Severe psoriasis - psoriatic arthritis

Psoriasis arthropathy (arthropathic psoriasis, psoriatic arthritis Arthritis - a variety of forms and complications , Psoriatic arthropathy) occurs more frequently in patients who already have skin manifestations of psoriasis in an average of 6 years after onset. But sometimes, joint damage develops before the rash appears, or simultaneously with it. This affects the small interphalangeal joints of the fingers (less feet) and almost always - nails. Often there sosiskoobraznoe swelling of fingers or toes - psoriatic dactylitis.

Sometimes the process involves two or three large joints (knee, hip, shoulder, etc.) And the defeat is symmetrical. In severe cases, the articular process becomes generalized multiple joint disease (generalized psoriasis).

Also affects the intervertebral joints of the lumbar region and sacroiliac joints, which develops stillness, so psoriatic arthritis, rheumatoid be distinguished from lesions of the spine - ankylosing spondylitis. Current articular psoriasis - a sharp alternation of exacerbations (they are often associated with skin rash) and partial remission. The lesions of the spine can lead to immobility of the spine and disability.

The effects of psoriasis joints can be very heavy - with the progression of developing major dysfunction of the joints.

Pustular psoriasis

Pustular psoriasis accompanied by the appearance of bubbles on the skin with a sterile purulent contents - pustules. This is a relatively rare type of psoriasis, which may develop as originally, and against the background of psoriasis vulgaris. In recent years, the incidence of psoriasis vulgaris Vulgar psoriasis - the most common form of the disease   growing, which, apparently, due to the use of glucocorticoids and cytotoxic drugs suppressing the immune system. The development of pustular psoriasis can be triggered by the cancellation or reduction of the dose of glucocorticoid hormones, pregnancy, stress How to beat stress? Create an oasis   and other factors. But often the cause of its origin remains unclear.

By the generalized form of psoriasis include pustular purulent Tsimbusha in which pustular eruptions occur in already existing psoriasis. The primary elements in this case are bubbles or blisters that appear on the papules and pustules quickly becoming - blisters with a sterile content. In some places, pustules coalesce into larger pockets - lake. The skin above and below the surface of the pustules inflamed, swollen, tight. In some cases, the process joins bacterial infection and pustules acquires contents unsterile character. It violates the general condition of the patient: there is a weakness, malaise, increased body temperature. The process involved all areas of the skin, including the face and scalp, can join the articular psoriasis and psoriatic erythroderma.

By localized form of psoriasis is pustuoeznogo pustular psoriasis Pustular psoriasis - a severe form of the disease   Barbera palms and soles, which is localized only on the palms and soles, and sometimes combined with the rash characteristic of psoriasis vulgaris. In rare cases, the process can take generalized with widespread pustules all over the body, and their tendency to merge into larger blisters.

In psoriasis, skin Barbera set palms and fingertips, or soles initially appear red spots, which then bubbles appear at first to clear, and then purulent contents. The pustules at the same time are located at the level of the rest of the skin, he seems to be drowned in it. Drying, pustules converted into brown, tightly attached to the surface of the cover, there is an atrophy (decrease in volume) of the skin of the palms and soles.

Psoriatic erythroderma

Erythrodermic psoriasis (erythrodermic psoriasis) - this is usually widespread psoriasis, which is most often a complication develops as a result of improper treatment of psoriasis vulgaris. The cause of this complication may also be a variety of external influences such as prolonged exposure to the sun (in the summer type of psoriasis). Sunburn in psoriasis can be dangerous, psoriasis and the sun, psoriasis and solarium - incompatible concepts, especially in the period of exacerbation. In the period of remission for the treatment of psoriasis are sometimes used sunbathing, but with great caution.

Erythrodermic psoriasis is more common in men and almost never occurs in children. It starts with a general disease of skin redness (erythema), which then appears large and plentiful melkoplastinchatoe peeling, accompanied by a feeling of tightening of the skin, pain, burning and itching. The process may end with generalized inflammation, peeling and exfoliation of skin in large areas of the skin and sometimes the whole body, the accession of infection, sepsis and death of the patient.

Laboratory diagnosis of herpes

How to identify herpes? If the mucous membranes or skin have blisters, erosions or ulcers, it is taken from these areas smear for herpes. The smear in a large amount by the polymerase chain reaction (PCR) can detect infectious agents. PCR DNA reveals herpesviruses particular type.

In primary herpes, HSV-I and HSV-II, the virus can be detected in the cells of skin and mucous membranes for weeks after the first signs of infection and for recurrent chronic infection - for four days. When violations immunity virus can be detected for 20 days.

Detection of HSV-I or HSV-II in the cells of the skin and mucous membranes says an acute infectious process. The herpes virus in blood as detected during an exacerbation. But the positive test results for herpes PCR method does not allow us to establish whether this process is a primary or secondary.

More significantly herpes blood can be detected by enzyme immunoassay - ELISA. In this case, the blood does not reveal itself herpes virus, and antibodies thereto. Antibodies - are special proteins (immunoglobulins), which the body releases in response to the introduction of a specific pathogen. Depending on the class to which the immunoglobulins are detected in blood antibody can accurately determine active inflammation primary herpes or relapsed chronic infection. This is very important during pregnancy, when the main blow to the fetus can cause cold sores is the primary, whereas chronic recurrent herpes relatively safe.

In primary infection within the first 4-7 days there are antibodies of class M (IgM - IgM), their number reaches a maximum in the second or third week of the disease. IgM disappear within 2-3 months after the onset of the disease. But in some people they can be found and at relapse of chronic herpes. After the seventh day of the disease begin to appear in the blood of antibodies to HSV-I and HSV-II class G (immunoglobulin G - IgG), which remain in the patient's blood for life.

When the degree of primary infection IgG avidity is low and only a few months after infection, IgG avidity becomes high. This allows a high degree of confidence to determine whether the process of primary herpes or exacerbation of chronic herpes.

How to live with herpes?

Herpes - a chronic viral infection. Completely remove the herpes virus from the body is not possible, therefore it is necessary to learn to live. In order not to aggravate cold sores, you need to pay special attention to the state of immunity, since frequent acute herpes talk about violations of immunity.

First of all, you should find out what caused the decrease in immunity. Very often are the cause of various chronic diseases and intoxications caused by chronic foci of infection. These foci of infection often include ENT diseases. In children it is a chronic adenoids and chronic tonsillitis Chronic tonsillitis - inflammation of the tonsils In adults - chronic sinusitis and carious teeth. In men, the cause of frequent herpes recurrences may be abusing alcohol. Alcohol and herpes - incompatible concepts, frequent consumption of alcoholic beverages, particularly spirits, always causes aggravation of herpes. This should always be remembered, especially in the presence of genital herpes and frequent relapses of herpes zoster Shingles and chickenpox - from the same pathogen .

Is sex with herpes? In identifying genital herpes is best to confine sex with one partner. Whether it is contagious herpes? Most likely, yes, although there is evidence that if humans have HSV-I, it inhibits the penetration into the body of HSV-II and in some cases, the infection occurs. But to define it is possible only by means of laboratory tests, since good immunity infection can occur, but it will not cause any changes in the genitals.

Fight with herpes should begin with a healthy lifestyle, proper nutrition, sports or physical therapy (depending on the age and health), detection and treatment of foci of infection and chronic diseases.

When genital herpes if exacerbation occur frequently (some every month they develop) prescribe antiviral drugs in specially selected dosage. The duration of treatment is chosen as a doctor. The most popular antiviral drug acyclovir is Acyclovir - as it is safe? . More effective antiviral drugs of the last generation - valacyclovir (Valtrex) and famciclovir (Famvir). Long-term preventive courses of these drugs may be reduced virtually no threat of transmission of herpes infection of sexual partners.

Herpes - a special infection, the risk of humanity began to realize that only in recent decades. World Health Organization (WHO) is related to herpes TORCH infections that cause serious complications during pregnancy - miscarriage and fetal abnormalities are often incompatible with life. That is why it is so important to early detection and treatment of herpes Treatment of herpes - a serious problem .

Galina Romanenko