Whole Body Psoriasis, Vulgaris, Seborrheic, Guttate And Palmar-plantar Psoriasis

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Types and types of psoriasis

Types of psoriasis

In view of its polyetiological origin, psoriasis is also characterized by various clinical manifestations. By grouping them, its individual types were identified. The need for such a division arose in connection with the different effectiveness of specific methods of treating psoriasis of certain forms of this disease. According to the clinical course of psoriasis, the following types are distinguished:

1. Plaque psoriasis or simple psoriasis (classic form);
2. Guttate psoriasis;
3. Pustular form;
4. Exudative psoriasis;
5. Atypical species;
6. Lesion of the soles and palms;
7. The defeat of the flexor surfaces;
8. Scalp psoriasis;
9. Damage to the facial area;
10. Lesion of nails with psoriasis;
11. The articular form of the disease;
12. Erythrodermic form of psoriasis;

It makes sense to briefly dwell on the most common types of psoriasis due to their relevance. After all, they can disguise themselves for a long time under the guise of other diseases, remaining without proper treatment. This can aggravate the course of the process and its sensitivity to more gentle treatments.

Content:

• Psoriasis on the head
• Nail psoriasis
• Psoriasis on the hands
• Psoriasis on the face
• Psoriasis on the legs
• Psoriasis on the elbows
• Vulgar psoriasis
• Psoriasis on the genitals
• Seborrheic psoriasis
• Guttate psoriasis
• Palmar-plantar psoriasis

Scalp psoriasis (scalp)

This form of the disease occurs in almost half of patients with psoriasis. The severity of the clinical picture can also be very diverse: from thin whitish crusts that turn into thin small scales and peeling in the form of dandruff, to coarse and thick plaques that form the same large scales. The skin against this background is reddened, especially after exfoliating a large number of scales at the same time. This form occurs, both isolated and in combination with other types of psoriasis.

Symptoms of psoriasis on the head

Symptoms of the process often go beyond hair growth, spreading to the skin of the forehead, back of the head and ears. Requires differential diagnosis with seborrheic dermatitis, in which the crusts have a yellowish tint, in contrast to whitish in psoriasis. There are no particular difficulties in making the correct diagnosis.

Causes of psoriasis on the head

The causes of psoriatic inflammation of the skin in the scalp area are associated with impaired maturation of the surface layers of the epidermis and the release of keratin. This can be caused by such factors:

• Microtrauma and irritation of the scalp;
• Incorrectly selected hair care cosmetics or frequent hair changes;
• Dry scalp;
• Strong stressful effects;
• Changing climatic conditions;
• Medicinal influences;
• Violation of dietary recommendations for psoriasis;
• Dyshormonal and metabolic disorders in the body.

How is scalp psoriasis treated?

If the process is represented only by a local lesion on the head, then local effects on the inflamed foci will be quite sufficient. The following methods are great for this:

1. Cryotherapy - exposure to inflamed areas of ultra-low temperatures. In this case, there is a one-step destruction of inflamed and defective keratinocytes. After a few days, they leave as a single layer;
2. Ultraviolet irradiation. Ordinary quartz lamps or ultraviolet combs are used. The effect is the better, the shorter the hair length;
3. Shampoos and soaps. They are an auxiliary method and complement the basic techniques. The most common: kertiol, tana, nizoral, freederm with tar. The only soap that is indicated for psoriasis is tar.
4. Ointments and creams. Well moisturizes dry psoriatic plaques and helps to cleanse them of scales with salicylic ointment in 2% concentration. Hormonal ointments based on glucocorticoids have proven themselves quite well: prednisolone, sinaphlan, betamethasone, trimistin, triderm, flucinar. It is advisable to apply them to inflamed skin after removing the crusts.
5. Traditional medicine methods - the use of various recipes based on elecampane, egg yolks, onions, herbs.

Nail psoriasis

Sometimes psoriasis affects not only the skin, but also the appendages. These are, first of all, the nail plates. Fingers are mostly affected. The frequency of such changes in the general structure of patients with psoriasis does not exceed 7%. Psoriasis localized on the nails (psoriatic onychia) is much more difficult to treat than any other localization, although it causes less discomfort in patients.

Symptoms of nail psoriasis

Symptoms of psoriatic onychia can manifest themselves in different ways. They are always based on clouding of the nail plate with its deformation due to longitudinal and transverse grooves. Sometimes layering or point retractions occur. In severe cases, there is a gradual complete detachment of the nail due to the destruction of the nail bed or the transition of the process to the periungual skin. Such changes can result in irreparable loss of nails.

Causes of nail psoriasis

The reasons for the described changes are local in nature and are realized exclusively against the background of other forms of psoriasis:

1. Violation of hygienic nail care;
2. Permanent dry skin of the hands;
3. Microtrauma of nails;
4. Manicure procedures using various chemicals and varnishes;
5. Exposure to aggressive environments when working with them;

How is nail psoriasis treated?

Since the disease is systemic, the treatment should be not only local, but also include general measures. They consist of:

1. Vitamin preparations, including trace elements (selenium, silicon, zinc, calcium). It is better to use them after the reduction of inflammatory changes and the transition of the process to the stationary phase;
2. Medical and cosmetic varnishes that hide the deformation of nails with a mild course of the disease;
3. Careful care should be taken for the nails: short circumcision, massage of rollers, baths, refusal of manicure, protection from harmful factors with gloves;
4. Retinol acetate or palminate solution. Process several times a day. The duration of treatment is about three months;
5. Occlusive (oilcloth) dressings based on calcipotriol and glucocorticoid hormones (betamethasone) once a day, alternating these ointments every other week;
6. Local application of 5-fluorouracil or methotrexate solutions to nails. It is mixed with creams based on urea or propylene glycol and applied to the affected nails for several hours in the form of an occlusive dressing;
7. Systemic administration of cytostatics and glucocorticoids is indicated only in case of an extremely severe course of the process, especially when it is combined with other forms.

Psoriasis on the hands

Psoriasis symptoms on the hands

Very often, psoriatic eruptions spread to the skin of the hands. The dorsal surfaces and the skin between the fingers are more often affected. Inflammatory rashes on the palms are less common. The type of psoriatic plaques on the hands does not differ from the processes of other localization. On the palmar surface, they take on the appearance of rough red callosities with large scales.

Causes of psoriasis on the hands

The reasons for the spread of psoriasis on the hands are mainly associated with a violation of the rules for caring for the hands and constant microtrauma to the skin of this area. This is especially true for people who are already sick with psoriasis. Hand contact with toxic chemical compounds is of great importance.

How to treat psoriasis on the hands?

Since isolated psoriatic lesion of the hands is extremely rare, the treatment should be local and general in nature:

1. Hand skin care using moisturizing and emollient ointments (based on petroleum jelly, salicylic ointment);
2. Refusal to stay hands in a humid environment and prolonged wearing of rubber gloves;
3. Treatment of inflamed skin with hormonal ointments (triderm, flucinar, trimistin, kremgen);
4. Antihistamines: loratadine, erius, claritin;
5. Systemic administration of glucocorticoids and cytostatics;
6. Physiotherapy methods combined with photochemotherapy.

Psoriasis on the face

Symptoms of psoriasis on the face

Symptoms of psoriasis localized in the face area are no different from the general symptoms of this disease. Psoriatic plaques occur on the cheeks, forehead, and chin and can spread over wide areas. The whole problem is that such changes cause a pronounced cosmetic defect, which made this form stand out as a separate heading.

Causes of psoriasis on the face

The causes of inflammation of the facial skin in psoriasis, in addition to general factors, can also be local. This means that any external influences on the skin of the face in patients with psoriasis or its primary occurrence can provoke inflammation in this area. Such factors can be microtrauma, the use of various cosmetics, severe dry skin.

How to treat psoriasis on the face?

The very first measures of assistance are proper hygienic care of the skin of the face and the rejection of aggressive cosmetics. For the duration of an exacerbation, it is better to completely abandon any cosmetics with the exception of moisturizers.

Various masks and creams based on vegetable oils (coconut, jojoba, lavender, aloe) help well. It is best to use a tar-based soap to cleanse your face several times a day. All other measures in the form of tablet forms of antihistamines, systemic hormone therapy and other methods of treatment should be decided strictly individually by only competent specialists.

Psoriasis on the legs

Symptoms of psoriasis on the legs

Symptoms of leg lesions in psoriasis resemble the clinic for hand lesions. In fact, everything is identical. If we talk about the skin of the thighs and legs, the extensor surface of these segments is more often affected. The initial rash is localized, as a rule, in the knee area. Then they gradually spread to the surrounding tissues. The rash is typical with massive scaling. Sometimes the process extends to the plantar surface, where calluses with peeling are determined against the background of reddened skin.

Causes of psoriasis on the legs

The reasons for the transition of the process to the lower extremities, and especially the feet, are associated with damage to the skin of this area and violations of the rules for caring for them. Risk factors are wearing uncomfortable and tight shoes, staying feet in high humidity conditions, fungal infection of the skin and nails.

How to treat psoriasis on the feet?

The main emphasis should be on local therapy. These are, first of all, baths with various medicinal plants (celandine, string, chamomile) in combination with processing with tar soap. After such procedures, the skin is treated with salicylic ointment or other moisturizing cream without chemical compounds. After a few hours, the feet are washed again. This removes crusts well. Hormonal ointments (flucinar, triderm) are applied to the cleansed, inflamed skin. If necessary, various systemic drugs and instrumental methods of treatment are prescribed (PUVA therapy, ultraviolet irradiation).

Psoriasis on the elbows

Elbow psoriasis symptoms

Symptoms of psoriatic eruptions in the elbow area are among the most typical manifestations of this disease. This localization of plaques, limited only to the posterior ulnar surface, occurs more often than other forms. This makes it one of the most favorable in terms of course and sensitivity to treatment.

Causes of psoriasis on the elbows

The reasons for the described features are hidden in the most frequent traumatization of the elbow region. After all, the elbow, as one of the pivot points of the human body, is often exposed to tight contact with hard surfaces and constant friction. This forms a local skin lesion in persons with psoriasis.

How to cure elbow psoriasis?

Given that psoriasis of the elbows rarely spreads to the surrounding or distant areas of the skin, it can be attributed to the most favorable forms. Therefore, local therapy will be sufficient. Suitable for these purposes:

1. Vitamin D analogs (calcipotriol, daivonex);
2. Ointment preparations based on zinc and salicylic acid: zinc ointment, salicylic ointment, zinc-salicylic paste, cinocap, sudokrem;
3. Birch tar ointments and tar soap;
4. Topical corticoids: hydrocortisone, prednisolone ointment, fluorocort, beloderm;
5. Physiotherapy and herbal medicine.

Vulgar psoriasis

The most common form of psoriasis is its vulgar or simple type. In other words, this is the classic course of the process. They are characterized by the appearance of single small papules on the trunk and extensor surfaces of the extremities, prone to grouping into peculiar clusters, accompanied by reddening of the skin and its severe peeling in the affected area. This form tends to go into any other, expanding the area of the lesion.

Psoriasis on the genitals

The defeat of the genitals in psoriasis is not so common. There is never an isolated form of the disease. Necessarily combined with the simultaneous appearance of plaques in other areas of the skin (face, trunk, limbs).

Clinical manifestations occur most often in men. A rash appears on the head of the penis. It looks like small grouped papules in the form of hyperemic plaques. There is no peeling due to the absence of keratin bodies in this zone. It is often perceived for any other disease, especially if the manifestations of a rash of a different localization are hidden.

Seborrheic psoriasis

Sometimes the clinical course of psoriasis resembles seborrheic dermatitis. In this case, it is called seborrheic psoriasis. The symptoms of the disease look like this:

1. The scalp or behind the ear is affected;
2. Inflamed plaques look like whitish crusts against the background of reddened skin;
3. Rubbing the plaques leads to the formation of a large number of small scales;
4. After removing the crusts and scales, a hyperemic thin, shiny skin remains;

These symptoms are the main diagnostic differences between common seborrhea and seborrheic psoriasis.

Guttate psoriasis

Guttate psoriasis is the only form of this disease, in the etiology of which an infectious factor plays a role. This was proved by bacteriological examination of crops from the surface of psoriatic plaques, in which staphylococci and streptococci are detected.

Usually such psoriasis appears after an infectious or viral disease. Clinically it looks like single small clusters of papules, accompanied by desquamation. They are located on the trunk and limbs.

Palmar-plantar psoriasis

The defeat of the palms and soles with psoriasis is not common. This is due to the peculiarities of its structure and relatively greater thickness compared to other areas. This feature is the basis of clinical manifestations.

Usually, the lesion develops synchronously on the palmar and plantar surfaces. The rashes look like inflammatory foci of irregular shape, like large flaking, resembling cracks, against the background of reddened skin.

The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist

Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).