The director of the Dermatology Department at Beijing Red Cross Donghua Hospital mentioned that the causes of psoriasis are relatively complex and not yet fully understood. In recent years, most scholars believe it is related to genetics, infection, metabolic disorders, immune dysfunction, and endocrine imbalance. Nowadays, it has become increasingly common, especially in developed cities. Psoriasis is not a contagious disease, but due to skin issues faced by patients, it often brings great physical pain and economic burden.
It initially appears as pinpoint or mung bean-sized red papules, gradually expanding; some papules may merge to form plaques. The surface is covered with dry silvery scales. Gently scraping off the scales reveals small blood spots, which is a characteristic feature of this condition.
Clinically, most patients experience exacerbation of their rash during winter and spring, while it naturally improves during summer and autumn. This is because the climate in winter and spring is cold and dry, causing vasoconstriction in the epidermis, poor blood supply to the skin, and malnutrition. In cases of individual immune dysfunction, it can lead to a lack of resistance, thereby causing the disease.
This disease is a chronic inflammatory, relapsing skin condition characterized primarily by erythema and papules, with scaling. It is generally believed that genetics, immunity, metabolic disorders, infection, trauma, and mental factors are triggers for this disease. Both men and women of all ages can be affected, but it is more common among young adults, with males being more affected than females. Commonly affected areas include the scalp and extensor sides of the limbs, followed by the trunk, and in severe cases, it can generalize over the entire body.
Clinical characteristics of skin lesions: For plaque psoriasis, the initial lesion appears as a small red papule or maculopapule, gradually enlarging or merging into plaques, covered with multiple layers of silvery-white dry scales. The scales are easily scraped off, revealing a shiny red film underneath, known as the "film phenomenon." Scraping away the film results in pinpoint bleeding, known as the "punctate bleeding phenomenon," which is a clinically specific symptom of this disease. During the progression of the lesions, they can present in various forms such as guttate, nummular, geographic, annular, or oyster-shell shapes, accompanied by symptoms like itching.
For pustular psoriasis, the characteristic lesion is the rapid appearance of sterile pustules on erythematous bases, scattered or coalescing into pustular lakes. Rupture leads to ulceration and crusting, and may be accompanied by systemic symptoms such as high fever and joint swelling and pain.
For arthropathic psoriasis, the lesion characteristics are similar to those of plaque or pustular psoriasis, but it is accompanied by swelling and pain in large and small joints throughout the body, and in severe cases, it can lead to joint stiffness or deformity.
For erythrodermic psoriasis, the characteristic lesion is generalized erythema and edema of the skin, covered with a large amount of scales that continuously shed, leaving normal skin isolated like islands in an ocean. The affected area may feel burning pain, and may be accompanied by systemic symptoms such as chills, fever, headache, and joint pain.
After years of clinical research, the Dermatology Department at Beijing Red Cross Donghua Hospital found that although psoriasis manifests on the skin, its root lies in the blood. Hot blood and toxic blood, due to external exposure to wind pathogen and damp-heat, cause blood heat to generate wind, leading to dryness from excessive wind. This results in emotional internal injury, stagnation of qi circulation, prolonged stagnation transforming into fire, heat lying latent in the nutritive blood, disharmony of qi and blood, malnutrition of the skin, leading to the formation of patches and scales, thus causing the disease. To enable a wide range of psoriasis patients, especially those in difficult circumstances, to promptly understand their health status and achieve early detection and treatment.