Psoriasis on the elbows: causes, how to treat with ointments at home

Psoriasis is a very common disease. It can affect almost any part of the skin and body. Thus, there are lesions of the nails, fingers, face, scalp, as well as bones and joints. But psoriasis on the elbows is still most often diagnosed.

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Epidemiology

• Psoriasis on the elbows is one of the most frequently diagnosed chronic skin diseases. According to various statistical information, the frequency of pathology in the population can be approximately 2%.
• Most often develops in middle age.
• It can affect both male and female populations equally.

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Causes psoriasis on the elbows

Elbow lesions in psoriasis are nothing more than accelerated cell division in the superficial skin layers. Why cell division accelerates – there is no exact answer to this question yet. But experts identify a number of key factors that can influence the development of the disease:

• unfavorable heredity in terms of psoriasis;
• metabolic disorders and endocrine diseases;
• severe infectious diseases;
• frequent or severe stress, prolonged depressive states, neuroses;
• immune disorders;
• injuries and damage to various layers of the skin.

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Risk factors

Risk factors do not necessarily predict psoriasis on the elbows, but only remind that a person has a predisposition to this pathology.

Psoriasis on the elbows itself is a disease of non-infectious genesis, so it is impossible to become infected with it. The disease progresses in waves, periodically worsening and retreating.

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Pathogenesis

Failures in the immune system in psoriasis on the elbows were detected at the cellular and humoral levels. These failures were manifested in non-standard levels of immunoglobulins, circulating immune complexes, T-lymphocyte pools, leukocytes, and phagocytes.

Initial psoriatic pathological changes are observed at the cellular level of the dermis and epidermal layer. Regulatory failures in fibroblasts provoke excessive proliferative changes in the healthy epidermis. Such changes potentiate the synthesis of cytokines and eicosanoids, causing acute skin inflammation.

In the affected areas of the epidermal layer, cellular structures secrete interleukin-1, which is similar to the stimulating factor of epidermal T-lymphocytes. It is interleukin-1 that explains T-lymphocyte chemotaxis: stimulation of T-lymphocyte migration into the epidermal layer and epidermal infiltration occurs.

Interferons and interleukins, which are secreted by T-lymphocytes, can act as mediators of the inflammatory reaction and contribute to the formation of a vicious circle, which leads to the chronic course of psoriasis on the elbows.

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Symptoms psoriasis on the elbows

Signs of psoriasis on the elbows are always characteristic: these are uniform rashes that merge into groups, have a plaque-like shape and a pinkish-reddish color (depending on the "freshness" of the rash). Groups of rashes are outlined by clear borders of irregular shape. On top, the elements have a pronounced roughness caused by the formation of whitish silver scales.

As a rule, with psoriasis on the elbows, both the left and right elbows are affected at the same time.

The first signs are the same for any psoriatic skin lesion and look like this:

• If you scrape off the surface of the plaque, characteristic scales will appear that resemble stearin, a hard fatty substance;
• if you scrape off the “stearin” flake, you can see a moistened glossy film;
• If you scrape off the film, tiny drops of blood will be found on the surface.

The appearance of symptoms of psoriasis on the elbows is usually not accompanied by general discomfort: body temperature remains normal, there is no pain. Itching often occurs, and is quite pronounced: after a while, both the itching and the rash disappear, as remission begins. The frequency of exacerbations and relief of the condition is different for all patients, but the most common is the autumn-spring seasonality of psoriasis.

Stages

It is customary to distinguish several stages in the course of the psoriatic process on the elbows:

• stage of progress;
• stationary stage;
• stage of regression.

The initial stage of psoriasis on the elbows - progressive - is accompanied by the appearance of a large number of small bright nodules outlined by a red rim, which is called the "crown of peripheral growth".

The stationary stage is a period of calm, when existing rashes persist, but new ones do not appear. The rash becomes brownish-bluish and flat, and areas with altered pigmentation may appear.

The regressive period is a subsidence of psoriatic processes: the skin temporarily clears up and remission occurs.

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Forms

Psoriasis on the elbows is classified as follows:

• common psoriasis;
• exudative form, which is accompanied by severe exudation with the formation of crusty scales with a yellowish tint over the rash;
• the pustular form is characterized by the symmetrical formation of intraepidermal pustules on a reddened and lichenified surface;
• psoriatic erythroderma, which is acute, generalized, with deterioration of the general condition, damage to the joints, nails, etc.

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Complications and consequences

Psoriasis on the elbows can be complicated by a more severe course, with the development of psoriatic erythroderma, generalized pustular psoriasis, psoriatic arthritis.

In psoriatic erythroderma, the process from the elbow area spreads to all skin areas. Usually, this form is a consequence of abrupt cessation or ignoring of systemic drug treatment, as well as alcohol abuse, stressful situations and severe infectious pathologies.

The generalized form is considered the most severe and complex form of psoriasis. This complication occurs with mass fusion of pustules and the formation of large lesions, in the place of which epithelial detachment and the formation of purulent lakes are observed.

Psoriatic arthritis is a disease of the joints with the development of swelling, pain and decreased mobility.

Diagnostics psoriasis on the elbows

Recognizing psoriasis on the elbows is usually not difficult, because the disease has its typical signs. At the same time, the diagnosis of the pathology does not differ in any specific types of research or tests. Only in the active phase of exacerbation, as well as in complicated advanced psoriasis on the elbows, some changes can be detected in a blood test. In this case, the tests indicate the presence of a pronounced inflammatory reaction, an autoimmune reaction and rheumatic processes: an increase in rheumatoid titers, acute proteins, as well as such general signs of inflammation as leukocytosis, accelerated ESR, etc. are observed.

Instrumental diagnostics for suspected psoriasis on the elbows is rarely used: sometimes a skin biopsy is performed in order to exclude other dermatological pathologies, or to histologically confirm psoriasis.

Biopsy shows the presence of specific Rete bodies, compaction of the keratinocyte layer, histological immaturity of keratinocytes, extensive infiltration of the skin by T-lymphocytes and phagocytes. Additionally, areas of excessive proliferation of keratinocytes and immunocompetent cellular structures, increased angiogenesis in thick layers directly under the rash are detected.

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Differential diagnosis

Differential diagnostics can be carried out with eczema, lichen planus and lichen pink, mycoses, syphilitic skin lesions, neurodermatitis.

In some cases, additional consultation with specialists such as a rheumatologist, physiotherapist, or neurologist may be required.

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Treatment psoriasis on the elbows

Psoriasis on the elbows cannot be completely cured, but the disease can be transferred to a stable stage of symptomatic remission, when old rashes disappear and new ones do not appear. For this purpose, the patient is prescribed complex treatment, which includes a number of approaches and procedures. Let's consider this treatment in more detail.

• Diet food

A patient with psoriasis on the elbows is prescribed a special diet. The diet excludes the use of all kinds of spices, spicy dishes, alcoholic beverages, coffee, chocolate, and limits salt intake. The diet includes plant products, grains, white meat, greens, and a large amount of clean drinking water.

• Sanatorium and resort treatment

A patient with psoriasis on the elbows should preferably stay more often in areas with a dry hot climate, in sanatoriums where it is possible to take sulphide or radon baths. However, this type of treatment has its contraindications: this is the so-called "summer" psoriasis, as well as common pustular rashes.

• Medicines

Drug treatment is prescribed for localized psoriasis on the elbows, which is accompanied by itching. Antihistamines, hyposensitizing treatment and vitamins are most often used.

	Dosage and method of administration	Side effects	Special instructions
Suprastin	Take 25 mg up to 4 times a day.	Usually, taking the drug is accompanied by increased fatigue, drowsiness, and dry mucous membranes.	Suprastin is not compatible with alcoholic beverages.
Fenistil	Take 30 drops three times a day.	Dizziness, nausea, and thirst may occur.	Fenistil should not be heated or exposed to sunlight.
Sodium thiosulfate	Take orally 2-3 g per dose in the form of a 10% solution in water or saline.	Dyspeptic symptoms are possible.	The drug is taken only under the supervision of a physician.
Fenkarol	Take 50 mg one to four times daily.	Sometimes headache and vomiting occur.	Fenkarol may cause an allergic reaction.
Diazolin	Take 200 mg daily.	Dizziness, drowsiness, hand tremors, and dyspepsia may occur.	Diazolin is not prescribed for kidney and liver diseases.

• Ointments for psoriasis on the elbows

For psoriasis on the elbows, ointments and other external agents are used twice a day. In the initial stage of psoriasis on the elbows, it is appropriate to use the following drugs:

• salicylic ointment 1-2%;
• ointment based on birch tar 2-3%;
• cream with naphthalene oil 2-5%;
• Daivobet ointment;
• Belosalik ointment;
• Diprosalic ointment;
• Lorinden A ointment (flumethasone and salicylic acid);
• Elokom S ointment (mometasone and salicylic acid).

During the inpatient period, the following external agents are used:

• salicylic ointment 2-5%;
• ointment based on birch tar 3-10%;
• ointment with naphthalene oil 5-10%;
• Daivonex ointment;
• Cignoderm ointment.

• Vitamins

Vitamin preparations are prescribed only in the stationary and regressive stages of psoriasis on the elbows, avoiding their use in the initial stage of the appearance of rashes.

Vitamin complexes such as Vitrum Q10+, Aevit, Undevit are taken 1 tablet (dragee) once a day for a month.

In addition, for psoriasis of the elbows, intramuscular administration of vitamin preparations is often prescribed:

• 5% pyridoxine solution, 2 ml daily or every other day;
• 6% thiamine bromide solution, 2 ml daily or every other day.

Additionally, it is recommended to take vitamins E, A, ascorbic acid and B vitamins.

• Physiotherapy treatment

Physiotherapy for psoriasis on the elbows consists of the following useful procedures:

• General or zonal UV radiation, with an optimal wavelength of 311-313 nm (using narrow-band medium-wave irradiation);
• SFT – selective phototherapy – is one of the variants of UFO, with an optimal wavelength of 310-340 nm. SFT helps to achieve a more stable remission – up to two years;
• application of ozokerite or paraffin to the affected area;
• cryotherapy – eliminates itching, improves local metabolism. The temperature of the mass is most often -160°C, and each procedure lasts 2-3 minutes. The procedures are carried out every day for 20-25 days.

• Surgical treatment

Surgical treatment for psoriasis on the elbows is not performed.

• Homeopathy

Homeopathic remedies are always prescribed to patients individually, after diagnostic confirmation of the disease. The best results are observed after treatment with complex preparations: for example, the external remedy Psoriaten and drops PsoriNokheel can be purchased from pharmacists without a prescription.

Psoriaten is applied three times a day to the affected areas, and can be used for a long time.

PsoriNoheel is taken 10 drops three times a day 15 minutes before meals for 1-1.5 months.

For patients with irritated, reddened elbows, as well as in cases where the course of psoriasis worsens under the influence of high humidity, doctors advise using Acidum formicicum, in an individual dosage.

For elderly patients, as well as for those with general weakness and poor immunity, it is recommended to use Arsenicum iodatum.

Folk remedies

Patients with psoriasis on the elbows are recommended to treat the skin with the following folk remedies:

• pine needle extract;
• propolis tincture;
• Naftalan ointment;
• bay leaf decoction;
• pure birch tar;
• infusions of chamomile, celandine, and succession.

Sea buckthorn oil accelerates the restoration and cleansing of the skin: it is applied to the affected areas 3 times a day. In addition, peach, apricot, olive, and avocado oils can be used to soften rough areas.

In addition to external treatment, it is useful to regularly take internally such medications as pharmaceutical tincture of ginseng or echinacea, 20 drops in 100 ml of water, in the first half of the day.

A good effect is achieved by adding medicinal plants such as elderberries, string grass, sage leaves, dill seeds, St. John's wort, and dandelion roots to tea.

In winter, outside the acute stage of psoriasis on the elbows, it is recommended to support the body with hot drinks based on currant leaves, raspberry branches, rose hips and rowan berries.

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Herbal treatment

Among herbal preparations for psoriasis on the elbows, the most effective are considered to be aloe, sedum, sea buckthorn berries, valerian root, St. John's wort, calendula and chamomile flowers, sage, leuzea, and young pine shoots.

In the progressive period, it is recommended to take medicinal baths and foot baths with a decoction of succession, celandine, pine needle and fir extracts - daily or once every two days.

Immediately after taking a bath, apply vegetable oil (olive, sea buckthorn or even sunflower) to the elbow area.

A medicinal ointment is prepared on the basis of succession and petroleum jelly; the succession content in it should be 2-3%.

The infusion of the herb of the succession is taken 1/3 cup three times a day before meals, for 2-3 weeks. At the same time, the elbows should be lubricated with the succession extract or fresh celandine juice.

At night, many successfully use sage infusion compresses: to prepare the infusion, pour 1 tbsp of sage with 1 cup of boiling water and leave to infuse under a lid until cool. Filter the cooled infusion, soak gauze or a linen napkin in it, and apply to the affected areas until the morning.

Prevention

As experience shows, exacerbation of psoriasis on the elbows can be avoided if you follow simple preventive recommendations.

• Clothing should be loose, made from natural fabrics that allow air to pass through.
• It is necessary to avoid contact of hands with alkalis and chemicals, and if forced contact is necessary, it is necessary to wear protective gloves.
• We must not forget about special care cosmetics for the skin of the elbows: such products should moisturize and maintain the pH balance.
• It is necessary to protect the nervous system and avoid stressful situations.
• It is important to lead an active life: play sports, walk, move.
• You can sunbathe, but in moderation: sunburn can cause an exacerbation of psoriasis on the elbows.
• It is necessary to establish proper and healthy nutrition.
• Any diseases in the body should be treated promptly.

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Forecast

• Health prognosis: psoriasis on the elbows is a recurrent disease with a chronic course, but there are descriptions of fairly long periods of remission (up to 20 years).
• The prognosis for life is relatively favorable: if psoriasis on the elbows is complicated by the development of psoriatic arthritis, the patient may become disabled.

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