- Clinical forms of psoriasis
- treatment of psoriasis of the scalp
Psoriasis - a chronic dermatosis of multifactorial nature, which is characterized by hyperproliferative processes keratinization disorder and inflammation in the dermis, the changes in the internal organs and systems.
Final cause of the disease remains unclear.Currently, the most probable is considered an autoimmune nature of psoriasis.Among other theories most widely following:
- genetic predisposition
- neurogenic (psoriasis is the consequence of vasomotor neurosis)
- infectious viral
- exchange (violation of lipid metabolism and biogenic amines)
- allergic and infectious-allergic
Clinical studies show that the majority of patients can not identify any single factor that could explain the onset of the disease.Most often there is a combination of several of these reasons, which gives reason to include psoriasis polietiologichesky disease.to the content ↑
Clinical forms of psoriasis
Classification of psoriasis is based on its clinical manifestations and includes the following forms:
- Common or vulgar psoriasis - noted the appearance of miliary flattened papules, pinkish or red, dense on palpation and a fewtowering above the skin.Almost immediately from the time of occurrence, papules begin to be covered with loose, silvery scales that are easy to fall off when touched.Papules tend to merge, gradually turning from miliary in lenticular and nummulyarnye, forming plaques of various shapes and sizes.
- Exudative psoriasis - most often develops in patients with diabetes, obesity, hypothyroidism.Characterized by soaking flakes exudate, causing them to take the form of a greyish-yellow crusts.
- Seborrheic psoriasis - most often localized on the scalp, behind the ears, in the area of the shoulder blades and chest.The scales have a yellowish tint.
- Palmoplantar psoriasis - most often occurs in people engaged in physical labor.Clinically shown bright red psoriatic papules having clear boundaries, with a major scaling.Sometimes there may be psoriatic corn.
- Psoriatic erythroderma - usually a worsening of pre-existing psoriasis.The skin has a bright red color, the scales cover almost the entire surface of the body.
- pustular psoriasis - extreme manifestations of exudative form.Eruptions are pustular character.There are generalized form Tsumbusha, and palmar-plantar form Baber.
- psoriatic arthritis - occurs simultaneously with psoriatic skin lesions or precedes it.It characterized by "axial" defeat of small joints of the feet and hands, with their deformity and loss of function.
treatment of psoriasis of the scalp
must be comprehensive and include general and local therapy adherence and diet, physiotherapy.In appointing the drug therapy accounted stage of the process, clinical form and severity.
In the period of acute treatment is carried out permanently and begins with systemic immunosuppressive drug therapy.It includes
- Corticosteroids (prednisone, dexamethasone)
- Cytotoxic agents (methotrexate, cyclosporine A)
- Biological drugs (infliximab, rituximab)
When exudative form appointed diuretics (furosemide, spironolactone).The development of psoriatic arthritis requires the appointment of nonsteroidal anti-inflammatory drugs (diclofenac, ibuprofen, meloxicam).In protracted process, resistance to therapy can assign pyrogenic therapy (pirogenal).
In marked itching and anxiety appointed antihistamines 1-2 generations, who have also expressed sedation (tavegil, diazolin, pipolfen).
Effectively himself showed immunomodulatory therapy, vitamin therapy, especially the appointment of vitamins A (retinoids).
pronounced effect can be achieved with the help of extracorporeal therapies, in particular in exudative process.These include hemosorption and plasmapheresis.
special place in the treatment of psoriasis takes physiotherapy: UV irradiation, PUVA therapy (a combination of long-wavelength UVA with psoralens - special herbal preparations), paraffin baths.Perhaps a combination of PUVA therapy with methotrexate (IU-PUVA) and aromatic retinoids (re-PUVA).
Local therapy for psoriasis of the scalp is to appoint anti-inflammatory drugs (with the progression of the process) - 1-2% salicylic cream, corticosteroid ointment - lubricate the neck and behind the ears.Places of hair growth are lubricated with 1% sulfur or salicylic 2% mercury-salicylic ointment.In the stationary stage used keratolytic agents - 10% sulfuric ointment, resorcinol, ointments containing 5-20% lactic and 5-15% of benzoic acid.Ointments are used for dissolving or softening flakes, after which they should be carefully schesat comb.
Reducing drug administered in a regressive step.They are administered in low concentrations: 5% ihtiolovaya ointment, 2% tar ointment, 10% Naftalan ointment, with a gradual increase.In addition to creams and ointments produced special shampoos which contain these substances - psorian gamma, etc. vitapsor
Currently more successfully applied the D3 vitamin (calcipotriol), topically, in an ointment (Dayvoneks).Its mechanism of action is the ability to modulate differentiation and proliferation of keratinocytes through specific intracellular receptors, tropic to vitamin D3.
positively acquitted itself climatotherapy and special resorts.Patients with psoriasis are shown sunbathing, mud baths, hot springs.In this case it is proved that one of the best resorts is the Dead Sea - climatotherapy efficiency here reaches almost 80%.
diet for psoriasis is not a decisive factor, but as the skin performs excretory function, it is recommended to avoid eating spicy, fatty and smoked foods, which irritate the gastro-intestinal tract and adversely affects the liver.