psoriasis
Introduction
Introduction to psoriasis Psoriasis is a chronic intractable skin itching disease, equivalent to neurodermatitis. Because it is good for the neck, it looks like a cow's collar, thick and strong. The clinical features are skin lichenification, hypertrophy and rough, itching is severe, the course of disease is slow, repeated attacks, constant years of unhealed, and easy to relapse after treatment. It occurs mostly in the neck, elbow, and sputum, and is characterized by itchy skin and mossy. According to the size of the lesion, it can be divided into two types: localized and general. basic knowledge The proportion of illness: 0.03% Susceptible people: more in young adults Mode of infection: non-infectious Complications: folliculitis lymphitis
Cause
Psoriasis cause
Neuropsychiatric factors (20%):
Due to emotional fluctuations, excessive mental excitement, depression, nervousness, anxiety, horror or neurasthenia, the regulation function of the cerebral cortex is disordered, causing nerve dysfunction around the anus. When stimulated, the skin is prone to reaction and is lichen-like.
Stimulus factor (20%):
Such as drinking alcohol, coffee and other hot stimulants, or taking some drugs acting on the nervous system and panty, scratching and other local stimuli are all incentives.
Disease factors (20%):
Digestive diseases, endocrine disorders, etc. are also important incentives.
The disease is mainly caused by the seven emotions, the wind and evil intrusion, resulting in the loss of the camp and the meridian imbalance.
Wind and heat evil resistance: wind evil outside the body surface, depressed in the tendon and heat, causing bloody heat, meridians, body hair spots. If the wind and evil are long-lasting, the skin is ruined, the meridians are lost, and the wounds in the camp are bloody, and the disease is not cured for a long time.
Bloody winds and winds: wind evil heat or seven emotions internal injuries, temperament temperament, heat and fire, fiery heat in the camp blood, blood loss, and meridians are filled with rash and red. The blood is hot and windy, the wind is dry, and itching is itchy, and the dander is removed.
Blood deficiency and wind dryness: Emotional sorrow does not reach, heats up the heat, and burns yin and blood for a long time. Insufficient blood in the camp, dry and windy, skin dystrophic, meridian insufficiency, so hair rash dermatitis, itching is unbearable.
In short, emotional internal injuries, wind evil intrusion is the predisposing factor of this disease; the camp is not harmonious, the meridian imbalance is the pathogenesis of this disease. Rubbing the clothes and rubbing them repeatedly is not conducive to the blood in the camp and the thinning of the meridians, which will aggravate the rough and thickening of the lesions.
The disease is injured by the seven emotions, mostly due to the endogenous heart, the spleen through the damp heat, the lungs through the wind poisoning between the skin care, exogenous rheumatic fever, resulting in block the skin, blood deficiency and dryness, skin glory To.
Prevention
Psoriasis prevention
First, prevent infection
Local infection is an important cause of psoriasis, especially after a cold, complicated with tonsillitis, bronchitis, need active treatment, try to shorten the course of the disease, tonsils repeatedly inflammation, and closely related to the onset of psoriasis, consider tonsillectomy This is especially important for adolescents.
Second, allergic factors
It is one of the important causes of psoriasis. Because of allergies caused by eating or taking drugs or touching certain substances, psoriasis can often be induced. After each recurrence, patients should carefully recall what they have taken recently or have contacted. A substance that makes the skin itchy and then erythema, then this substance should be avoided in the future. For example, some seafood, beef and mutton, spicy things and other substances.
Third, damp and cool
There are many cases of psoriasis induced by wind and cold. Due to the damp environment and cold weather, the disease may occur or worsen. Therefore, patients should try to avoid large heat and heat to stimulate the skin, and the room should be kept ventilated and dry.
Fourth, spiritual factors
In daily life, due to work stress, poor rest, excessive mental stress, emotional instability, anxiety and anger, but also can not reasonably adjust the skin or long-term diet without rules, overeating, eating more food, Excessive drinking and drinking tea, as well as external causes of colds, fever, inflammation of the tonsils, low immune function, lack of resistance, resulting in the onset and recurrence of psoriasis, excessive mental stress, temperament, depression and other mental factors as incentives, accounting for other causes The first cause of inducement, accounting for 18.6% of the total incidence of psoriasis in China, excessive mental stress, can produce a series of psychological or physiological reactions, promote neuroendocrine disorders, damage the body's immune defense system, and metabolic disorders of certain enzymes, thereby promoting The occurrence of psoriasis, so in the event of irresistible or unpredictable sudden events, patients should try to control the mood, maintain a calm mood, ensure adequate sleep time, if necessary, take appropriate amount of sedative.
5. Use the following controlled drugs with caution
What kind of drugs were used for the first time to treat psoriasis, which played a key role in the efficacy and recurrence of the disease. In a period of time, the medical community has entered the misunderstanding on the direction of the treatment of psoriasis, mainly in: When pimples erythema begins to appear in patients with psoriasis, it indicates that the patient's immune system is reduced, endocrine dysfunction, microcirculation is unsatisfactory, causing skin excretion dysfunction, so that the endotoxin to be excreted in the body accumulates under the skin, and the drugs used. It is not used to improve immunity, restore normal metabolic function of the skin, excrete endotoxin, but use hormones and immunosuppressive agents to suppress immunity and control skin excretion function. The result is more and more severe, and eventually the disease is more stubborn and difficult to treat. Then as a patient should have a basic understanding of these drugs, the drugs commonly used to control psoriasis are corticosteroids, anti-tumor, etc., corticosteroids: mainly for external use, oral administration, external use of drugs commonly used Easy, skin dying, skinkang, skin lotion, skin cream, Dalux (Denmark), etc. Oral administration of prednisone, dexamethasone and some imported high-concentration hormone injections of threxine (usp), corticosteroid control psoriasis, although effective, easy to use, but the side effects are very large, can make patients short-term Fat, squeaky hair, long hair, osteoporosis, and even fractures, become the main cause of severe psoriasis, so the general patient can not abuse hormones, must be used only externally or under the guidance of a doctor, or easy to use Atrophy or sudden withdrawal of the local skin, that is, a serious rebound recurrence, making the condition worse.
In short, there are many reasons for the induction of psoriasis. Only patients pay more attention to their daily lives, pay attention to environmental hygiene, and actively eliminate predisposing factors such as avoiding alcohol, avoiding spicy, fish and shrimp, seafood, mutton and cockroaches, and prevent colds and tonsils. Inflammation, illness should be treated in the formal medical department, and some controlled drugs should be used with caution to reduce the chance of recurrence.
Complication
Psoriasis complications Complications folliculitis lymphitis
Neurodermatitis is a kind of local skin neurological dysfunction, which is more common in life. There are many incentives, the symptoms are light and heavy, and prolonged unhealed will have many adverse effects on the normal life of patients and their families. The disease is chronic, the symptoms are light and heavy, and it is easy to relapse after curing. In severe cases, folliculitis and lymphitis can be secondary. Persistent rubbing of the ankle or upper back can cause starchy material to deposit in the dermis, which in turn develops plaque and bryophyte-like disease.
Symptom
Psoriasis symptoms Common symptoms Skin scaly wind papules rash papule joint swelling red hay rash itching erythema erythema (clear boundary
Clinical manifestation
In the early stage of the disease, only the intermittent itching of the affected part, especially at night, often cause insomnia, the skin appears light brown round or polygonal papules, the surface is smooth or covered with sugar-like scales, densely integrated, with the development of the disease, The papules gradually merge into pieces, forming a moss-like change in the British. At this time, the diseased skin is dry, thickened, and the skin lines are deepened, interlaced with each other, and the skin is protuberanced, showing a diamond shape or a polygonal shape, and the boundary is clear. I have seen this young man in this disease.
Syndrome differentiation
The disease can be divided into three types. Most of the initial development is wind and heat stasis, and then the blood is hot and windy.
Wind and heat on the muscle surface: local only paroxysmal itching, mostly due to scratching or rubbing and other irritations, local skin appears mossy rash, polygonal (or round), such as the size of the cap, reddish skin Or as usual, see also emotional depression, insomnia and other symptoms.
Blood deficiency and wind dryness, evil muscles table: pimples merge into pieces, skin thickening, dry and rough, or a small amount of gray scales, resulting in mossy, paroxysmal itching increased, often scratched and scratched, Bloody and secondary infections.
Wind and heat stasis: more common in patients with localized disease, skin lesions into pieces, mainly papules, pale red or light brown, rough and fat, bursting itchy, rapid mossy changes after scratching. The tongue is thin or slightly greasy, and the veins are slippery or gentle.
Bloody and windy: more common in patients with generalized skin, red skin lesions, generalized body, large invasive flushing plaques, scratches, blood stasis, mossy changes, itching, especially people night, With upset, thirst, insomnia and more dreams, anxious and irritable. Red tongue, thin fur, slippery pulse or string.
Blood deficiency and wind dryness: The disease is not healed for a long time, it is getting worse, the local skin lesions are thick and rough, the color is light or light brown, the surface is dry and scaly, itchy and itchy, especially at night. The tongue is light, the fur is thin, and the veins are thin.
Examine
Psoriasis examination
Abnormal performance of skin live cell examination:
1. The skin protrusions are neatly extended and the lower part is thickened.
2. Prolonged dermal papilla and edema.
3. The particle layer disappears.
4, parakeratosis: cells in the keratinized layer contain concentrated non-disappearing nuclei, called parakeratosis or incomplete keratinization.
5, MUNRO micro abscess: micro-abscess formed by neutrophils accumulated in the stratum corneum, called Munro microabscess. Found in pustular psoriasis.
Diagnosis
Psoriasis diagnosis and identification
diagnosis
The diagnosis is mainly based on typical clinical manifestations, and histopathology has certain diagnostic value.
Differential diagnosis
According to the clinical good site and typical moss-like damage, no blister, bursting itching, chronic passing, etc., can generally make a diagnosis. However, it must be differentiated from the following diseases:
(a) chronic eczema.
(B) scrapie: more common in the elderly, often associated with the season, skin lesions are secondary.
(C) lichen planus: occurs in the wrist flexion, forearm, calf extension, trunk, etc., rash is large, round or polygonal, flat papules, slightly rounded center, dark red color, pale purple or normal skin color, The surface has a waxy luster and special changes in histopathology.
(4) Psoriasis: The base of the lesion is in reddish or dark red infiltrated, and the silvery white scales are covered. After peeling off the scales, the base has a thin film phenomenon and punctiform hemorrhage, and psoriasis damage is common in other parts of the body.
(5) Primary skin amyloidosis: occurs in the lateral extension of the calf, the lesion is a round or semi-circular brown pimples from high to large mung beans, densely integrated with plaques without fusion, waxy luster, rough surface, Inconsistent, the Congo red skin test was positive.
