Winter psoriasis: how to treat it

Winter psoriasis is one of the varieties of this pathology. Psoriasis itself is a chronic skin disease of non-infectious origin. When it develops, the patient develops inflamed areas on the skin, covered with silvery scales. Psoriasis often recurs (this form worsens in winter), affecting the tissues located near the joints.

Epidemiology

Approximately 2-3% of people on the planet (depending on where they live) suffer from psoriasis. Statistics show that this disease mainly occurs between 30-40 and 50-60 years of age, but sometimes it also develops in children.

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Causes winter psoriasis

The causes of winter psoriasis are a reduction in the amount of UV rays reaching the patient's skin, as well as dry air.

Due to the fact that on cold days people try to spend less time outdoors and also dress in several layers of warm clothing, the skin receives less UV rays, and it is they that weaken the manifestations of winter psoriasis in the spring and summer. According to researchers, ultraviolet light allows you to delay the accelerated growth of skin cells (this is considered the main symptom of the development of psoriasis). Therefore, as a result of reducing the periods of time spent outdoors, patients with this disease have an increased risk of exacerbation, as well as worsening of the condition of psoriasis plaques.

In addition, due to the fact that the cold winter air outside (and, conversely, the hot air inside many buildings) is not humid enough, this also has a negative effect on the skin.

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Risk factors

An exacerbation of psoriasis symptoms may occur under the influence of a virus or bacterial infection that has entered the patient’s body.

Any disorders, viruses, microbes and bacteria – anything that can disrupt the stable and correct functioning of the immune system can provoke a worsening of the disease. Even the simplest viruses – for example, respiratory or cold viruses – can initiate an exacerbation of psoriasis.

Also, the condition may worsen due to alcohol abuse. Especially if it is accompanied by smoking – this doubles the negative impact on the body.

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Pathogenesis

The pathogenesis of psoriasis is currently not fully understood. There are many hypotheses about the development of this disease, and the main one is considered to be hereditary.

The fact that the pathogenesis of the disease depends on genetic pathogens is indicated by the fact that the concentration of its development is much higher in families with a history of psoriasis. In addition, in this case, a higher concordance is also noted between monozygotic, rather than dizygotic twins. There is no final data yet on the type of inheritance of psoriasis, but there is much evidence that it is a multifactorial disease, the share of the genetic component of which is 60-70%, and the environmental component, respectively, is 30-40%.

As for the infectious hypothesis, there is some indirect evidence (such as the detection of viral-like immune inclusions and complexes, and in addition the presence of cytopathic effects on chicken embryos and tissue cultures due to the influence exerted by the supposed virus) that viruses can provoke the development of psoriasis. However, the available data are insufficient to discuss the viral etiology of the disease - because the infection has not yet been reproduced experimentally, the virus has not been identified, and no reliable cases of psoriasis infection have been described.

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Symptoms winter psoriasis

The main symptoms of psoriasis are inflamed and flaky red patches on the skin - both on the body and on the head. In these areas, there is also severe itching. In some cases, the disease can affect the nails.

Depending on the period when relapses most often occur, the disease can be classified into several separate types. For example, if exacerbations occur in winter, such psoriasis is called winter psoriasis.

In case of exacerbation of psoriasis, a red rash appears on the patient's body, similar in appearance to plaques. The spots on the skin can be small (no larger than a pinhead) or huge, occupying a large area of the skin. The rash flakes and itches a lot, and its surface layer, which is called scales, can peel off. During the peeling process, deep skin layers, which differ in density, appear on the surface. In some cases, suppuration may develop in the affected areas, as well as cracks.

Stages

According to the severity, psoriasis can be divided into 3 stages - severe, moderate, and mild. In mild psoriasis, psoriatic plaques occupy a maximum of 3% of the skin surface, and in moderate psoriasis, 10% of the surface. Severe is the stage when the disease covers more than 11% of the skin surface.

There are also 3 stages of disease development - regressive, and in addition, stationary and progressive.

When the patient has a progressive stage of pathology, against the background of the formation of new papules, old elements also grow. In this case, a special crown is formed around the papules, and new plaques arise due to the fusion of papules.

During the stationary stage of development, the growth crown does not form, nor do new papules.

During the regressive stage, the lesions become pale and flattened, and also become smaller. The flaking also disappears, and a depigmentation ring forms around the papules.

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Complications and consequences

Psoriasis as an independent disease is not dangerous to health, and is not contagious. Its plaques can appear on the skin, and then disappear and reappear in other places. The danger is that with psoriasis, pathological changes can occur in other organs (mainly in the joints). Such a complication is called psoriatic arthritis. About 20% of all cases of this disease occur in the knee area, but other joints can also be affected - for example, in the phalanges of the fingers. In severe cases of the disease, complete immobilization of the joints occurs.

In addition, a complication of psoriasis may be a decrease in tissue sensitivity to the substance insulin, which may lead to the development of type II diabetes, especially in older people.

Psoriasis impairs the production of melatonin (a hormone of the pineal gland/epiphysis) – it is responsible for sleep function. Also, in 10% of cases, the disease can cause eye disease.

In addition, the development of psoriatic glomerulonephritis is possible, as well as damage to the cardiovascular system.

Patients with psoriasis (especially in its widespread form) may also experience psychological disorders – depression often develops.

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Diagnostics winter psoriasis

Psoriasis is diagnosed mainly by the presence of external symptoms, as well as anamnesis (after talking with the patient). External symptoms are manifestations that are part of the psoriatic triad:

• stearin spot symptom (after scraping the plaque, the scales begin to come off in the form of shavings, similar to stearin);
• the phenomenon of psoriatic film (after removing all the scales, a shiny, red, inflamed surface remains on the skin, resembling polyethylene);
• Auspitz symptom (after scraping clean skin, droplets of blood appear on it due to damage to small superficial vessels).

To confirm the diagnosis, a biopsy procedure is performed.

Also, when diagnosing psoriasis, a dermatoscopy procedure can be performed.

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Differential diagnosis

Although the clinical picture of psoriasis is quite characteristic, it is still necessary to clarify the diagnosis, differentiating the disease from other dermatoses. Among them are lichen planus, nodular syphilid, Reiter's syndrome, seborrheic dermatitis and seborrhea. In addition, there are also atopic dermatitis, Gibert's disease, parapsoriasis, Flegel's disease, primary form of cutaneous reticulosis, premycotic stage of fungoid granuloma, DLE, and along with this erythrokeratodermia, etc.

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Treatment winter psoriasis

After the diagnosis of psoriasis, the patient is prescribed complex treatment, which includes the use of the most effective methods.

Medicines

Hormonal medications are used for treatment, which should be applied to inflamed areas of the skin.

Among the most effective drugs are Elokom, Diprosalik, Betamethasone, and in addition Schering-Plough and Flucionolone.

It should be taken into account that the frequency of use of these drugs can only be determined by a specialist, since uncontrolled use of hormonal drugs can provoke allergies, the development of contact dermatitis or secondary infections, as well as dry skin.

Vitamins

Vitamins are very effective against psoriasis – they help to alleviate the symptoms of the disease.

Retinol (vitamin A) is a fat-soluble element used to eliminate skin diseases. This component slows down the processes of its keratinization, and also reduces the rate of fat secretion. Retinol is absorbed into the body in 30 minutes. It is effective for the treatment of psoriasis because it maintains the required level of keratin in skin cells. Vitamin A is used for treatment in oil drops, which are recommended to be taken 15 minutes after eating. Doctors can also prescribe retinol derivatives - retinoids.

As a result of using retinol in large doses, liver pathologies and pancreatic diseases may worsen, therefore, for psoriasis, it is prescribed in doses that do not exceed the body's need for it.

Of the medications, Cetrin may be prescribed. Doses depend on the course of the disease and its form (range 25-50 mg/day). Then the amount may change - an individual dosage is selected. If the patient develops a rash and itching at the beginning of the intake, it is necessary to stop using the drug.

Vitamin A can also be obtained from peppers, and in addition, liver and butter - these products contain it in fairly large doses.

Vitamin D is also fat-soluble. It does not break down under the influence of high temperature and is insoluble in water. It can have a positive effect on the skin condition.

In the treatment of psoriasis, it helps to stabilize the processes of phosphorus metabolism, as well as calcium. It is well produced as a result of exposure to UV rays. The use of vitamin D helps to reduce the rash (or remove it completely, but only for a certain period of time). Vitamin D also helps to more effectively absorb calcium, which strengthens bones well.

Vitamin D3 for psoriasis is prescribed in the form of Calcipotriol ointment. The medicine should be applied to plaques, but it is only allowed to be used when the area of the rash on the skin is no more than 40% of the entire surface.

Pregnant women can get this component from food - butter or vegetable oil, fermented milk products. In addition, a large amount of this substance is contained in seafood (such as halibut liver, as well as cod), parsley, and also oatmeal with potatoes and other products.

In addition to sunlight, clean, fresh air is also required to produce vitamin D inside the body. Due to the deficiency of this component in psoriasis, bones begin to soften - this is why it is extremely important to consume it. It helps strengthen bones.

Vitamin E is an effective antioxidant that promotes metabolic processes occurring inside cells and is also involved in DNA synthesis. For the treatment of psoriasis, it is taken orally - it is available in the form of an oil solution. For pregnant women, the dosage is 15-100 mg (taken every other day or 2-3 times a week). The use of injections is a rather rare method, because such injections are very painful and can provoke the appearance of a seal. In psoriasis, this component contributes to a noticeable improvement in the condition of the skin.

Experts recommend taking it together with vitamin A in the form of special capsules Aevit. The capsules should be taken one at a time 1-2 times a day (the frequency depends on the form of the pathology, as well as its severity).

A lot of vitamin E is contained in vegetable oil with rose hips, nuts with raspberry leaves and green onions, and in addition in radishes and cucumbers.

Vitamins from the B category are water-soluble. They are used to treat psoriasis, since B1 together with cocarboxylase, which is its derivative, have a healing effect on the skin. They can be prescribed for oral use (in diluted form), as well as for intramuscular administration.

Pyridoxine is actively involved in carbohydrate, protein and fat metabolism. This vitamin is found in fish (for example, herring and halibut), as well as meat products, pearl barley, buckwheat and barley groats, as well as coarse flour products.

Also, during the treatment of psoriatic manifestations, B12 is always prescribed to stabilize the functioning of the nervous system and improve the hematopoietic process.

Calcium pangamate tablets contain B15. They help normalize the process of oxygen absorption by tissues.

In case of psoriasis, all vitamins from category B should be taken exclusively according to the scheme prescribed by the attending physician. The vitamin complex is selected for each patient individually.

Physiotherapy treatment

There are also several methods of physical therapy treatment for psoriasis.

UFO procedure. If this method is used correctly, psoriasis will stop spreading over the skin, and at the same time, the previously pronounced manifestations of the disease will begin to fade.

Photochemotherapy is considered one of the most effective methods of treating the disease (especially in severe cases). The treatment course is based on a combination of two elements - exposure of the skin to long-wave UV rays, as well as the use of drugs from the category of photosensitizing (psoralen, puvalen, as well as methoxypsoragen and ammifurin). Thanks to photochemotherapy, the patient can get rid of about 80% of all plaques, and in the case of regular use of this method, 90-95% of all deformations on the skin can be eliminated.

Nowadays, psoriasis is successfully eliminated by laser therapy. It can also be used to treat pathology developing in the scalp. During the procedure, the molecules of living tissues are excited as a result of the use of laser beams. This has a photomechanical, photochemical and other positive effects on the skin.

In addition to the above methods, the disease can be treated with ultrasound, X-ray and electrotherapy, as well as ultraphonophoresis and exposure to low temperatures or magnetic waves. Thalassotherapy is also effective - it qualitatively strengthens the patient's immunity.

Traditional and herbal medicine

There are many different folk remedies that help eliminate the symptoms of psoriasis. Among the most popular and effective recipes are the following.

Pour boiling water (2 cups) over dry bay leaf (20 g). Keep the medicine on low heat for about 10-15 minutes, then strain and cool it. Take the decoction three times a day in the amount of 1/3 cup.

Medicinal baths with the addition of St. John's wort, sage, succession, celandine or fir extract to the water are also effective for psoriasis.

Taking a herbal infusion (from St. John's wort, elderberry, string, horsetail, and elecampane root) also helps well. You should pour boiling water (1 glass) over the herbal mixture (1 tablespoon), then leave it in a water bath for about 15-20 minutes. You should drink the infusion in the morning and in the evening immediately after eating.

Sea buckthorn oil also works well against psoriasis – it should be consumed once a day, 1 teaspoon at a time.

Black elderberry leaves and flowers are also considered an effective remedy. You need to pour boiled water (0.5 l) over the herbal mixture (2 teaspoons), and then leave it to infuse for 1 hour. After that, strain the tincture. Keep it in a cool, dry place, and drink 1/3 cup three times a day.

Among the medicines used externally, one can single out fish oil, celandine juice, and garlic tincture. They should be applied to the affected areas of the skin 1-2 times a day. In addition, it is recommended to take baths of oatmeal or corn flour.

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Prevention

The most effective method of preventing psoriasis is to regularly maintain an optimal level of skin moisture. But it should be taken into account that there are also forms of pathology in which skin moisture, on the contrary, can only provoke an exacerbation.

You should also protect your skin from any damage: scratches and abrasions, as well as injuries during the process of cutting your nails.

Regular stress and a state of constant nervous tension can also provoke psoriasis.

To prevent the development of psoriasis, you need to give up bad habits (alcohol, smoking), and also strengthen your immune system as much as possible.

Forecast

Winter psoriasis, like any other form of this disease, is incurable, but the prognosis for its course can be favorable - modern treatment methods allow achieving long-term remissions - from 1 year to periods of 30 or even 50 years. To achieve such a result, it is necessary to maintain a healthy lifestyle - proper diet, rest and work, no overwork, and stressful conditions.