Biopsy psoriasis. Diagnosis of psoriasis - how to recognize the disease. How psoriasis is treated: modern approaches to therapy

The outer covering of the human body is very large, which means the list of dermatological diseases can be quite wide. The skin seems to be a fairly accessible organ for research, but in practice this turns out to be far from the case.

Dermatological research methods are available without violating the integrity of the skin, as well as with their violation and the introduction of substances into the body cavity:

visual assessment of skin lesions;
feeling the patient's body;
bleeding of rash elements by pressing with a glass slide;
Koebner phenomenon - rashes at the site of mechanical, chemical or physical impact;
the appearance of follicular nodules in response to running a spatula over the skin or as a result of its cooling;
prick skin tests;
histological examination of skin biopsy.

A skin biopsy is a medical procedure during which a specific area is removed skin for thorough histological examination under optical instruments.

In addition, a skin biopsy with histological examination is done in the following cases:

to evaluate tissue at the site of tumor removal;
diagnosis of bacterial, fungal or viral infections;
identifying the nature of inflammatory lesions;
chronic, non-infectious lichen planus;
lupus;
autoimmune systemic lupus erythematosus;
amyloid deposition in the skin;
specific nodular rashes of a genetic nature;
systemic vasculitis with damage to the walls of small and medium arteries;
progressive disease connective tissue with noticeable seals;
leukemia with progressive proliferation of reticular cells of the hematopoietic organs.

Basic biopsy techniques

In modern dermatological practice, 3 biopsy techniques are mainly used:

Razor - involves a superficial cut of the lesion with a scalpel or a special blade.
Trephine biopsy - this type of biopsy extraction involves the use of a trephine needle, which is used to pierce the central part of the affected area. Then they begin to carefully rotate it around its own axis. After this, the needle is removed, and the resulting column of tissue is pulled up with tweezers and cut at the level of fatty tissue.
Excision - taking a biopsy occurs when a special instrument is used to excise the lesion and the adjacent healthy area of skin. A sample with obvious changes is selected for research.

Depending on the method used, the biopsy site may simply be cleaned with a sterile wipe at the end of the procedure, or it may require sutures or skin grafts.

Biopsy of the scalp

Most often, a scalp biopsy is prescribed for baldness. During the procedure, as a rule, the specialist removes several hairs (if any) and the surrounding area of skin.

The histology of the samples taken allows us to exclude the following pathologies:

cicatricial alopecia due to lupus or lichen planus;
trichotillomania ( mental illness, in which the patient has an irresistible desire to pull out his own hair);
fine focal skin atrophy with Broca's pseudopelade;
microsporia and trichophytosis (fungal infections).

The procedure is performed under local anesthesia, so it does not cause pain to the patient. discomfort. Stitches are placed on the resulting wound, which are usually removed after a week. Hygienic procedures for the head should be postponed for two days to prevent infection of the wound surface.

Skin biopsy for psoriasis

Psoriasis is a disease that may have no significant external manifestations. If the patient has already been diagnosed with such a pathology, then the appropriate tests should be taken on an ongoing basis.

A skin biopsy for psoriasis is usually recommended in the early and middle stages of the disease. Collecting a sample does not require any special preparation. It is quite enough to temporarily abandon medications that reduce blood clotting.

The procedure for collecting material takes up to 30 minutes. After manipulation, a cotton-gauze bandage or a bactericidal adhesive plaster is applied to the damaged area of skin to protect against secondary infection. The result of a histological examination can be obtained in 7 days, and in some cases it may be necessary to wait 1.5 months.

Recovery period

Occurrence of complications and duration recovery period depends on where you give the biomaterial sample. If you do this in a specialized clinic, and not in a dubious beauty salon, and then follow all the recommendations, then the negative consequences will be minimized.

During the recovery period, the skin should be properly cared for:

You can touch the wound, but before doing this you should wash your hands well;
wound surface must be kept clean and dry;
before applying a bandage or plaster, the wound should be treated with an antiseptic;
in cases where stitches were placed on the wound, it is not recommended to wet the affected area for 2 days;
contact with water (immersion) is possible only after complete healing of the tissues;
The skin should not be intentionally stretched, as bleeding may occur, the wound will increase in size and a scar will appear.

Histological examination sample makes it possible to distinguish between various skin pathological processes, which greatly simplifies the diagnosis. The patient should cooperate in this matter with the attending physician. If the patient is concerned about any questions related to the procedure, then it is better to find out everything thoroughly from a specialist than to refuse an important diagnostic method due to unfounded fears.

Skin biopsy: indications, technique, results

Medical procedures cause panic in many patients. They do not understand the terms and the essence of the procedure. Some even refuse the necessary tests, guided by the opinions of home-grown neighboring experts or falling under the influence of stereotypes. But all you need to do is talk to your doctor and ask him to explain in more detail the essence of the prescription. For example, if a patient is offered a skin biopsy, then he must understand that this procedure is prescribed to clarify the diagnosis and gain the opportunity to overcome the disease early stage.

Skin biopsy - what is it?

A biopsy is called diagnostic procedure, in which a piece of living material is taken for further study cellular composition. Accordingly, a skin biopsy is an excision to examine a piece of skin.

Material for research can be obtained in several ways:

shaving;
trepanobiopsy;
existential.

The choice of method depends on the suspected disease, but in all cases the procedure is performed with a sterile, most often disposable, instrument.

Indications for skin biopsy

Histological examination of biopsy material (biopsy) may be prescribed in the following cases:

in the diagnosis of bacterial, fungal, viral diseases;
to determine benign formations;
to clarify malignant formation;
to check the result after tumor removal;
if lupus is suspected;
if skin tuberculosis is suspected;
for psoriatic plaques;
for scleroderma, amyloidosis, reticulosis;
in the presence of deep mycosis;
in case of periarteritis nodosa;
for diagnosing Darier's disease;
as a treatment control.

The maximum number of appointments is the detection of oncological tumors. Having noticed a change in pigmentation or deterioration in the healing of the integument, the doctor prefers to prescribe a biopsy in order to be able to carry out treatment at an early stage of development.

Who makes the appointment?

If you have skin diseases, you should consult a dermatologist. If the problem is not obvious, but the patient feels discomfort, then he should consult a therapist. After the examination, the diagnostic therapist will refer you to the right specialist. He will also tell you where to do a skin biopsy.

What instrument is used to perform a biopsy?

As already mentioned, there are several methods by which a biopsy is performed. Depending on this, it is selected necessary equipment and tool. In most cases, this is a customized kit that contains a cannula with an opening, a probe, and a movable tube with a projection to hold the tissue sample.

A puncture biopsy is performed with a needle of the required diameter. This could be a special thin syringe, an automatic system with a spring mechanism, or a vacuum needle.

In many cases, a skin biopsy is performed by curettage. In this case, the instrument is a ring-shaped curette or a surgical spoon. These instruments vary in the diameter of the gripping surface.

Methodology. Shaving skin biopsy

A shave biopsy is performed with a scalpel or medical blade. In this case, a superficial cut is made at the site of thickening. The cut protruding part of the pathological neoplasm is placed in a container with a formaldehyde solution. And the manipulation area is covered with a sterile napkin. The procedure, as in other cases, is performed under local anesthesia.

Trephine biopsy

In this case, a histological examination of biopsy material taken from the center of the affected area is carried out. A column of skin and subcutaneous fat is pierced with a trepanation needle, rotated and removed. Then it is picked up with tweezers and incised at the required level. A sterile plaster is applied to the wound surface not exceeding 3 mm. If the diameter of the wound is larger, a suture is applied.

Excisional biopsy

Using this method, the lesion is excised with an adjacent healthy area of skin. The method is effective for identifying malignant tumors. The remaining wound is covered with a sterile napkin, but if the wound area is large, then it is sutured or covered with a skin graft.

The individual skin biopsy instrument is not reused. All dressing must be sterile. The analysis result is ready in 1-4 weeks. The period depends on the complexity of processing the biopsy.

Biopsy for psoriasis

Many patients believe that psoriasis can be diagnosed without tests based on characteristic appearance. However, a skin biopsy for psoriasis is necessary to exclude other pathologies. In severe cases, the biopsy specimen contains Reete bodies, which are a manifestation of histological immaturity and thickening of the keratinocyte layer.

When removing material for examination, pinpoint bleeding is visible under the plaque. This is evidence of pathology of vascular permeability at the site of the lesion. Additionally, this makes it possible to detect accelerated angiogenesis.

Preparing for the study

No complicated preparation is required for a skin biopsy. Before the procedure, you should inform the doctor about the anti-inflammatory drugs you are taking, allergic reactions and bleeding tendencies. Women should notify their doctor about pregnancy.

Recovery after the procedure

The sample collection site should only be touched with hands thoroughly washed with soap. The bandage or other surgical material is removed one day after the procedure.

To wash the wound, soap without dyes or flavoring additives is used. After washing, Vaseline or bactericidal ointment is applied to the wound surface. Re-dressing the wound is performed as prescribed by the doctor. If there were no additional instructions, then apply a sterile napkin or bandage if the wound is located in places that are rubbed by clothing. The area where the skin biopsy was performed must be moisturized with special ointments several times a day. This will avoid the appearance of a scab.

If the biopsy mark is red or swollen, you should consult a doctor. This may be a sign of infection.

For at least a week after the procedure, limit your intake of foods with vitamin E, do not drink alcohol, and do not take aspirin or ibuprofen. Violation of this requirement may cause bleeding.

Diagnosis of psoriasis

Detection of psoriasis, as well as other skin diseases, is carried out by dermatologist. Most often, a visual examination is sufficient to diagnose plaque psoriasis (the most common type). At the first stage there is rash in the form of papules various sizes. Located close to each other, they merge to form psoriatic plaques, which have a clear boundary and rich brightness pink color. In addition, the plaques are covered with a white, gray or yellowish coating - scales that easily peel off when scratched.

Thus, psoriasis is characterized by the presence "psoriatic triad"– pinpoint bleeding, stearin stain symptom and terminal film. Stearic stain- these are easily removable scales on the surface of the plaque. The spot is formed due to the accumulation of air bubbles in the stratum corneum of the skin and increased release of lipids. Intercellular connections are weakened, the stratum corneum does not receive nutrition, and the cells die. Terminal film– the affected area, represented by thin, inflamed skin under the stearin stain. The film is wet and shiny, very thin and easily damaged. It contains many capillaries that expand when inflammatory process. They are easily damaged by tearing off the terminal film. Many droplets of blood will appear on the surface - that’s what pinpoint bleeding.

Psoriasis can affect any part of the body, including the palmoplantar surfaces and scalp heads, depending on the type of disease.

Examined by a dermatologist

Taking a sample for a skin biopsy

However, in some cases, psoriasis can be confused with dermatitis or eczema. In this case, inspection alone is not enough; skin biopsy and blood test. Blood tests for psoriasis reveal increased level leukocytes, proteins and high speed erythrocyte sedimentation.

Since psoriasis is of an autoimmune nature, histological analysis of the skin should not show the presence of microorganisms (for example, seborrheic dermatitis is characterized by the presence of Malassezia furfur fungi). In addition, a biopsy of skin affected by psoriasis reveals an accumulation of so-called Rethe bodies, thickening of the stratum corneum of the epidermis, accelerated formation blood vessels in the skin under the plaque, immaturity of young skin cells, absence of a granular layer of skin.

Also, in the progressive (acute) stage of psoriasis, Koebner's sign– the appearance of new papules at the site of skin damage: cut, burn, injection, etc.

In addition to progressive, there are 2 more stages of psoriasis development. At stationary stage the appearance of new ones stops and existing plaques stop increasing. Regressive stage characterized by discoloration of plaques, their flattening, and elimination of peeling. Hypo- or hyperpigmentation is often observed in the area of previous rashes.

Diagnosis of psoriasis: from external examination to laboratory tests

Many skin pathologies begin in almost the same way; only a specialist can recognize the disease. Modern research methods will help make an accurate diagnosis. If psoriasis is suspected, it is necessary differential diagnosis. What does the diagnosis of psoriasis include? What will the tests tell you?

Currently existing skin pathologies manifest themselves in different ways. Some begin to worry after exposure to certain negative factors, and there are those that accompany a person throughout his life, sometimes showing their symptoms more vividly, sometimes weaker. Such diseases include psoriasis. Diagnosis and treatment are prescribed only by a specialist.

What is the disease

Psoriasis is chronic illness, which has a wave-like flow. The pathology affects the skin, although nails and joints may be affected. Psoriasis manifests itself as a monomorphic rash, pinkish nodules, which are also covered with a scaly film on top.

Redness on the skin, which gradually becomes covered with white scales, indicates the development of psoriasis.

Formations on the skin can merge with each other, forming various configurations. The disease is often accompanied by itching, although it is not as severe as with other skin pathologies.

Need to know. Psoriasis has its own characteristic symptoms, but they can manifest themselves in different ways - depending on the severity of the disease, its form and general condition body.

Causes of the disease

Doctors can name a lot of reasons that cause the development of pathology. The main factors are:

Hereditary predisposition.
Emotional stress and frequent stress.
Impact of factors environment.
Traumatic lesions of the skin.

Any injuries to the skin can provoke the appearance of skin pathologies in the future

Allergic reaction to certain medications.

Important. When the first symptoms of the disease appear, it is very important that a full diagnosis of psoriasis be carried out.

How to recognize the onset of pathology

Tests will help accurately determine psoriasis, but some of its manifestations are so characteristic that they allow one to immediately suspect this particular pathology. The main symptom is a rash. At first, pinkish spots appear on the skin, their surface is shiny and smooth.

Red spots on the skin can be confused with manifestations of an allergy, so it is better to visit a dermatologist to rule out more serious illness

Some time passes, and the plaques begin to become covered with scales, and itching appears.

Pathology occurs in both men and women of any age. On the planet, 5% of the population suffers from psoriasis.

In addition to the main features, it can be noted initial symptoms damage to internal organs.

How to diagnose psoriasis

Diagnosis of psoriasis involves the use various methods, because this pathology can closely resemble other skin diseases.

At the first visit, a dermatologist must examine the patient to study the location of the formations and their nature

A dermatologist usually diagnoses the disease based on tests such as:

Blood analysis.
Biopsy of psoriasis.
Analysis of symptoms of the psoriatic triad.

Only after comprehensive examination The specialist makes an accurate diagnosis of the patient.

What does a blood test show for psoriasis?

Psoriasis is a pathology that experienced doctors recognized accurately and without additional tests. But There are cases when it is difficult to make a diagnosis, if the disease does not clearly manifest its symptoms, then a blood test is indispensable. In the laboratory, after drawing blood, the following indicators are considered:

A general analysis is performed. If there is anemia or leukocytosis, then psoriasis can often be a companion to these conditions.

Diagnosis of diseases is almost never complete without general analysis blood

Rheumatoid factor is being studied. With systemic inflammatory diseases The protein level increases, but this should not happen with psoriasis.
ESR in this case is most often within normal limits.
The level of uric acid in the blood is examined. With psoriasis it increases.

Need to know. During gout, the patient's blood contains high level uric acid, so it is necessary to differentiate psoriasis from this disease.

Antibodies to HIV. This pathology often provokes the development of psoriasis.

Biopsy for psoriasis

To ensure there is no doubt about the diagnosis, the dermatologist sends the patient for a biopsy. This analysis, in the presence of such a pathology, shows the absence of an inflammatory process, but a large number of dry cells.

To confirm the presence of psoriasis, a biopsy is necessary. Then there will be no doubts left

After a biopsy for psoriasis is taken, a histological examination is performed to identify the following changes:

No granular layer.
The presence of lymphohistiocytic infiltration.
Thinning of the epidermis layer.
Increased vascularity.
Munro's microabscesses.

Important. It is also necessary to pay attention to the nails - if psoriasis develops, then changes in the condition of the nail plates are often noticeable, and not just on the skin.

Studying the symptoms of the psoriatic triad

Tests for psoriasis help the doctor make an accurate diagnosis, but if such a pathology is suspected, it is important to analyze the signs of the psoriatic triad. This is the name for the phenomena that occur when plaque is scraped off from formations on the skin.

Stearic stain phenomenon. If you scrape the plaque, peeling appears, similar to a stearin stain.

Psoriasis is characterized by the manifestation of some characteristic symptoms that a competent specialist can recognize

Terminal film phenomenon. If you remove the scales from the formations, you will see a shiny and smooth surface of the skin underneath them.
The phenomenon of pinpoint bleeding. If you try to remove the terminal film, droplets of blood appear.

The phenomena of the psoriatic triad will help to accurately recognize the pathology. This is a very important diagnostic measure.

Differential diagnosis of psoriasis

On a note. If necessary, the doctor will prescribe the necessary tests to diagnose psoriasis, although most often there are no problems with the latter. The picture is quite clear and characteristic. But difficulties arise when the pathology is localized on the scalp and some other areas.

This is when differential diagnosis is required, which will help distinguish psoriasis from other diseases with similar manifestations:

Difference from seborrhea. Signs of damage to seborrhea are noted at the very border of the skin with hairy part and have yellowish color. To confirm the diagnosis, it is better to undergo a histological examination.
Psoriasis can be confused with neurodermatitis, but with such a pathology, the boundaries of the lesion are clearly defined. With neurodermatitis, moist skin with a bluish-red color is found under the scales.

Many skin pathologies manifest themselves in the same way. Only a competent specialist is able to differentiate diseases.

Pustular syphilis Although it resembles psoriasis, with this pathology the scales are located at the edges of the formations, and an increase in lymph nodes is observed.

Treatment of psoriasis will be more effective the earlier an accurate diagnosis is made. When the first symptoms appear, it is better not to self-medicate, but to immediately visit a specialist.

Diagnosis of psoriasis

The diagnosis of psoriasis is often made by a dermatologist or therapist based on characteristic external signs and the location of lesions on the body. If a patient experiences skin changes typical of psoriasis, a clinical examination is sufficient to make a diagnosis.

How is psoriasis diagnosed?

If the picture is atypical or if psoriasis is suspected in a child, you may need additional research. In cases where the clinical picture is unclear, the most accurate method is a skin biopsy. For a biopsy, a small piece of skin (about 6 mm in diameter) is taken, which is passed on to a pathologist - a doctor who specializes in microscopic examination of tissue samples. The pathologist describes the results of the analysis in a special report - conclusion.

As a rule, one biopsy is sufficient, however, if the result is unclear or if the nature of the disease changes over time, a repeat biopsy is performed.

For psoriasis, a blood test is most often done to make sure it is safe to start a new medication or to check whether side effects. The exception is severe psoriasis, which has affected a large surface of the body - in this case, changes in the protective function of the skin can lead to dehydration or disruption of the salt balance of the blood.

If a patient has painful or swollen joints, evaluation for psoriatic arthritis is necessary. This diagnosis is usually made by a dermatologist, rheumatologist, podiatrist, or other joint specialist. Typically, X-rays, joint examinations, and blood tests are done to check if the arthritis is due to other causes. It is important to remember that psoriatic arthritis can develop in anyone with psoriasis. To avoid permanent damage to your joints, it is important to get tested and treated promptly.

What does psoriasis affect besides the skin?

For most people, psoriasis appears only on the skin. However, it is also useful to know about less common forms of the disease. In addition to the skin, psoriasis can affect nails, joints and, less commonly, other organs.

Mucous membranes. Sometimes psoriasis affects the mucous membranes of the lips, mouth and tongue. When the tongue is affected, sharp, uneven boundaries appear on it, separating darker and lighter areas, like on a map. This is where the term “geographical tongue” arose - although it should be noted that this also happens in the absence of psoriasis.

Joints. Psoriasis, which occurs in the form of arthritis, can affect the joints, especially the fingers. This is the so-called psoriatic arthritis.

Eyes. In rare cases, with psoriasis, a red, painful rim appears around the pupil. This condition is called besides, or anterior uveitis. Sometimes it is the first symptom of psoriasis and is diagnosed by an ophthalmologist.

What causes psoriasis to worsen?

Psoriasis occurs differently in different people. For some, periods of improvement and deterioration of the condition alternate (in accordance with the seasons or other factors), while for others the disease never recedes and manifests itself constantly with the same intensity.

In some patients, exacerbation occurs from time to time. Although each patient's reaction is individual, some triggers, including medications and stress, are common to many.

Stress. Emotional and physical overload can cause exacerbation of psoriasis. Sometimes it appears weeks or months after the event that caused the stress. The cause can be a variety of events, from global life changes, such as the death of a family member or a change of job, to switching to a new diet or a cold.

Many people find relief from stress (yoga, meditation, etc.), relaxing with family or spending time with a pet. It is impossible to completely avoid illness and stress, but if you are careful, you can notice signs of deterioration in time and take the necessary measures.

Medicines. Any medications (or changing them) can affect the condition of the skin. In particular, several classes of drugs are known that can cause exacerbation of psoriasis. Among them:

High blood pressure medications

The article was written based on materials from the sites: diametod.ru, fb.ru, www.losterin.ru, zkozha.ru, www.medkrug.ru.

An important task of a dermatologist is to diagnose psoriasis. The quality of patient treatment depends on it. Determine psoriasis by blood tests and other studies - main responsibility doctor

Differential diagnosis of psoriasis

Psoriasis is a complex autoimmune pathology. Therefore, before making this diagnosis, you need to be sure of it. To this end, each patient must undergo examination for psoriasis. It will help rule out other pathologies. Differential diagnosis of psoriasis is carried out according to the main syndrome of the disease – skin manifestations. Pathologies that have similar dermatological signs include:

Various forms of dermatitis (seborrheic, atopic);
Lichen planus;
Syphilis;
Reiter's disease;
Athlete's groin;
Neurodermatitis.

WITH vascular diseases can be differentiated, which is rarely isolated. In addition to the main syndrome, attention should be paid to the nature of the pathology, the prevalence of skin rashes, and the general condition of the patient. Diff. Diagnosis of psoriasis should be carried out by a dermatologist. It is based on skin examination data and laboratory tests. Diagnosis of psoriasis in children must be performed especially carefully. This pathology is rarely encountered in pediatric practice. In some cases, it develops and requires special monitoring.

How to determine whether it is psoriasis or not?

It is necessary to identify psoriasis on the patient’s skin or some other disease as early as possible. This affects treatment tactics and prognosis. Find out psoriasis succeeds based on specific skin manifestations - plaques (photo 2). They are pink papules that rise above the surface of the skin. The progressive stage is characterized by the spread of spots and the appearance of silvery scales on them. The diagnostic algorithm is a sequential execution of studies.

To recognize psoriasis in a child, the same methods are used for adult patients. First of all, the skin is examined. It is possible to determine psoriasis in a child only after performing dermatological diagnostic methods. Therefore, the pediatrician must refer the patient to a specialized dispensary. Examination plan for psoriasis includes the following items:

Clarification of complaints and inspection;
Special examination of the affected skin - dermoscopy;
Laboratory tests - general and biochemical blood test, coagulogram, urine test;
Skin biopsy for psoriasis.

Only after receiving the results can a conclusion be made. Diagnosis is based on laboratory methods and physical findings. All examinations are important to identify the disease. The most important is a biopsy for psoriasis. It allows you to examine the affected areas of tissue.

Differential diagnosis of psoriasis

Diagnosis of psoriasis is carried out in a hospital setting. This is necessary to monitor treatment and exclude infectious diseases. The differential diagnosis of psoriasis and lichen planus is based on physical examination. Dermoscopy is also performed. Rash with lichen has a lilac tint, the center of the pathological focus is pressed inward, the edges of the papules are elevated. Pathological foci are localized on the flexor surfaces, in the groin area. Peeling of the skin is not pronounced.

Diff. diagnosis of psoriasis and syphilitic lesion based on medical history and a special laboratory test - the Wasserman reaction. Papules in this pathology are hemispherical in shape and identical in size. Differential diagnosis of arthropathic psoriasis carried out with Reiter's disease. For this pathological condition characterized by joint damage, urinary tract, eye. Diagnostics in the clinic includes monitoring the patient's condition. With Reiter's disease, the rash goes away faster and is more often localized on the genitals and in the oral cavity.

In the literature on dermatology you can find a special table for the differential diagnosis of psoriasis (photo in gal). It is based on skin syndrome. Formulation of diagnosis includes the phase of the pathological process, severity and clinical form diseases. A diagnosis of psoriasis can only be made after assessing all indicators and long-term observation. Symptoms of this pathology persist for several months.

Blood test for psoriasis

Research into psoriasis begins with laboratory diagnostic methods. They help to quickly exclude diseases such as syphilis, dermatitis, and allergic skin pathologies. What tests need to be taken for psoriasis? For diagnosis, it is necessary to perform blood and urine tests. With their help it is possible to determine infectious nature pathological condition and phase of the process. It is impossible to determine psoriasis using a blood test. However, it helps to suggest this diagnosis.

A general blood test indicates the presence of an inflammatory process of bacterial or viral etiology. These findings are nonspecific and therefore cannot be used to make a diagnosis. Blood test for psoriasis will show an increase in the number of leukocytes and an acceleration of ESR, in some cases there is a decrease in hemoglobin. It will help eliminate viral pathologies and allergic diseases. ESR in psoriasis can be greatly increased. This is due to the presence of chronic autoimmune inflammation. You should donate blood for psoriasis 2-4 times a year. The study allows you to monitor the activity of the inflammation process.

A biochemical blood test for psoriasis is also not specific. It will show an increase in protein fractions responsible for the inflammatory process. Rheumatoid factor must be negative. The most reliable test for psoriasis is skin biopsy from the surface of the plaques. Histological examination allows us to make a final conclusion.

Is it possible to donate blood if you have psoriasis?

Tests are performed regularly for psoriasis. With the help of these studies, the doctor evaluates the dynamics of the pathological process and treatment. Some patients are interested in the question: is it possible to donate blood if you have psoriasis? Only the attending physician can answer this question. It all depends on the tests that the patient has at the moment. If no changes are observed, you should consult a transfusiologist.

Patients often wonder: is it possible to get psoriasis through blood? The likelihood of transmitting this pathology is low, but infection is possible. If the inflammatory process is in the active phase, donating blood is prohibited for psoriasis. The disease is characterized by the accumulation of immune complexes that are aimed at destroying one's own skin cells. In the active stage of the process, pathological antibodies can cause infection in a person who has not been sick before.

It is worth prescribing with extreme caution, because the treatment of this disease uses hormones that are harmful to the growing body. A dermatologist, together with a pediatrician, should select and change the dosage of medications.

Photos and tables for diagnosing psoriasis disease

Playlist of videos about psoriasis (video selection in the upper right corner)

Diagnosis of psoriasis- the first step towards curing the disease. Modern research methods make it possible to make a very accurate diagnosis. In addition to visual examination and history taking, there are a number of instrumental and clinical methods for obtaining data on the causes of the disease and determining the stage of its development.

For differentiation, an additional analysis for psoriasis is carried out - the disease has an external similarity to other skin diseases. A specialist can sometimes make a diagnosis even by the appearance and location of the rash, however laboratory methods give undoubted results.

How to diagnose psoriasis? Currently there are no problems with this. The symptoms of the disease are so obvious that doctors have no doubts after a visual examination of the patient.

The main specific symptom is a rash on the skin, which is localized in various parts of the body. At the very beginning of the pathological process, it manifests itself in the form of small compactions that are pink in color. Their diameter is 1-2 mm. Gradually they become like tubercles. In the growth zone, the conglomerates become bright pink and are covered with loose white scales. The plaques increase to 7-8 cm. When examining the patient, the doctor makes a scraping. As a rule, these measures are sufficient. Additional research is used to understand what kind of disease we are talking about. There are many diseases that have similar symptoms. Differential diagnosis will help determine which pathology is progressing.

What tests need to be taken for psoriasis? First, a CBC (general blood test), UAM (general urine test) and, without fail, a stool test for I/worms.

If the clinical picture of psoriasis is unclear, then there is a need for skin biopsy. At this study A small pinch of the affected tissue is performed. This makes it possible to distinguish lichen planus from similar diseases that have similar symptoms. This is the only way to obtain histological confirmation of the diagnosis.

Among the main diagnostic criteria, the following should be highlighted:

Clinical manifestations and patient complaints;
The presence of concomitant pathologies and the patient’s lifestyle;
Collecting information about relatives in order to determine hereditary predisposition;
Presence of psoriatic symptoms: terminal film, pronounced scales and pinpoint bleeding;
Progression of the Koebner phenomenon.

The doctor prescribes a series of laboratory and instrumental tests to determine the cause of psoriasis. This approach eliminates the possibility of frequent relapses of the disease.

Instrumental diagnostics

Instrumental diagnostics- this is the maximum informative method research, prescribed mainly in advanced cases with progression of lichen planus. This technique is widely used when specific symptoms occur. Tests for psoriasis such as a potassium oxide test and a biopsy are necessary. It is mandatory to do a culture to determine the microflora, conduct an examination for the presence of syphilide, and determine the level of prolactin.

To determine the level of neutrophilic leukocytes (Reete bodies), the thickness of the keratinocyte layer and their histological immaturity, it is necessary to examine a pinch taken from conglomerates. An increase in the number of macrophages and T-lymphocytes in the blood and other signs are a sure sign of the development of lichen planus.

Biopsy implies carrying out histological analysis pinch under a microscope. If a number of signs are present, the result of the research will be positive:

Lack of a protective layer of the epidermis, which protects the skin from dehydration;
Swelling and elongation of the epidermal processes;
An increase in the number of capillaries (blood vessels) in the affected area;
The appearance of microabscesses - accumulations of neutrophilic leukocytes in the area of the stratum corneum;
Infiltration around vascular structures (lymphohistiocytic).

Among the main diagnostic methods it is worth highlighting scraping from conglomerate using a special glass slide. In this case, an analysis of the signs of the so-called psoriatic triad is also carried out. They appear in a certain order: first - the phenomenon of stearin spots, then - peeling and the phenomenon of terminal film.

When removing the scaly layer, you can see the smooth pink surface of the skin, as if polished. With further scraping, the appearance of pinpoint bleeding is observed, which is otherwise called “blood dew.”

Special attention focuses on the presence of the Koebner phenomenon. It is typical only for periods of exacerbation and represents the appearance of plaques on those areas of the skin that have been injured.

To clarify the diagnosis, you can use UV radiation method(wavelength 308 nm). If you shine an excimer laser on a conglomerate or papules, the scaly areas begin to glow.

When plaques are localized in the area of articular structures, psoriatic arthritis is called into question. In this case there is strong pain. To clarify the diagnosis, a blood test is taken and an x-ray or ultrasound is performed in the area where the lesion is located.

Clinical researches

Allows you to obtain more accurate information laboratory diagnostics psoriasis. Among the main methods, the following should be highlighted:

Complete blood count (CBC). It makes it possible to determine the general condition of the patient and identify pathologies such as anemia and leukocytosis. CBC shows ESR (leukocyte sedimentation rate) and other indicators;
General urinalysis (UCA). Provides information on the water-salt balance of the body;
Rheumatic tests. Necessary for determining the level of protein in the blood. When it increases, we are talking about the presence of a chronic inflammatory process. If we are talking about psoriasis, then these indicators remain normal.

The diagnosis of psoriasis cannot be made based on laboratory tests alone. Additional research is required. The patient is referred for consultation to specialists such as an immunologist, nephrologist, infectious disease specialist and dermatologist.

Differential methods

Many forms of psoriasis have similar symptoms to other skin diseases that need to be treated urgently. That is why the doctor prescribes additional studies to determine the real reason pathological change skin.

For psoriasis, differential diagnosis is carried out with the following diseases:

Seborrheic eczema and various dermatoses;
Lupus erythematosus, lichen (flat and pink);
Reiter's disease and neurodermatitis;
Papular form of syphilide.

Experienced dermatologists usually determine the type and form of the disease based on clinical picture. Psoriatic rashes have a peculiar appearance, despite this, more in-depth studies are required to exclude any type of dermatosis.

1- Seborrheic eczema; 2- papular syphilide; 3- limited neurodermatitis.

With psoriasis, the color expression is brighter when compared with papular form of syphilide. Conglomerates peel off over the entire surface, and with syphilis - only at the edges. In the first case lymphatic system does not undergo any changes. If a controversial issue arises, the patient is prescribed a serological blood test.

If we talk about psoriasis of the scalp, there is often confusion with this disease, like seborrheic eczema. Yellow flaking appears in the area of the scalp located at the border of the scalp. There is pronounced itching. To distinguish diseases, histological studies are prescribed.

Psoriatic plaques may appear on the back of the head. Most often this occurs in women menopause. This form of the disease is similar with limited neurodermatitis. Distinctive features of neurodermatitis from psoriasis are the silvery tint of the scales and the absence of infiltration.

Interesting to know! For differential diagnosis of psoriasis, histological analysis is prescribed. Examination of a small amount of affected skin under a microscope can determine the presence of bacterial and fungal infections.

How to distinguish from lichen

Differential diagnosis of psoriasis also includes identification with lichen planus (LP). The main differences between pathologies:

Location: lichen is characterized by rashes on the mucous membranes and in the folds of the skin, rarely in other areas.
Character of the rash: lichen planus, unlike psoriasis, has a darker skin color on the rash - crimson, sometimes with a dark bluish tint.
Other symptoms: if with psoriasis itching and burning occur in severe stages, then in the case of LP these signs are observed constantly.

Pityriasis rosea, unlike LP, is contagious and spreads throughout the body very quickly. However, you can recover from it just as easily as from LLP - you just need to see a doctor in time.

How to distinguish from dandruff

Dandruff is the exfoliation of dead skin particles, the nature of which depends on the general health and the care products used. Although sometimes severe dandruff causes itching, scratching does not have any painful consequences.

With psoriasis, the appearance of an inflamed spot on the head with a characteristic silvery sheen can be taken as a manifestation of dandruff only at the beginning. The skin is very thin and vulnerable; when scratched, microcracks appear and bleeding occurs.

Types of analyzes performed

Among the diagnostic measures for scaly lichen, standard and additional ones are distinguished. In the first case, we are talking about a blood test (general and biochemical), urine and feces examination. Studies do not confirm the fact that the patient is sick with this particular disease, but they make it possible to establish the cause of its development and the existing complications.

Many skin pathologies begin in almost the same way; only a specialist can recognize the disease. Modern research methods will help make an accurate diagnosis. If psoriasis is suspected, differential diagnosis is necessary. What does the diagnosis of psoriasis include? What will the tests tell you?

Psoriasis is a chronic disease that has a wavy course. The pathology affects the skin, although nails and joints may be affected. Psoriasis manifests itself as a monomorphic rash, pinkish nodules, which are also covered with a scaly film on top.

Redness on the skin, which gradually becomes covered with white scales, indicates the development of psoriasis.

Formations on the skin can merge with each other, forming various configurations. The disease is often accompanied by itching, although it is not as severe as with other skin pathologies.

Need to know. Psoriasis has its own characteristic symptoms, but they can manifest themselves in different ways - depending on the severity of the disease, its form and the general condition of the body.

Doctors can name a lot of reasons that cause the development of pathology. The main factors are:

Hereditary predisposition.
Emotional stress and frequent stress.
Impact of environmental factors.
Traumatic lesions of the skin.

Any injuries to the skin can provoke the appearance of skin pathologies in the future

Important. When the first symptoms of the disease appear, it is very important that a full diagnosis of psoriasis be carried out.

Red spots on the skin can be confused with manifestations of allergies, so it is better to visit a dermatologist to rule out a more serious disease

Some time passes, and the plaques begin to become covered with scales, and itching appears.

Pathology occurs in both men and women of any age. On the planet, 5% of the population suffers from psoriasis.

In addition to the main signs, one can note the initial symptoms of damage to internal organs.

Diagnosis of psoriasis involves the use of various methods, because this pathology can closely resemble other skin diseases.

At the first visit, a dermatologist must examine the patient to study the location of the formations and their nature

A dermatologist usually diagnoses the disease based on tests such as:

Blood analysis.
Biopsy of psoriasis.
Analysis of symptoms of the psoriatic triad.

Only after a comprehensive examination of the patient does a specialist make an accurate diagnosis.

Psoriasis is a pathology that experienced doctors recognize accurately and without additional tests. But There are cases when it is difficult to make a diagnosis, if the disease does not clearly manifest its symptoms, then a blood test is indispensable. In the laboratory, after drawing blood, the following indicators are considered:

A general analysis is performed. If there is anemia or leukocytosis, then psoriasis can often be a companion to these conditions.

Diagnosis of diseases is almost never complete without a general blood test.

Rheumatoid factor is being studied. With systemic inflammatory diseases, protein levels increase, but with psoriasis this should not be the case.
ESR in this case is most often within normal limits.
The level of uric acid in the blood is examined. With psoriasis it increases.

Need to know. During gout, the patient has a high level of uric acid in the blood, so it is necessary to differentiate psoriasis from this disease.

Antibodies to HIV. This pathology often provokes the development of psoriasis.

To confirm the presence of psoriasis, a biopsy is necessary. Then there will be no doubts left

Medical procedures cause panic in many patients. They do not understand the terms and the essence of the procedure. Some even refuse the necessary tests, guided by the opinions of home-grown neighboring experts or falling under the influence of stereotypes. But all you need to do is talk to your doctor and ask him to explain in more detail the essence of the prescription. For example, if a patient is offered a skin biopsy, he should understand that this procedure is prescribed to clarify the diagnosis and gain the opportunity to overcome the disease at an early stage.

A biopsy is a diagnostic procedure in which a piece of living material is taken for further study of its cellular composition. Accordingly, a skin biopsy is an excision to examine a piece of skin.

Material for research can be obtained in several ways:

shaving;
trepanobiopsy;
existential.

The choice of method depends on the suspected disease, but in all cases the procedure is performed with a sterile, most often disposable, instrument.

Histological examination of biopsy material (biopsy) may be prescribed in the following cases:

in the diagnosis of bacterial, fungal, viral diseases;
to determine benign formations;
to clarify malignant formation;
to check the result after tumor removal;
if lupus is suspected;
if skin tuberculosis is suspected;
for psoriatic plaques;
for scleroderma, amyloidosis, reticulosis;
in the presence of deep mycosis;
in case of periarteritis nodosa;
for diagnosing Darier's disease;
as a treatment control.

Psoriasis is a chronic incurable dermatosis that affects the skin, mucous membranes, nails, joints and internal organs.

Typically, diagnosing plaque psoriasis, which doctors encounter most often, is not difficult.

A dermatologist, based on a survey, examination and scratching (scraping of a pathological element), discovers symptoms, some of which are pathognomonic for psoriasis (that is, distinguishing this pathology from other skin diseases):

the rash consists of papules;
the surface of the papules is above the level of healthy skin;
papular elements form characteristic plaques;
plaques are covered with loosely arranged dry scales;
scratching leads to the alternate appearance of three symptoms that make up the psoriatic triad;
Pilnov's rim (red corolla) is detected with progressive psoriasis;
Voronov's rim accompanies the regression stage (folded whitish-pink corolla);
positive Koebner sign in progressive psoriasis;
resorption of the plaque from the center to the periphery with regressive psoriasis;
rash with psoriasis is monomorphic;
the patient complains of itching.

Detection of psoriasis, as well as other skin diseases, is carried out by dermatologist. Most often, a visual examination is sufficient to diagnose plaque psoriasis (the most common type). At the first stage there is rash in the form of papules various sizes. Located close to each other, they merge to form psoriatic plaques, which have a clear border and a rich bright pink color. In addition, the plaques are covered with a white, gray or yellowish coating - scales that easily peel off when scratched.

Thus, psoriasis is characterized by the presence "psoriatic triad"– pinpoint bleeding, stearin stain symptom and terminal film. Stearic stain- these are easily removable scales on the surface of the plaque. The spot is formed due to the accumulation of air bubbles in the stratum corneum of the skin and increased release of lipids. Intercellular connections are weakened, the stratum corneum does not receive nutrition, and the cells die. Terminal film– the affected area, represented by thin, inflamed skin under the stearin stain. The film is wet and shiny, very thin and easily damaged. It contains many capillaries that expand during the inflammatory process. They are easily damaged by tearing off the terminal film. Many droplets of blood will appear on the surface - that’s what pinpoint bleeding.

Psoriasis can affect any part of the body, including the palmar-plantar surfaces and scalp, depending on the type of disease.

Taking a sample for a skin biopsy

However, in some cases, psoriasis can be confused with dermatitis or eczema. In this case, inspection alone is not enough; skin biopsy and blood test. Blood tests for psoriasis reveal elevated levels of white blood cells, proteins, and a high erythrocyte sedimentation rate.

Since psoriasis is of an autoimmune nature, histological analysis of the skin should not show the presence of microorganisms (for example, seborrheic dermatitis is characterized by the presence of Malassezia furfur fungi). In addition, a biopsy of skin affected by psoriasis reveals an accumulation of so-called Rethe bodies, thickening of the stratum corneum of the epidermis, accelerated formation of blood vessels in the skin under the plaque, immaturity of young skin cells, and the absence of a granular layer of skin.

Also, in the progressive (acute) stage of psoriasis, Koebner's sign– the appearance of new papules at the site of skin damage: cut, burn, injection, etc.