Nail psoriasis can be a sole manifestation of psoriasis, as well as to develop on the background of other forms of the disease. The difficulty of diagnosis and treatment of nail psoriasis Nail psoriasis - particularly the treatment and care   It is known for a long time, and if in the treatment of other forms of psoriasis has been some progress, the treatment of psoriasis Advances in the treatment of psoriasis   nails still problematic.

Causes of nail psoriasis

Reasons nail psoriasis, as well as other forms of psoriasis is not fully understood. The disease is considered an autoimmune, that is with him for some reason disrupted immune system, it does not recognize its own cells and tissues, and contributes to their destruction. It is believed that the causes of such disorders of the immune system are associated with genetic (family) characteristics of the organism.

Nail psoriasis provokes metabolic disorders Metabolism: The basis of life of all living things   amid hypovitaminosis lack of macro- and microelements, neuroendocrine disorders, acute and chronic bacterial and viral infections, intoxications, reducing cleaning ability of the liver and so on. Provoke the development of nail psoriasis may also be injured.

Symptoms

The defeat of nail psoriasis can be for many years the only appearance of the disease. But it also happens that nail involvement is a complication of another form of psoriasis or vice versa, its first manifestation.

At the same time, together with a skin rash on the trunk, limbs and scalp (or independent of them) in some patients with psoriasis appear changes in the nail plate. These changes may be of a different character. So, nail psoriasis can manifest as a symptom of a thimble - the most typical violations of the nail plate.

Thus on the surface of the nail there are fine dots of deepening 0, 5-2 mm in diameter, as in a thimble. These depressions are the result of violations of the formation of the nail plate. These multiple recesses, but differ from each other in shape, size and depth. On different nail plate can be a different number of recesses.

Localized such grooves on the nails randomly one or two or in groups, often along longitudinal lines, but sometimes in another, while maintaining a certain order. One or two depressions on the nail often regarded as a normal variant.

Similar changes can occur on the nails and other skin diseases (eczema, lichen planus, and so on). Sometimes to distinguish one disease from another is problematic. However, it is noted that in psoriasis deepening more ordered and deep. They are also more painful when pressed with a sharp object (eg, a needle). In the form of a thimble symptoms often manifest nail psoriasis on the hands, but it is quite possible the emergence and legs.

Nail psoriasis can also occur oniholizisa - gradual painless separation of the nail plate from the nail bed without prior injury and inflammation in the area. Branch nail usually begins with a free edge (distal onycholysis), but sometimes from the root or from the side (central and lateral onycholysis). Branch nail can be complete or partial (full or partial onycholysis).

Branch nail can start up with raised edge of the nail plate or appearance of the nail in the separation of lines, shapes and so on. While gradually increasing the subungual area, wherein the deposited dust, dead cells of the epidermis, the air bubbles. All these changes are reflected in the appearance of the nail: it becomes grayish-white or brownish. A thin pink stripes on the surface of the nail (eventually it turns yellow) outlines oniholizisa zone. In some cases, the process oniholizisa accompanied by heavy smell of decay of tissues.

During oniholizisa may develop metabolic and degenerative changes at the base of the nail - onihomadeza. Onycholysis when it is more severe, and the rejection of the nail is faster than usual.

Psoriasis toenails often manifests itself in the form of subungual hemorrhage (bleeding). Meets this type of violations and on the hands. This symptom often occurs when wearing tight shoes. It is manifested in the form of a pink-red spots irregularly shaped, of different sizes, transmission through the nail plate. Such violations are also called "oil stains" or psoriatic hyponychial erythema. Sometimes, through the thickness of the nail shine dots or lines of dark red color, which after some time become black.

Another symptom of nail psoriasis - trahionihiya. It is characterized by the appearance of this symptom roughness and a turbidity of the nail plate. If the center appears traheonihii wide groove (in the center of the nail as it is pushed inside), it is called koilonychia. During the formation of the nail plate koilonychia first flattened, then the peripheral portion of the nail is bent upward, the center goes down and it gets spoon-shape, holding on the surface of the liquid drop (special test).

Sometimes nail psoriasis manifests as psoriasis paronychia - thickening and inflammation of the periungual roller, which then passes on all the final phalanx and even entire finger with the formation of pus. This symptom usually develops in severe forms of psoriasis - pustular psoriasis Pustular psoriasis - a severe form of the disease   or erythrodermic psoriasis. But sometimes psoriatic paronychia develops and non-severe forms of psoriasis.

Pustular psoriasis - is one of the most severe forms of psoriasis, which can threaten the life of the patient. Only the timely appointment of adequate treatment in a hospital can save a patient with generalized pustular psoriasis. There are also local forms pustular psoriasis, for example, with lesions only the palms and soles.

Why start pustular psoriasis

Pustular psoriasis is characterized by the appearance on the brightly colored, pinkish-red swollen areas of the skin surface bubbles and pustules (pustules) with sterile contents. Pustular psoriasis can occur in the form of generalized (common) and localized forms.

The main reasons pustular psoriasis as well as other forms of this disease is a genetic predisposition, metabolic disorders Metabolism: The basis of life of all living things   and immunity. But there are so-called trigger factors contributing to the development of this particular form of psoriasis, or move it to other forms of the disease:

• long-term use of drugs that suppress the immune system - glyukokortikosterodnyh hormones (SCS) system followed by rapid action to terminate them, cytostatics (drugs, actively suppress the proliferation of skin cells (such as methotrexate), oral contraceptives and other drugs;
• long-term use of strong irritating external agents (tar, anthralin), corticosteroid ointments, salicylic ointment fukortsinom and others;
• high emotional stress, stress;
• viral and bacterial infections;
• hormonal disorders and pregnancy, leading to immune disorders;
• prolonged exposure to sunlight and phototherapy Phototherapy - restores vitality ;
• jaundice caused by obstruction of the biliary tract, accompanied by itching and scratching of the skin;
• lower blood calcium.

Generalized pustular psoriasis

Generalized pustular psoriasis Tsumbusha - is hard, often life-threatening form of psoriasis. Disease begins acutely, in the skin appear red, slightly elevated above the surface of large areas clearly demarcated from the rest of the skin. At the same time the patient temperature rises, sometimes up to significant numbers, there is a weakness, malaise, pain in muscles and joints. Almost immediately on the surface of the modified parts of the skin appear groups of bubbles and pustules that rapidly merge with each other, forming a "pus Lake", which are then covered with a brown crust. When injury of such crusts formed long non-healing erosions and ulcers. They can also be collected in the vast eroded surface, however, quickly epiteliziruyutsya.

The pustules appear, covered with crusts and disappear at the same time on the skin appear fresh rashes on the skin creating a mixed picture. After the end of the process (usually two - eight weeks) on the skin can be bright red spots and rashes typical for simple psoriasis.

They are especially abundant precipitation in the crotch area and genitals, in skin folds and the flexion joint surfaces. In some cases, the process proceeds to the mucous membranes, characterized by, for example, loss of language. The disease can also Neiti nails and scalp.

Pustular psoriasis Barbera

Pustular psoriasis Barbera - a localized form of the disease characterized by lesions of the palms and soles. I suffer from this form of psoriasis often women.

In psoriasis Barbera on the palms and soles appear red scaly patches with sharp borders. After some time, they appear flat pustules with sterile contents diameter to 0, 5 cm, located deep within the skin. Located pustules are most often in the big toe or under the other fingers on the hands and on the inner side surface of the I toe under the soles. It is also possible the appearance of pustules on the flexion of the fingers, the arch of the foot and heel.

Palmoplantar psoriasis Barbera takes a long, undulating and difficult to treat. In addition, it is easy to be confused with a fungal infection Fungal infection: to prevent and defeat   and eczema.

Treatment

The treatment of generalized psoriasis Tsumbusha performed only in a hospital. Patients received detoxification therapy for the purpose of excretion of toxic products of tissue decay. To do this, intravenously administered various medicinal solutions. Introduced as glucocorticoid hormones in high doses short courses and antihistamines to relieve inflammation and edema. Recently, to suppress the inflammatory process applied retinoids (Vitamin A active derivatives Vitamin A: An important element of the health and beauty For example, tigazon). To suppress proliferation of tissues are used as immunomodulators general and selective (metatreksat, infliximab). Once the process enters the stage of stabilization, prescribe PUVA therapy (photochemotherapy).

Galina Romanenko