Psoriasis

Disease description

Psoriasis is a chronic autoimmune disease characterized by skin lesions with a tendency to recur. The skin changes present as scaly plaques with well-defined borders.

According to the World Health Organization, psoriasis affects approximately 1% to 3% of the global population.

The International Classification of Diseases (ICD) identifies the following types of psoriasis:

• Plaque psoriasis (psoriasis vulgaris) — the classic form with typical dry skin manifestations
• Exudative psoriasis — characterized by weeping lesions
• Generalized psoriasis — involves widespread inflammation and the presence of pus
• Palmoplantar psoriasis — affects the palms of the hands and soles of the feet
• Psoriatic arthritis (arthropathic psoriasis) — joint inflammation resembling rheumatoid arthritis

Symptoms indicating the need for diagnosis and treatment

Patients with psoriasis typically report redness, flaking, and itching of the skin. The lesions often appear as bright red patches with a scaly surface. Initially, plaques tend to form on the knees, elbows, chest, abdomen, back, and scalp; as the disease progresses, they may appear on any part of the body.

A distinctive diagnostic feature of psoriasis is the Auspitz Triad, which includes:

• Stearin spot — accumulation of white scales that are easily removed by gentle scraping
• Psoriatic film — a moist, exudative surface revealed after removal of the superficial horny layer
• Pinpoint bleeding — tiny bleeding spots appearing after detachment of the psoriatic film

Diagnostic and treatment methods

Diagnosis

Modern dermatology employs the diagnostic protocol of the American College of Rheumatology, which includes:

• Blood tests (rheumatoid factor, immunoglobulins, C-reactive protein)
• Skin biopsy — excision of a small sample of affected skin for histological examination
• Imaging methods (ultrasound, X-ray) in complicated forms with joint involvement

Treatment

The main goal of therapy is to suppress autoimmune inflammation. Treatment plans are tailored individually for each patient, depending on symptom severity and overall health status.

Conservative treatment options include: topical therapy (ointments and creams), phototherapy, systemic therapy for severe forms and biological therapy (monoclonal antibodies).

Innovations in global clinics

In top medical centers worldwide, molecular genetic testing is prescribed for patients with psoriasis. The presence of the HLA-Cw6 genotype increases the risk of developing autoimmune skin pathology by tenfold. It is detected in 80% of cases and is strongly associated with Type I psoriasis.