Psoriasis, Lichen Squamosus

Article "Psoriasis, Lichen Squamosus"

Psoriasis is a chronic skin disease that affects the skin, nails, and joints. Etiology and pathogenesis are unknown. The most common are viral, hereditary, neurogenic, metabolic theories of the origin of psoriasis, none of which is generally accepted.

Apparently, the disease is multifactorial in nature. In the pathogenesis, a certain role is assigned to immunological, enzymatic and other biochemical disorders. The disease occurs at any age and is non-contagious.

In typical cases, the clinical picture is characterized by the appearance of a monomorphic papular rash, located mainly on the extensor surfaces of the extremities (especially on the elbows and knees), torso, and scalp. Sharply demarcated papules with a diameter of 2-3 mm to 1-2 cm, pinkish-red in color, round in outline, protrude somewhat above the surface of the skin, covered with silver-white scales.

When scraping the papules, 3 diagnostic phenomena are revealed: 1) stearin stain; 2) terminal film; 3) blood dew.

Papules are characterized by a pronounced tendency to eccentric growth, which leads to the formation of plaques, which in turn merge into continuous lesions with uneven outlines.

As the process progresses, a bright red rim, devoid of scales, appears around the papules, and the number of new rashes increases; the Koebner phenomenon is positive; subjectively - itching. When the process regresses, a weakening of the color intensity, resorption of rashes, and the appearance of a Voronov's rim are characteristic.

Resorption of plaques usually begins from the central part, as a result of which the psoriatic elements acquire a ring-shaped or garland-like shape. Temporary depigmentation (pseudo-leukoderma) remains at the sites of resolved rashes. During periods of incomplete remissions, isolated “standby” plaques may remain in certain areas of the skin (usually in the area of ​​the elbow and knee joints).

The course of the disease is chronic and undulating. The seasonality of the process is usually pronounced - deterioration in winter with significant improvement in summer (winter type), less often - vice versa (summer type).

Treatment: diet with limited animal fats and carbohydrates, exclusion of spicy foods and alcohol. Keratoplasty, corticosteroid and other ointments are used externally. Spa treatment is indicated - hydrogen sulfide and radon springs, sunbathing and sea bathing. In severe forms, hormones and cytostatics are prescribed, phototherapy, hemosorption, and plasmapheresis are used.

Prevention: clinical observation, maintenance therapy in the winter-spring period.