronic dermatological disease that causes excessive rapid growth of skin cells, resulting in the appearance of skin plaques thickened (hyperkeratotic), white. These lesions may vary in size and location are mainly at the knees, elbows, scalp, hands, legs and sacral area (lower back). Psoriasis is most common among adults, but can occur among children and adolescents.
Normally, skin cells grow and mature gradually, over a cycle of 28 days (turn-over Cellular), will then be replaced by other young cells. Aged cells in the superficial layers of skin are gradually replaced with other new cells from deeper layers. Superficial cells die and are shed gradually with daily activities (bathing, wearing clothes).
In psoriasis, cells do not mature enough, but quickly migrate to the superficial layers of the skin (in 3-6 days) and form characteristic lesions at this level disease (hyperkeratotic plaques).
Etiology of psoriasis
Not known exact etiology of psoriasis. Most experts say the disease is genetic determinism (is inherited). About one third of people with psoriasis have at least one family member (blood relatives) with the disease. However, it is unclear whether genetic factors act alone in determining disease or if there are other personal or environmental factors also have a role in triggering the disease.
Psoriasis is not an infectious disease, so it cannot be passed from one person to another. Experts believe that immunological factors (immune system) have a role in psoriasis, given that this disease can reveal abnormal skin layers (hyperkeratotic plaques) a large number of leukocytes (white blood cells sanguine, with a role in mediating the response immune). Another argument for the nature of immune etiology of the disease is that the disease responds to immunosuppressive treatment (which inhibits the immune system).
There are several factors that have been implicated in the etiology or exacerbation of psoriasis, among them are:
- Cold and dry climate is a factor that can aggravate psoriasis symptoms experienced. Warm climate, wet and sun (UV rays) on the other hand can improve symptoms;
- Skin lesions, regardless of location, can cause the formation of hyperkeratotic plaques. The most common are injuries arising from the nail and periunghiale region;
- Stress and anxiety can cause the appearance of psoriasis and can also worsen existing lesions;
- Infections, especially infections throat (pharyngitis, tonsillitis) can cause psoriasis (immune mediated through different mechanisms). This is especially common among children infected with streptococcus;
- Certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), beta blocking agents (medicines used to treat heart disease and high blood pressure) and lithium salts can aggravate the symptoms of psoriasis. It is very important that people with psoriasis should consult doctor before taking this medicine.
Forms of psoriasis
- Some boards sized skin (usually scalp is affected more than 80%);
- Skin plaques may cover up to 20% of body surface (skin equivalent both upper limbs);
- Arthralgia (joint pain) without functional impotence;
- Aesthetic discomfort (appearance of skin lesions related complex).
Severe forms of psoriasis, have the following symptoms:
- Tile Skin skin covering large portions (20-30%). To calculate body surface mention that hand equals 1% of the total skin surface and higher each member represents about 10% of it;
- Plates localized skin on the face
- Pustule type skin lesions (raised skin lesions filled with fluid) or erythrodermic psoriasis and psoriatic arthritis with severe inflammation and massive exfoliation of the skin
- Psoriatic arthritis, which involves inflammation and swelling of joints with pain.
Psoriasis may persist for a longer period of time without worsening or improving symptoms. The disease can cause mental stress and anxiety. Some studies have shown that some patients with psoriasis show a similar impairment and mental functioning of patients suffering from other serious diseases such as cancer, chronic arthritis, depression and heart disease. Sometimes it is necessary to associate the treatment of psoriasis medication and psychotherapy.
Treatment of psoriasis
We know that currently there is no treatment (the cure) for psoriasis. On the other hand, there are several types of treatment that can relieve symptoms such as special ointments, phototherapy or oral medications. Most cases of psoriasis are mild and require no treatment than using some ointments (topical treatment).
Severe forms are difficult to treat and often require oral treatment drug. Psoriasis, regardless of type, is a disease relapsed (come back at a certain time).
The goal of treatment is to reduce the sharp rise in skin tissue (plaques) and its secondary inflammation. Psoriasis treatment is done according to the type and severity of the disease (depending on the location of skin lesions, expansion and complications associated diseases). Besides physical component (affecting skin, joints) must take into account the psychic component (secondary depression, frustration or unpleasant physical appearance), so in some cases you may need psychiatric treatment (psychotherapy, antidepressant medication).
Initial treatment
Treatment of mild psoriasis (skin plate separated a few isolated body regions without complications), starts with the use of specially formulated creams to keep skin soft and moisturized. Most products used to treat psoriasis can easily be purchased without a prescription and are given no special problems:
- Creams, lotions, ointments, used for proper hydration of the skin;
- Shampoos, oils, sprays, used to treat plaque psoriasis on the scalp appeared;
- Ointment for the treatment of psoriatic nail lesions;
- Limited exposure to the sun.
Usually treatment
Some ointments and creams may be used alone or in combination with phototherapy (ultraviolet therapy) in the maintenance treatment of uncomplicated psoriasis (with skin lesions spread less than 20% of body surface). Should be noted that local treatment (topical) as ointments, creams or lotions are more effective in some cases than in others. If symptoms do not improve after taking local treatment, doctor will choose a treatment or a combination of several treatments.
If the treatment involves phototherapy (exposure to ultraviolet rays short type B, known as UVB), specialized medical supervision is necessary to avoid possible side effects that may occur using this type of therapy secondary (lesions, skin burns).
A combination of phototherapy with ultraviolet A (PUVA) and Psolaren is also used to treat psoriasis and has beneficial effects. There are certain medical substances, photosensitizers such as methoxsalen, which can be administered orally or topically (in ointments), before exposure to UVA. The treatment is performed in cycles of 2-3 times a week and most patients get an improved clinical status (reduced, missing skin plaques), after about 19-20 sessions of phototherapy.
Topical medication used to treat psoriasis include the following agents find in various lotions and ointments:
- Compounds of vitamin D, calciferol;
- Topical steroids (substances with strong anti-inflammatory effect);
- Retinoids, such as tazarotene;
- Certain types of tar and anthralin.
Treatment of psoriasis by topical administration body wraps consist of creams, gels or lotions with strong moisturizing effect, then that area is done with foil packaging or plastic material. This treatment helps to maintain adequate hydration and increases the efficiency of topical treatment.
Outpatient treatment
GANIKDERMA® in treatment of psoriasis
- Emollient: restore skin barrier function;
- Antioxidant;
- Anti-inflammatory properties are given natural ingredients: phenol, oleocanthal, fatty acids that also favors restoring the lipid barrier of the skin. Subgallate bismuth has anti-inflammatory properties and is a hemostatic agent and antimicrobial;
- Neutral pH (6.5 to 7.5);
- Antibacterial action of phenolic acids, flavonoid, ferulic acid and ricinoleic acid, components of GANIKDERMA® ointment;
- Antiseptic action of Gum rosin and camphor