Exacerbation of psoriasis

This non-infectious chronic dermatosis causes a lot of physical and psychological discomfort during an exacerbation, itchy rashes (often on a large surface of the body) do not give rest either day or night. Psoriasis recurs due to many reasons. Very often, patients themselves are at a loss as to what provoked the next exacerbation.

Studies of this disease are usually conducted on the anamneses of hospitalized patients with a severe form of this disease. The results of these observations are very contradictory, and there are no general recommendations for getting rid of psoriatic exacerbations.

However, some of the most common factors that provoke relapses of the disease are known today.

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Epidemiology

More than 2% of people on Earth suffer from psoriasis. However, not everyone is equally susceptible to this disease. Representatives of the planet's white population suffer from it much more often than Asians, black people of Africa suffer from psoriasis even less often, and red-skinned people (North and South American Indians and Eskimos) do not have psoriasis.

In economically developed countries, this disease affects more than 4% of the population. In the United States, according to last year's data, 7.5% of the population suffers from psoriasis, in Ukraine - about 3.5%. The prevalence of psoriasis is higher in countries located further from the equator.

Both women and men can get sick from the first to the last years of life, but about half of the debuts of the disease occur between 15 and 25 years. The disease is complicated by psoriatic arthritis in about 10-30% of patients with psoriasis, and the manifestations of this complication become noticeable about ten years after the first manifestation of the disease.

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Causes psoriasis exacerbations

Many patients note that their exacerbations occur at a certain time of year. The winter type of psoriasis is more common (exacerbations always occur in winter), and the summer type is less common. There is also a third type that does not depend on the season.

People with psoriasis should try to avoid sudden changes in climate zone. For example, if you celebrate the New Year in Egypt or Tunisia, you can almost certainly get a bonus in the form of an exacerbation.

People with this problem are strictly prohibited from drinking alcohol, eating oversalted, sweet, fatty foods, and overeating in general. To prevent exacerbations, it is worth sticking to a dietary diet, which will be discussed below.

One of the probable causes of exacerbation may be nervous and physical overstrain - it is advisable to avoid stressful situations and try to increase your stress resistance.

It is necessary to exercise caution when using household chemicals, at least always wear gloves.

Exacerbation of psoriasis can be provoked by vaccinations and some medications, in particular, for the treatment of infectious diseases of the respiratory system, antibiotics, immunomodulators, certain antidepressants, anticonvulsants, antimalarial drugs, vitamin complexes and even drugs for psoriasis. Exacerbation of psoriasis is possible from Kartalin, a plant-based ointment positioned as a remedy for serious dermatoses, including psoriasis. This exacerbation at the initial stage of treatment is stipulated by the manufacturer in the instructions; over time, the skin condition should normalize.

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Risk factors

Risk factors for a new exacerbation are smoking, infectious, immunopathological and endocrine factors, any new cosmetics and perfumes.

Most often, psoriatic rashes during exacerbation occur in areas with drier and thinner skin that has been subjected to mechanical or chemical influences. People with dry skin are more susceptible to this disease than those with oily and well-moisturized skin.

Psoriasis can be considered as an idiosyncrasy to any external influences. Sometimes it spontaneously worsens and can also disappear, leaving the patient perplexed about the cause of the worsening. It is a very individual disease.

Currently, there are two main hypotheses about the pathogenesis of psoriasis.

The first classifies it as a primary dermatosis with dysfunction of the epidermal layer and its cells, in which individual areas of the epidermis are characterized by forced division and formation of keratinocytes.

Proponents of the first hypothesis consider the autoimmune attack of T-lymphocytes and macrophages on keratinocytes to be secondary, assessing it as an immune response to an excess of pathologically transformed skin cells.

The second hypothesis considers the pathogenesis of psoriasis as an autoimmune pathology, when the overproduction of skin cells is caused by their autoimmune damage.

Both of these assumptions have a right to exist, as they are confirmed by some facts of positive results of treatment based on some hypothesis. There are also research results that partially refute each of them.

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Symptoms psoriasis exacerbations

The first signs of a relapse are the appearance of reddish papules measuring 1.5-2 mm on different parts of the body with drier skin (e.g., limbs, head, lower back). They are clearly defined, covered with loose, large-plate scales that tend to grow to form scaly, pale-gray psoriatic plaques. Their size varies from small (up to 1 cm) to large surfaces – the size of a palm or more.

Dermatosis is usually accompanied by itching. The rash begins to peel, the scales on the surface easily peel off and denser ones located deeper remain under them (this explains another name for the disease - psoriasis).

Overproduction of keratinocytes and the formation of skin infiltrates in psoriatic plaques cause a thicker, raised layer of skin in these areas. When scraping off the scales, the plaques may bleed slightly. Cracks and suppuration may appear on the damaged skin, and it is constantly felt tight.

By scraping off the papule, a triad of specific signs can be observed:

• a heavily flaking silvery-gray spot, similar to a crushed drop of stearin;
• after removing the scales, a terminal film appears on it, moist and shiny;
• droplets of blood released on the exposed spinous layer (blood dew).

The disease is characterized by a wave-like course - the latent period alternates with the manifest period, it can be divided into three stages:

• progressive, when new bright red papules are steadily born, growing into a clear itchy erythema surrounding the primary formation;
• stationary, when new primary papules stop forming, the growth of old lesions stops, a dry rim up to five millimeters wide appears around them, and the papules become covered with scales;
• regressive, when symptoms begin to disappear in the direction from the center of the foci to their periphery.

Psoriasis has many clinical varieties and course options. Its most common type is common or vulgar psoriasis, which in turn is divided into subtypes, the main ones being plaque (described above) and drop-shaped.

Plaques usually appear on the elbows, knees, scalp, and less frequently on the body. The face usually remains clear, although sometimes the lesion spreads to the forehead. Small lesions on smooth skin do not itch much, but the scalp is characterized by severe itching. On the head, lesions may be isolated or merge into one continuous surface with cracks and exudation.

In children and adolescents, guttate psoriasis may develop as a complication of streptococcal tonsillitis. One or two weeks after the onset of tonsillitis, small spots appear all over the body, especially the trunk and limbs. The size of the spots, as a rule, is less than a centimeter in diameter, they do not itch much. This subtype of vulgar psoriasis is less common than plaque psoriasis, it is easily treated with local medications, sometimes in combination with physical therapy with ultraviolet light, sometimes it can go away on its own, but it also happens that it becomes chronic.

In addition to the usual type, there are also such types as atypical psoriasis (seborrheic, oyster-like, warty, intertriginous, palms and soles, mucous membranes and nails) and complicated (exudative, erythrodermic, arthropathic, pustular).

Seborrheic - localized on the corresponding parts of the body (scalp and behind the ears, in the area of the nose, lips, on the chest and between the shoulder blades). The outlines of the spots are not distinct, the scales are not stearic, but yellowish. There is a lot of dandruff under the hair on the head, which masks the psoriatic spots with a transition to the forehead in the form of a psoriatic crown.

Oyster-like (rupioid) - round plaques with multiple layered large scaly crusts, which makes them look like an oyster.

Verrucous - common localization sites: ankles, wrists, lower third of the shin and the instep. Papules are rounded, with prolonged exacerbation and mechanical impact, the skin in these areas hypertrophies. Malignancy is likely.

Intertriginous - psoriatic plaques located in the area of large folds of the body (anogenital, armpits, under the breast, between the fingers) also have an atypical appearance (almost no peeling, the surface of the lesion is smooth, bright red, often moist). Accompanied by pain. Diagnostics and treatment cause certain difficulties.

Nail psoriasis (psoriatic onychodystrophy) - destructive colors - yellowish, whitish, gray, the surface becomes spotty, striated, the skin under the nail and around it becomes rough. The process can drag on to the state of hyperfragility of the nails and their absolute absence (onycholysis). Most often, nails are affected by psoriatic arthropathy.

Pustular or exudative psoriasis is a complicated form of the disease. Psoriatic plaques are covered with painful blisters filled with sterile inflammatory exudate - pustules. The skin around them is edematous, inflamed, and peeling.

Clinical manifestations of this type are Barber's palmoplantar localized psoriasis and Zumbusch's generalized psoriasis with dissemination of pustules on the skin of all parts of the body and an orientation towards unification into more significant elements.

This is a very severe, life-threatening type of psoriasis. The onset of exacerbation is sudden and rapid - bright red erythema covers almost the entire body, small groups of pustules begin to appear on it, their number increases, they unite into so-called "purulent lakes". This process has a wave-like nature - while the pustules that appeared earlier dry up, the next ones form. The process is accompanied by fever, increasing weakness and leukocytosis. This condition requires immediate hospitalization.

Erythrodermic - characterized by the spread of dermatosis over large areas of the body, sometimes generalized, severe itching, swelling of the skin and subcutaneous tissue, pain. This type often represents a relapse of common psoriasis with an unstable course, usually developing when systemic therapy or treatment with topical preparations containing glucocorticosteroids is interrupted.

Erythrodermic psoriasis can lead to the death of the patient, since the thermoregulatory and protective function of the skin is disrupted, which contributes to complications - septicemia or disseminated pyoderma.

Localized pustular and erythrodermic psoriasis may be the debut of the disease and change over time into a common plaque-like psoriasis.

Psoriatic arthropathy (arthropathic psoriasis) typically involves inflammation of the small joints of the extremities. However, there are arthropathies of any localization (hip, knee, spine). This type of disease is a combination of dermatosis with arthritis, the consequences of which can be disability of the patient or death.

As a rule, at the onset of the disease, damage to small parts of the skin is observed, they increase over time, and the progression of psoriasis may begin. A mild degree of the disease is considered to be the spread of damage occupying up to 3% of the body area, moderate - from 3 to 10%, severe - more than 10%.

The question often arises: can the temperature rise during an exacerbation of psoriasis? For vulgar psoriasis, an increase in temperature is not typical, however, in severe forms of the disease - psoriatic erythroderma, generalized pustular psoriasis and psoriatic arthritis, an exacerbation is accompanied by a high temperature (≈39°).

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Exacerbation of psoriasis during pregnancy

According to observations, pregnant women suffering from psoriasis experience an improvement in about 2/3 of cases (although the disease still manifests itself after childbirth), but the possibility of a relapse during this period cannot be ruled out. A change in a woman's hormonal background can trigger the development of the disease. An exacerbation of psoriasis in the first trimester allows one to predict the further situation and the outcome of pregnancy.

The symptoms of relapses of the disease in pregnant women depend on the type and severity of the disease.

The most severe relapses are rare, but you should be aware of them. For example, psoriatic arthropathy for an expectant mother can result in increased joint pain, which is explained by the increased load on the joints due to rapid weight gain.

A severe form of exacerbation can sometimes manifest itself as generalized pustular psoriasis caused by hormonal and metabolic changes in the woman's body. Plaques, usually appearing on the abdomen and groin, become covered with pustules. The process is accompanied by severe itching, dyspeptic disorders, fever and even mental disorders. The main cause of exacerbation of psoriasis in pregnant women is increased production of the hormone cortisol by the adrenal glands. It is necessary to seek medical help immediately. In case of termination of pregnancy, the symptoms usually disappear immediately.

In pregnant women, the exacerbation may be expressed by herpetiform psoriatic impetigo (impetigo of pregnant women), which in the vast majority of cases develops precisely in this condition. The rash looks like small pustules, usually located in large folds. They are located in groups or in the form of a ring, the skin is inflamed, edematous, there is no itching, the pustules are not infected, subsequently the rash sites are covered with brownish crusts. The process can become chronic or worsen, moving to the mucous membranes.

Presumably, neuroendocrine disorders provoke the appearance of impetigo in pregnant women. According to most experts, this is a form of generalized pustular psoriasis. With the birth of the child, the mother's condition stabilizes, but, usually, subsequent pregnancies proceed in exactly the same way.

The consequences and complications of such exacerbations can ultimately lead to fetal death and spontaneous abortion, premature birth, the birth of a low birth weight baby, and even maternal death.

Scaly lichen during pregnancy is often accompanied by depression, the occurrence of which is not explained by modern medicine.

An exacerbation of the disease in the expectant mother causes difficulties in selecting medications, since most drugs for the treatment of psoriasis are teratogenic. During this period, it is not recommended to use retinol preparations, cytostatics, antibiotics, hormonal drugs.

Women expecting a child are recommended to reduce the manifestations of relapse by using natural remedies, ultraviolet radiation, and fat-based cosmetics. To prevent depression, one can drink herbal teas, undergo SPA procedures (after consulting a doctor), do yoga for pregnant women, undergo psychotherapeutic training, and go for walks.

If an exacerbation of psoriasis threatens the life of a woman, the question of terminating the pregnancy is raised; during breastfeeding, the child is transferred to feeding with adapted formulas, and the mother is prescribed specific medications.

Psoriasis is not a contraindication to motherhood. A conscious, competent attitude to the upcoming pregnancy, including preparatory measures for conception (vitamin therapy, spa treatment, massages, general strengthening procedures, yoga classes, getting rid of foci of infection in the body) reduces the risk of severe complications.

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Diagnostics psoriasis exacerbations

Psoriasis has characteristic signs described above, based on which this disease can be suspected. For example, the formation of pinpoint hemorrhages and the manifestation of bleeding of the skin under the plaque due to scraping (Auspitz symptom). Together with two other symptoms from the psoriatic triad, they make up the clinical picture of psoriasis. The doctor conducts an external examination and interviews the patient in order to establish the causes of the disease, prescribes the necessary laboratory and instrumental examinations.

In the initial and non-severe forms of the disease, blood tests are usually within normal limits.

However, in complicated forms or with a significant area of damage, some indicators in blood tests significantly exceed the norm and reveal intense inflammation, the presence of systemic and endocrine disorders, rheumatism (titers of rheumatoid factor, acute phase proteins, leukocytosis, erythrocyte sedimentation rate, autoantibodies, hormones of the adrenal glands and thyroid gland, etc.).

In some cases, to clarify the diagnosis, a skin biopsy and histopathological examination are performed, which reveals histological immaturity of keratinocytes and their proliferation (Rete bodies), impregnation of the epidermis with immunocytes, and accelerated formation of new blood vessels in the skin layer under psoriatic plaques.

Instrumental diagnostics during exacerbation of psoriasis – dermatoscopy.

Additional examinations to get an idea of how the body works and the condition of internal organs (prescribed if necessary at the discretion of the attending physician) - electrocardiography, ultrasound of the thyroid gland, abdominal organs, radiography.

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Differential diagnosis

Differential diagnostics of psoriasis is performed to establish an accurate diagnosis of the disease and differentiate it from diseases with similar symptoms. It is performed on the basis of a complete anamnesis based on external signs, test results and examinations. It is necessary to exclude the presence of cutaneous T-cell lymphoma (in addition to external differences, a puncture of the cerebrospinal fluid is sometimes prescribed); lichen planus, which is usually localized in "bracelets" on the wrists and ankles; pink and simple chronic lichen; nummular eczema; seborrheic dermatitis under the scalp; secondary syphilis; dermatophytosis and candidiasis.

Treatment psoriasis exacerbations

A relapse of this chronic disease, even in a mild form, causes significant discomfort to the patient. In addition to physical discomfort (itching, painful sensations), patients suffer psychologically, and when the palms and soles are affected, it is problematic to simply walk and pick up anything.

First of all, you need to see a dermatologist. After diagnosis, the doctor prescribes drug therapy.

Treatment of exacerbation of psoriasis is initially carried out with creams and ointments that do not contain hormones. Traditional remedies include topical preparations based on zinc and salicylic acid: salicylic ointment, salicylic-zinc paste, zinc ointment and paste, aerosol and cream Zinokap. These are proven remedies that relieve inflammation, and the salicylic component of the ointment softens and dissolves the affected layer of skin, removing flaking.

Zinokap cream can be used to treat children from one year of age. The active substance is zinc pyrithione, which has anti-inflammatory, antibacterial and antifungal effects. The affected areas are treated two to three times a day, the duration of psoriasis treatment is a month and a half.

To treat psoriasis, modern topical preparations are used, which are available in the form of cream and solution - Daivonex and Psorcutan, with the active substance calcipotriol (analog of vitamin D), which deactivates T-lymphocytes and inhibits the growth of the keratinocyte layer. The therapeutic effect should occur in two weeks. They are used both in monotherapy of psoriasis and together with corticosteroids, cyclosporine, and are not used in combination with salicylic drugs. They can cause allergies.

In case of relapses of the disease, solutions and ointments containing birch, juniper, coal, pine tar are used, for example, Colloidin, Anthramin, Antrasulfonic ointments, Berestin solution. These preparations are first used on small areas of skin. If the preparation does not cause irritation, then the area of its application is increased. They are used with caution in the summer, since products with tar are phototoxic.

Also used are ointments based on solid oil, which soften the stratum corneum of the epidermis, providing an exfoliating effect (Kartalin ointment, Cytospor cream-balm).

Kartalin ointment includes extracted succession and chamomile, retinol, vitamin D, lavender and eucalyptus oils, solidol, salicylic acid, lysozyme and bee honey. The manufacturer promises softening of psoriatic plaques, gradual cleansing and restoration of the skin with regular use. The treatment regimen is step-by-step, given in the manufacturer's instructions. The full course of treatment is from two to four months. At the initial stage, an exacerbation is possible, in case of allergies, it can be combined with taking antihistamines in the first month of treatment.

Oil preparations are also used for local treatment of psoriasis.

The most pressing question: how to quickly relieve an exacerbation of psoriasis? The fastest action, to date, is in drugs containing hormones. They are used only as prescribed by a doctor and in the treatment of exacerbations in severe form, they have many side effects, they are also discontinued in stages. Hormonal drugs in the form of creams and ointments differ in strength of action. The most powerful active glucocorticosteroid is clobetasol propionate - ointment or cream Dermovate. A thin layer of the drug is applied once or twice a day. The duration of therapy is no more than four weeks, the weekly dosage is no more than 50g. An undesirable effect from use can occasionally be pustular psoriasis.

Modern hormonal drugs for local use are relatively safe, but they can only be used as prescribed by a doctor. Their use usually gives a quick but short-term effect. They are addictive, the drug is difficult to stop, side effects increase, and it is worth thinking seriously before achieving such a quick effect.

If local therapy is ineffective, then physiotherapy is prescribed - ultraviolet irradiation of long-wave and medium-wave range using Psoralen, which increases sensitivity to radiation and enhances pigmentation. This drug is available in two forms: a solution for application to the skin and tablets for oral administration. It can cause digestive disorders, headaches and heart pain, and increased blood pressure.

Exacerbations of psoriasis, in particular psoriatic arthropathy, are very effectively treated using physiotherapeutic procedures: laser blood irradiation; PUVA therapy; magnetic therapy; electrophoresis with the use of glucocorticosteroids; phonophoresis; therapeutic exercise.

To eliminate severe (moderate) relapses of the disease, systemic treatment is used using vitamins A and D, glucocorticosteroids, and immunosuppressants. Such prescriptions are an extreme measure, since these drugs have many side effects.

Alternative treatment

Psoriasis is a serious chronic disease that has been known and studied for a long time, but even research specialists who have knowledge, laboratories and equipment at their disposal have not come to a consensus on its etiology and have not developed a unified approach to treatment. Trying to treat this disease on your own is dangerous, since you can provoke a complication of the disease. Folk remedies are not always compatible with drugs prescribed by a doctor, so they can be used in practice only after consulting with your doctor.

There are many ways to treat psoriasis flare-ups at home. For example, folk medicine suggests using home "balneotherapy" to alleviate skin conditions and relieve itching during relapses of the disease:

• take baths with the addition of lavender, rose, chamomile, bergamot essential oil;
• take baths with soapwort, succession or yarrow.

Herbal infusion from all herbs is prepared in the same way: dry crushed grass (3/4 of a handful) pour two liters of water at room temperature and leave for an hour. Boil and simmer on low heat for a quarter of an hour, let it sit for another hour, strain and squeeze, add Bolotov vinegar No. 19 for psoriasis and eczema to the infusion. Pour water (37-38 ° C) into the bath, pour the infusion into it. Repeat after 24 hours. The duration of the procedure is 15 minutes. The course of treatment requires taking 10 to 12 baths.

You can use mustard: take ½ teaspoon of dry mustard and vegetable oil, 2 teaspoons of eucalyptus tincture; mix the tincture with mustard, combine with oil; spread on the affected areas and leave there; after five to ten minutes, wash off with warm, and then with cold water. After finishing the procedure, provide the skin with moisture and nutrition with a hypoallergenic cream.

For the treatment of psoriasis and prevention of exacerbations, ointments with honey are used. Therapy begins during the period of remission. Ointments prepared according to the recipes below are applied to the affected areas of the skin for two to three months. According to reviews, psoriasis can be completely cured.

• mix in the following proportions: medical petroleum jelly (50g), fresh (up to 3 days) egg white (6g), bee honey collected in May (3g), baby cream (1g);
• mix 100g of honey and one tablespoon of garlic ash (Avicenna used a similar ointment to treat eczema and psoriasis).

Herbal and cereal treatments are widely used. It is quite simple - to eliminate peeling skin, rub psoriatic sores with oatmeal for steaming; smear these areas with calendula ointment or sea buckthorn oil, while also taking a teaspoon of oil internally once a day.

Celandine poultices: for 300g of fresh celandine herb - a quarter of a glass of red wine; mince the herb and squeeze out the juice, add half of the red wine; soak a cotton swab in the mixture and lubricate the psoriasis plaques, then lubricate them with the rest of the red wine.

Celandine tincture: pour four tablespoons of chopped plant roots with 0.5 liters of alcohol, wrap and leave for several hours, lubricate psoriatic plaques with the tincture.

Homeopathy is a therapeutic system of treatment with small doses of drugs based on the principle of similarity, which should give good results in the treatment of such an individual disease as psoriasis. Especially with long-term treatment, since no harmful side effects have been noted in the treatment with homeopathic drugs. About 30 drugs are used to treat psoriasis in homeopathy, each of them is suitable for some specific cases, so self-medication with homeopathic drugs can only do harm. It is imperative to get a prescription from a homeopathic doctor. For example, in the treatment of psoriasis, the following are used:

• Arsenicum album (Arsenicum album) - is used for small itchy scales, when patients feel worse in cold weather and in cold rooms, is prescribed to restless, and at the same time neat and pedantic patients; children - for psoriasis of the scalp.
• Arsenicum iodatum (Arsenicum iodatum) – prescribed for large-scale plaques, weakened and old patients.
• Aquifolium (Aquifolium) – for psoriasis of the scalp extending to the face and neck.
• Crotalus horridus (Crotalus horridus) – psoriasis of the palms with an unpleasant odor.

In cases where it is not possible to visit a homeopathic doctor, you can use pharmacy products produced according to the principle of homeopathic remedies. For example, the homeopathic ointment Psoriaten, containing Mahonia aquifolium in homeopathic dilution. The ointment is intended for the treatment of mild forms of the disease, it can be used by children over infancy, pregnant and lactating women under the supervision of a doctor.

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Surgical treatment

Surgical interventions for psoriasis are extremely rare, only when conservative therapy has failed to cope with the disease in cases of psoriatic arthritis. Surgical treatment involves removing the affected tissue from the joint to restore its function, prosthetics of large joints, and their fixation in the correct position.

Diet for exacerbation of psoriasis

There are no clear recommendations regarding the most effective set of products, since different patients react very individually to the same product. Therefore, each patient is given personal recommendations. However, there is a general principle for building a diet, and it should be followed. The goal of dietary nutrition for psoriasis is to maintain a certain acid-base balance in the body.

The diet should be dominated by alkaline-forming foods (70-80%), half of which should preferably be eaten raw in the form of salads. Alkaline-forming foods are most juicy fruits (except for cranberries, currants, plums and blueberries); most vegetables - almost all types of cabbage, celery, lettuce, spinach, carrots, beets, sweet potatoes, onions; fresh juices from vegetables and fruits.

Vegetables from the nightshade family (tomatoes, eggplants, potatoes, paprika, hot peppers) should be removed from the diet regardless of their acid-base reaction.

Acid-forming foods should make up 20-30% of the diet. These are foods rich in proteins, starch, glucose, fats - meat and meat products, grains and potatoes, cheese and cream, sugar and legumes, animal and vegetable oils.

Products that provoke an exacerbation are nuts, alcohol, spices, hot, sweet, fatty, salty foods, smoked foods, blue cheeses, citrus fruits.

Products containing polyunsaturated omega-3 fatty acids, vitamins C, E, PP, group B, carotenoids, calcium and zinc have a positive effect.

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Prevention

Diet even during remission and absolute ban on alcohol and tobacco consumption. Alcohol aggravates the course of the disease, provokes exacerbation and contributes to the transition of uncomplicated disease to psoriatic erythroderma.

Patients with winter psoriasis, who experience exacerbation under the influence of sunlight, should, after consulting a doctor, visit solariums and physical therapy in winter. With the summer form, try to avoid sunlight with the help of clothing, umbrellas, and wide-brimmed hats.

Patients with psoriasis should use medications for the treatment of other diseases with caution.

Psoriasis, like other severe chronic diseases, causes depressive disorders in patients, especially during periods of exacerbation. At the first signs of depression, it is a good idea to seek help from a psychotherapist.

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Forecast

This disease is chronic and incurable so far, so its prognosis is relatively favorable. Treatment of psoriasis currently aims to achieve long-term remission and improve the quality of life of patients, but does not eliminate the disease. Severe forms of psoriasis sometimes lead to patient disability.

Over time, the disease slowly develops, and in moderate and severe forms of the disease, it is accompanied by other pathologies. When the patient meticulously follows the doctor's instructions, follows a diet and a certain lifestyle, this contributes to the remission of psoriasis, sometimes very long (up to several years).

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