Is psoriasis a genetic or acquired disease, the role of external factors? When does psoriasis begin?

Of the various factors that can contribute to the occurrence of psoriasis and even be the direct cause of its development, genetic factors currently play a significant role.

The possibility of familial cases of psoriasis was noted at the beginning of the 19th century; The subsequent reports were sporadic and did not allow us to confidently judge the hereditary nature of this disease, although it was noted in several generations. In the 20th century, especially in the 50-60s, too many such observations accumulated, and the familial nature of psoriasis could no longer be explained only by chance. According to numerous statistical reports, familial psoriasis is registered within a fairly wide range - from 5-10% [Darier (J. Darier)] to 91% [Lomholt (G. Lomholt)], which depends on the number of observations, the thoroughness of the examination of relatives of probands and others reasons. However, despite significant fluctuations, these data are too regular to be ignored.

It should be emphasized that to accurately determine the familial nature of psoriasis, a very long period of observation is required, since the disease often does not appear immediately after the birth of children in parents with psoriasis, but develops 10-20 years or more after birth. Farber and Carlsen (E. Farber, R. C arisen, 1966) examined 1000 patients with psoriasis, analyzing the timing of the onset of the disease depending on age. It was noted that in the largest number of those examined, psoriasis arose before the age of 20 (and there were twice as many female patients); this difference was not observed in patients who became ill over the age of 20 years.

Lomholt (1965) noted this disease in 9% of the examined relatives of 312 patients with psoriasis. According to Hellgren (L. Hellgren, 1964), the incidence of psoriasis in close relatives is 36% and is significantly higher than in the control group.

The number of generations of relatives who have psoriasis ranges from 2 to 5. There are isolated, but very convincingly traced observations of psoriasis even in 6 generations [for example, Grayson and Shair (L. Grayson, N. Shair, 1959) reported psoriasis in 6 generations in 27 relatives]. Abele (D. S. Abele) et al. (1963) published an analysis of the pedigree of 537 living relatives, among whom were 44 patients with psoriasis in six generations.

Interesting data were obtained from a study of twins. In 1945, T. Romanus published an analysis of psoriasis in 15 pairs of identical twins, among whom concordance for psoriasis was noted in 11. This and numerous other descriptions of psoriasis in identical twins undoubtedly confirm its genetic nature. The reason for discordance must be sought in the difference in external influences, which in one case may manifest a genetic predisposition, but not in another.

Advances in genetics have stimulated cytogenetic studies in psoriasis. Hornstein and Groop (O. Hornstein, A. Groop) at the XII International Congress of Dermatologists reported that the karyotype of psoriasis patients obtained by culturing blood cells was normal. Fritsch (N. Fritsch, 1963), who examined patients with psoriasis, also did not reveal chromosomal aberrations. Similar data were obtained by Goldman and Owens (L. Goldman, P. Owens, 1964), as well as by S. Gimenez (1968). In 1965, Hochglaube and Karasek (J. Hochglaube, M. Karasek) studied a karyotype obtained from fibroblast cells of a culture of normal and pathological skin taken from patients with psoriasis; no changes in the number or structure of chromosomes were detected. When studying the content of sex chromatin in patients with psoriasis, no deviations from the norm were found (G. B. Belenkiy, 1968; G. V. Belenkiy and S. S. Kryazheva, 1968). However, these data do not exclude changes at the gene level that cannot yet be detected morphologically.

Back in 1931, K. Hoede, having studied 1,437 patients with psoriasis and examined their families, established the familial nature of the disease in 39% of cases and suggested an irregular dominant type of inheritance in psoriasis, partially linked to sex. Romanus (1945) confirmed the possibility of dominant transmission of psoriasis with incomplete penetration of the mutant gene (about 18% of cases), Abele et al. (1963) - approx. 60% of cases. In 1957, V. Ascher et al. described a family where both parents and two of five children had psoriasis; one of them had a particularly strong generalized process, which the authors regarded as the result of the action of the dominant psoriasis gene in the homozygote. Steinberg (A. Steinberg, 1951), having studied the families of 464 patients, found that 6% of parents suffer from psoriasis, and diseases of children are observed 4 times more often if one parent is sick than if they are both healthy. Since the incidence of psoriasis in children depends on the presence or absence of psoriasis in the parents, the authors conclude that at least two autosomal recessive genes are responsible for the occurrence of psoriasis. Lomholt (1963) recognizes the possibility of each of these modes of inheritance. Burch and Rowell (P.R. Burch, N. Rowell, 1965) admit the possibility of somatic gene mutation in the lpmphoid cell stem. According to F. M. Burnet, they may be accompanied by the growth of the affected clone. Cells of the clone synthesize autoantibodies that are able to penetrate the damaged epidermal basement membrane, causing hyperplasia of epidermal basal cells. This hypothesis suggests that psoriasis is a disease caused by a spontaneous disorder of autoimmunity. G. B. Belenky, S. M. Belotsky and I. A. Ivanova (1968) discovered natural antibodies to tissues in the serum of patients with psoriasis both during remission and during exacerbation; however, the level of serum immunity and antibody activity did not differ from the control group. The possibility of genetic changes at the biochemical level has prompted a number of studies in this direction. Abele et al. (1963), determining the levels of plasma uric acid and cholesterol in patients with psoriasis, did not reveal any abnormalities. Hellgren (1964) noted a decrease in albumin in the serum of patients with psoriasis and an increase in alpha 2 -globulins and beta globulins. In patients with psoriasis, an increase in the excretion of acidic mucopolysaccharides and hydroxyproline was observed. Rosner and Baranowska (J. Rosner, B. Baranowska, 1964) did not note any peculiarities in patients with psoriasis when determining amino acids in blood and urine. An attempt was made to identify the connection between blood groups and psoriasis. Gupta (M. Gupta, 1966) noted that most patients with psoriasis have blood type 0.

Wendt (G. G. Wendt, 1968) reported that in patients with psoriasis, blood with group M antigen is more often observed than in the control group.

Intensifying the study of hereditary factors in psoriasis will be able to shed light on its etiology and pathogenesis and determine the true place of psoriasis in the nosology of dermatoses.

Psoriasis is a very common skin disease, affecting more than 100 million people worldwide. Out of every 100 people on earth, approximately five suffer from psoriasis.

This disease can strike at any age and last for many years. However, if you follow the doctor’s recommendations, almost every patient can achieve results. Effective treatment allows people with psoriasis to live a completely normal life.

When does psoriasis start?

It is difficult to pinpoint exactly when the disease began. Typically, a patient consults a doctor if he already has grounds for complaints. However, in 75% of cases, psoriasis affects people during puberty - the time of puberty. According to German experts, psoriasis is divided into two types: the first appears at the age of about 20 years and is somewhat more severe, the second occurs around 50 years. There is a possibility that psoriasis will begin in youth if one of your relatives has already been diagnosed with it. But, unlike other hereditary diseases, the nature of the transmission of psoriasis from generation to generation is not obvious, therefore it is impossible to predict with certainty whether any family members will get sick and who exactly.

So you can become a victim of psoriasis at any time, from infancy to old age.

Genetic predisposition to psoriasis

Hereditary factors play a significant role in the development of this disease - this is indicated by the fact that it is more common in people whose relatives already suffer from psoriasis. The risk of developing psoriasis in a child whose parents are healthy is 12%. When psoriasis is diagnosed in the father or mother, the probability increases - this is already 10-20%. If both parents are sick, the risk for the child will be as much as 50%.

Scientists now believe that the inheritance of psoriasis is multifactorial, that is, several different genes are responsible for the predisposition to this disease, and in order for it to develop, several different external or internal factors are needed. Let's look at which ones exactly.

Causes of occurrence or exacerbation of psoriasis

According to the latest scientific medical research, psoriasis is not caused by any one cause, but by a whole complex of factors that are in complex interaction. Most often, it is impossible to determine the exact cause of psoriatic rashes. For example, those who have a genetic predisposition to psoriasis may not experience any manifestations of it for many years, although, on the other hand, it is well known what exactly triggers the appearance of psoriasis symptoms in them.

Such provoking influences are skin injuries (the so-called Koebner phenomenon) - ordinary scratches and cuts or surgical incisions, all kinds of abrasions (including in places where clothing simply pinches or rubs), injections, sun, thermal or chemical burns. The mechanism of this has not yet been fully studied, but this peculiar reaction also accompanies some other skin diseases.

The connection between psoriasis and the sun deserves a special discussion. The sun has an ambiguous effect on the course of the disease. In moderate quantities, its effect is beneficial - patients living in cold climate zones, simply by sunbathing, and even more so by going on vacation to the south, record a significant improvement in their condition. But it is important to remember to be careful: sunburn, on the contrary, can cause a negative effect - in 5-10% of psoriasis sufferers, sunbathing provokes an exacerbation.

The course of psoriasis is significantly influenced by other dermatological diseases. For example, if a person predisposed to psoriasis has a fungal infection in the folds of the skin, psoriatic plaques may also form in these areas (interdigital, axillary, inguinal folds, navel area).

Often, psoriasis begins with concomitant streptococcal infections - sore throat, chronic tonsillitis, upper respiratory tract infections, as well as vaccinations (primarily this applies to children). If the patient already suffers from psoriasis, streptococcal infections of the upper respiratory tract can cause an exacerbation.

The greatest danger of concomitant infections for a patient with psoriasis is HIV. When AIDS develops, psoriasis is especially severe: rashes can cover almost the entire skin (this condition is called psoriatic erythroderma).

Alcohol, especially strong drinks, beer, and champagne, also causes the disease to worsen. Alcohol abuse, as a rule, leads to the fact that psoriasis becomes practically insensitive to prescribed drugs and procedures.

Finally, psoriasis partly confirms the old formula “all diseases come from nerves” - its appearance can be provoked by excessive stress on the nervous system and stress. The mechanism of this cause-and-effect relationship is not entirely clear, and in addition, some patients note, on the contrary, the beneficial effect of stress on their condition.

What processes occur in the skin during psoriasis

As we already know, in the skin of a person genetically predisposed to psoriasis, under the influence of certain external or internal factors, pathological changes can begin, as a result of which psoriatic plaques form. As a rule, their boundaries are clear, the color is red-pink, and the surface is covered with scales. These clinical manifestations are a consequence of impaired reproduction and maturation of skin cells, inflammation and changes in the blood vessels of the skin.

The pathogenesis (mechanism of development) of psoriasis in its primary links at the cellular level has not been studied. But it is reliably known: in the superficial layers of the skin, cell division accelerates. If healthy skin cells live 30-40 days - from the moment they appear to die and exfoliate, then with psoriasis this process occurs 6 times faster. Such active cell proliferation leads to thickening of the skin, in particular its spinous layer. These pink-red areas of thickened skin are called psoriatic papules, and when the papules coalesce, they are called psoriatic plaques. But, although the cells multiply rapidly, they do not have time to mature and fully go through all stages of their development. Because of this, the granular layer of the skin practically disappears, and the processes of keratinization of epidermal cells are disrupted. The result of this is that the stratum corneum thickens significantly, which explains the appearance of numerous scales on the surface of the psoriatic plaque.

In the following sections you can learn about psoriasis (how the disease manifests itself), the disease and the use of the drug.

Psoriasis is a complex skin disease, the lesion of which is expressed by rashes and scaliness and is accompanied by a feeling of tightness and severe itching.

Some statistics

How to cure psoriasis forever? This disease, considered rare, affects about 4-8% of the world's population (approximately 4.5 million people). Moreover, highly developed countries have also not been spared skin damage, due to the fact that a healing cure for psoriasis has not yet been invented. Among ethnic groups, whites have a higher prevalence than blacks, Hispanics, and Native Americans. This disease does not discriminate by gender, affecting both women and men equally.

The appearance of psoriasis is due to genetic and hereditary factors: of 100% of the patients surveyed, 40-65% had relatives and friends who suffered from the skin disease. In a number of studies, when assessing the risk of morbidity, it was found that if one of the twins is diagnosed with psoriasis, then the probability of the disease developing in the second will be 58%. This conclusion was made public in a study of 141 pairs of twins. If a brother or sister suffers from psoriasis, the risk is reduced to 6%. If both parents are sick, in 65% the child will also be affected by this disease; If one member of a married couple is sick, the risk of getting sick is reduced to 20%. Moreover, the degree of the disease and its localization vary among different family members.

Psoriasis is not contagious

There is a widespread belief that psoriasis is contagious, especially strengthened when looking at a person affected by the disease. Psoriasis is not contagious! Neither touching diseased skin, nor using common objects, nor caring for a patient will cause infection, since the source of the disease is the leukocytes of the patient himself, who sincerely thinks about how to cure psoriasis forever.

External signs of the disease

External signs of psoriasis:

The disease can manifest itself:

• in partial form, characterized by the presence of several spots on the body;
• in continuous form, affecting the skin completely.

Causes of psoriasis

Psoriasis occurs due to a disruption in the performance of its functions by the epidermis, which normally should be renewed approximately once a month.

With psoriasis, this happens several times faster, that is, the skin tries to rejuvenate in 3-4 days. The factor causing the accelerated and abnormal process of passing through the full cell cycle is inflammation. This forces new cells to come out not fully formed, which not only negatively affects the entire body, but also leads to deterioration of the outer skin layer, namely the appearance of repulsive scaliness.

Once started, the process accompanies a person throughout his life, alternating with periods of exacerbation and temporary lull of skin manifestations (otherwise, remission). How to cure psoriasis forever and get rid of not only psoriatic rashes, but also painful itching, which can still be somehow controlled during the day? At night, a sleeping patient has to involuntarily scratch the affected areas, which leads to damage to the epidermis and aggravation of the disease.

Factors that cause psoriasis

Factors causing the occurrence of psoriasis are:

• metabolic disorders, as well as the functioning of the immune and endocrine systems;
• genetic predisposition;
• systematic use of medications;
• previous illness (sore throat, flu, etc.);
• unfavorable environment;
• stress and neurosis, constant emotional tension.

The true cause of psoriasis is genetics

Provoking the onset of psoriasis, none of the above factors is the cause of the disease, the presence of which does not in any way affect the deterioration of the patient’s well-being and decreased performance. Discomfort is caused only by unpleasant sensations, itching and the appearance of the skin. It is most difficult for the patient psychologically, since he has to constantly experience a wary attitude and sidelong glances from the people around him. The feeling of loneliness provoked by society and an unattractive appearance prompt the patient to intensively search for methods that can solve the question of how to cure psoriasis forever.

Living with psoriasis

Having discovered signs of psoriasis, do not panic: this is not a death sentence. Unfortunately, a completely curative medicine has not yet been invented, but modern methods of therapy can reduce the degree of damage, stop the development, and also control the course of the disease with the help of many medications.

People live side by side with such a disease, which is tamed using methods that suppress the active activity of the immune system. By removing them forever, modern remedies cannot affect the true cause: the overactive effect of the immune system on the skin. The disease, which lasts for years, has a variable course, sometimes subsiding for a long time (even disappearing completely), sometimes worsening. In any case, psoriasis, having affected the body, will never leave it; immune system cells will always attack the skin.

Treatment of psoriasis

Treatment of psoriasis is a complex process, divided into several stages depending on the form and stage of the disease, the area of ​​skin lesions, the gender and age of the patient, the presence of associated diseases, and restrictions on a particular treatment method or drug. It is important to listen responsibly to the doctor’s recommendations, not to self-medicate and not to be deceived by tempting advertisements of a “miracle cure for psoriasis”, which are a means of easy money for scammers. It is unrealistic to cure psoriasis with its complex and ambiguous nature; some methods can only remove the symptoms for a while. Therapeutic tactics must be selected individually, taking into account previously conducted therapy. In severe cases, with sufficient prevalence

Psoriasis is not a dangerous infectious disease, but if the virus does penetrate the human body, it is not possible to get rid of it. The only salvation to avoid regular relapses is continuous maintenance therapy. Seeing unattractive pathological lesions and conspicuous papules, healthy people involuntarily become wary and wonder whether this disease is contagious?

Due to a lot of misinformation, some are convinced that lichen planus can be transmitted from one person to another. However, this is not the case - the disease is not subject to either airborne or contact transmission, since its nature is not contagious. Due to the ignorance of others, patients with a wide area of ​​affected areas often experience psychological and aesthetic discomfort and lead an isolated, almost reclusive lifestyle.

Causes of psoriasis

To date, there is no precise scientific and medical data to explain the appearance of lichen planus. It has not yet been possible to thoroughly study the factors that provoke psoriasis and the further activity of the disease, but natural provocateurs that “promote” the development of the disease have been identified.

These include:

• disruptions in the immune system, general weakness of the body (while undergoing a complex operation or after a serious illness);
• skin diseases;
• disorders of a nervous or psychological nature;
• hypersensitivity reactions;
• viral or infectious diseases;
• sudden climate change;
• genetic predisposition;
• interaction with harmful substances.

Other provocateurs are also possible, but they are purely individual.

Development mechanisms

Experts almost unanimously came to the conclusion that this disease can only occur under the influence of biological or physical factors. There are only a few basic theories that explain such a disturbance in the body’s activity. The most likely form of transmission is heredity.

It has been scientifically proven that psoriasis is transmitted genetically to a child from a sick parent. Statistics also say that children whose at least distant ancestors suffered from scaly lichen have a predisposition to the disease and become ill with it significantly more often. The key reason for the transmission of the disease to descendants from predecessors is a disturbance in metabolic processes.

In cases where both parents are affected by psoriasis, the chance of passing it on to the child is about 75%. If the pathology is inherent in only one parent, then the risk is reduced by 25%. However, the disease will not necessarily bother the child - in the absence of strong provoking factors, the virus may be in a “dormant” state.

Viral, infectious, allergic, endocrine and immunometabolic theories of transmission have also been developed, but clinical studies do not confirm them.

Is infection possible through household contact?

Of course, the factors that activate the proliferative growth of skin cells are different, but when communicating with patients with psoriasis, you don’t have to worry about your own health at all. Under no circumstances will this pathology be transmitted through touch or handshake. Hugs or kisses with a sick person do not pose any danger - a healthy person cannot become infected with this skin disease.

If among relatives or in the family circle there is a person who has psoriasis, and after a while the disease is diagnosed in another family member, then the explanation for this is solely a hereditary predisposition. And scaly lichen can worsen due to poor nutrition, lack of sleep, psycho-emotional outbursts, and changes in living conditions.

During sexual contact, the probability of “catch” psoriasis is also zero. Even for a person with a predisposition, sexual contact with a sick person does not threaten anything.

How to recognize the disease?

Before starting treatment, the disease must be diagnosed. The main symptom of lichen planus is spots that can be located in any area of ​​the body. Psoriatic spots can vary in size. The predominant color is rich red tones, but initially they may appear sporadically and have a light pink color. A sure sign is silvery, loose scales that form on the surface of pathological lesions. The precursors of psoriasis are unexplained fatigue, sudden general loss of strength, nausea.

As a rule, at the initial stage, the main areas of localization are the trunk, scalp and flexor areas of the limbs. Unbearable itching and swelling are absent at first, however, such symptoms can occur due to severe stress or after a therapeutic course of aggressive medications.

Usually, at the second stage, doctors register Koebner syndrome. Irritated and scratched areas of the body become covered with plaques. There is a connection of new elements with existing papules. As a result, serious swelling forms in the affected area.

Stage three psoriasis is characterized by clear contours of the spots. New elements do not appear. Peeling begins in psoriasis areas, and the affected skin becomes somewhat bluish. The lesions thicken and warts and papillomas form. In the absence of proper treatment, the disease becomes aggravated. The person’s recovery is proceeding slowly. First, the scales disappear and the swelling subsides, then the color of the skin normalizes. Towards the end of therapy, tissue infiltration disappears.

Is it possible to permanently cure psoriasis?

Due to the fact that scaly lichen is a hereditary, genetic disease, the achievements of modern medicine can only combat external manifestations. However, innovative medicines are very effective and allow the patient to forget about the rash for a significant period of time.

Types of treatment, therapeutic methods

It is very likely that of all diseases, psoriasis stands out as an ailment, with the most extensive list of medications against it. In dermatology, there is an active use of both external agents, such as lotions, creams, aerosols, ointments, and internal ones, such as injections, tablets. Procedures aimed at improving the health of the skin are extremely individual; all cases must be considered separately.

Before prescribing treatment, the doctor needs time to identify the key cause of the activation of the disease and find the provoking factor. Based on the results of examinations and diagnostics, the doctor will be able to determine the optimal course of treatment. Combining treatment with clinically proven drugs with drug-free therapy allows you to achieve long-term remission and relief of the disease.

Protection against lichen planus

It is enough to provoke psoriasis once and then experience discomfort and suffering for the rest of your life.

In order to avoid the awakening of the disease and try to outwit genetics, you should follow a few simple recommendations, which are not superfluous for an absolutely healthy person: