Pustular psoriasis - treatment and photo. Pustular psoriasis: Barber's form, treatment with folk remedies

Among the existing types of psoriatic disease, the most severe form of skin dermatosis is pustular psoriasis. The disease is accompanied by profuse exudative rashes in the form of pustules covered with a purulent crust, which causes symptoms of severe itching, burning and painful abscesses. All these manifestations are dangerous, since there is a possibility of infection on the open wounds of the affected areas. Therefore, in order to avoid irreversible consequences, one should timely contact qualified specialists who can prescribe effective treatment.

The main reasons for the development

The nature of pustular psoriasis is not fully understood, so there are various hypotheses regarding the appearance of this type of dermatosis. Modern researchers identify several factors contributing to the development of pustular psoriasis:

weakening of the immune system against the background of long-term use of potent drugs that stop cell growth;
predisposition;
metabolic disorders against the background of hormonal disruptions in the body;
smoking and alcohol abuse;
violation of the nervous system;
severe infectious and bacterial diseases;
high dose of ultraviolet radiation;
deficiency of calcium in the blood.

Also, in the pustular form of psoriasis, the starting factors of the disease are a severe form of hepatitis, which causes disruption of the liver and suppresses the body's immune system.

Features of the course of the disease

Forms of the disease:

widespread generalized;
localized.

Development stages:

regressive stage;
a progressive stage in which the number of rashes increases;
stable stage, turning into a chronic form of the disease.

Symptoms of Barber's psoriasis appear gradually and affect areas of the body on. Pustular psoriasis is manifested by peeling of the skin, then rashes appear in the form of vesicles, which subsequently merge into separate inflamed islets of a red hue.

For a long time, rashes can appear only occasionally and do not cause much discomfort to the patient. But if the body is exposed to irritating factors, the disease will develop more intensively.

Pustular psoriasis is easily diagnosed because only certain areas of the body are affected. The photo shows pustular psoriasis localized mainly on the palms and feet.

In severe cases of the disease, pathological processes such as:

violation of the production of keratin in the cells of the epidermis with parakeratosis;
fusion of epithelial cells and the formation of foreign cells in agranulosis;
violation of intercellular connections with Munro microabscesses;
development of uneven papillomatosis.

Treatment Methods

For effective treatment of pustular psoriasis, a comprehensive examination by a dermatologist should be prescribed. When making a diagnosis of pustular psoriasis, treatment should take place in a hospital, which includes a number of medical measures:

taking drugs to remove toxins from the body;
with drugs of the diuretic group in order to reduce the fluid content in the tissue integuments and serous membranes;
a course of antihistamines to suppress acute symptoms;
taking hormonal drugs;
local treatment when using special ointments and creams against psoriasis;
well ;
diet therapy with restriction of the use of salty and peppery foods that cause an allergic reaction in patients;
a course of physiotherapy procedures;
a course of drugs to normalize the nervous system;
systematic therapeutic and mud baths in sanatorium conditions (especially recommended in the remission stage).

With local treatment, dermatologists prescribe several effective drugs:

hormonal ointments and creams that have a calming effect;
anti-inflammatory lotions for wiping the affected areas of the body;
non-hormonal ointments to relieve acute symptoms and edema.

Timely complex treatment of pustular psoriasis allows you to achieve a stable remission of the disease, quickly suppress intolerable symptoms, and also normalize the metabolism inside the body.

Due to the cyclical course of pustular psoriasis and with frequent relapses, patients suffering from the chronic form of the disease require regularly undergo a course of medical and preventive procedures for the normal state of the whole organism.

Generalized psoriasis is one of the most complex and severe forms of psoriatic disease, in which pustules look like large spots of a pinkish or red hue, appear in waves on the body and cover a large amount of tissue. Accompanied by fever, deterioration of general health, pain, itching, burning in the area of skin lesions. In the absence of timely and competent treatment, such an ailment leads to arthritis of varying severity and, as a result, disability.

Generalized pustular psoriasis

With Zumbusch psoriasis, large pustules occur on the body of patients, which slightly rise above the skin, and are clearly limited from healthy skin. At the same time, the foci become covered with crusts, the stratum corneum becomes denser. After the acute process of the disease ends (as a rule, symptoms subside after 4-8 weeks), rashes that are characteristic of ordinary psoriasis may remain on the skin.

Main symptoms:

temperature rise;
and burning;
weakness;
malaise;
the presence of "purulent lakes" on the surface of the skin;
abundant rashes that are located in the genital area, on the bends of the knees, joints, on the back, abdomen, arms, chest, in some cases - on the scalp, nails, mucous membranes;
brown crusts that cover large pustules;
erosion and ulcers at the sites of damage to the foci of rashes;
large erosions on the skin.

Treat generalized pustular psoriasis by taking the following measures:

detoxification therapy (droppers are used to remove toxins from the body);
taking antihistamines;
the use of sorbents;
taking anticytokine drugs;
a course of taking glucocorticoid hormones;
taking retinoids;
the use of immunomodulators;
taking sedatives;
the use of cytostatics;
photochemotherapy;
a course of vitamins;
plasmapheresis;
hemosorption;
topical therapy using emollients and gels, as well as corticosteroid drugs, formulations containing salicylic acid.

Barber's pustular psoriasis

Barber's psoriasis is a localized form of the disease that affects the soles and. This form is most often found in female patients.

Barber's psoriasis occurs for a long time. Very often, the disease proceeds in waves - acute symptoms either worsen, then subside, then again turn into an acute form. Only an experienced doctor should diagnose such a disease, since the signs of the disease are very similar to eczema or a fungus, and improper treatment can lead to a worsening of the condition.

The disease is accompanied by such symptoms:

spotting with clear boundaries that peel off;
flat pustules with internal contents, which are localized deep in the skin;
inflammatory foci are located near the thumb, on the lateral surface of the foot or palm, arches of the feet and heels;
itching and burning in the area of pustules;
general deterioration in health.

As experts in the field of dermatology note, none of the types of Barber or Zumbusch psoriasis can be completely eliminated, but it is always possible to reduce the manifestation of the disease, make the remission period longer, and improve the patient's quality of life.

Such a type as pustular psoriasis often leads to disability, even disability. Almost always it is accompanied by exudative psoriasis. Severe symptoms of the disease forces the use of intensive treatment of pustular psoriasis.

What does pustular psoriasis look like?

life threatening pustular psoriasis(photo 1) always starts suddenly. Bright red erythema develops in a matter of hours. Pustular psoriasis against this background is manifested by small grouped superficial pustules. Increasing in size, they gradually merge and form purulent lakes. Purulent elements can also be found on already formed foci of psoriasis. An eroded surface is observed under the crusts.

Pustular psoriasis causes headache, arthralgia, nausea, myalgia. Another type of disease is pustular psoriasis of the palms and soles. At the same time, small pustules containing a sterile liquid appear on the inflamed areas. The morphological structure of the skin is located in the deep palmar surfaces. Pustular psoriasis of the palms has large pustules with yellow contents.

What does exudative psoriasis look like?

Many sources erroneously attribute exudative psoriasis(photo 2) to one variety with pustular. This is fundamentally wrong, since exudative psoriasis is characterized by the absence of papules. It has an overly pronounced exudative element that impregnates clusters of scales. The exudative form of psoriasis is more often observed with immune and endocrine disorders. After removing the crusts, erosion remains on the body. It is often possible to observe rashes of the inverse type.

Exudative psoriasis of the scales has grayish-yellow, sometimes there are massive greenish crusts - scales glued together by leukocytes. The favorite place for the appearance of the disease is skin folds, legs, therefore this type is not observed, although the presence of crusts in severe form is outwardly similar.

Forms and types of pustular psoriasis

Pustular dermatoses have several forms:

generalized pustular psoriasis;
subcorneal;
acrodermatitis Apollo;
Endus bacteride;
pustular psoriasis of the soles and palms of Barber, which is more common than others.

Barber's pustular psoriasis(photo 3) sometimes accompanies psoriasis vulgaris. Its characteristic rash can be found on the feet, hands. The first symptoms that indicate can be detected simultaneously with the appearance of pustules. That is why it is called palmoplantar pustular psoriasis. Gradually drying out, the pustules turn into a dense brown crust. Any pustular form of psoriasis is a danger to the life of the patient. According to statistics, pustular psoriasis of the palms and soles often affects the fair sex of mankind.

Pustular psoriasis and treatment

To a full recovery treatment for pustular psoriasis will not lead. Medicine is able to achieve only stable remission. Treatment for pustular psoriasis depends on the severity of the inflammation and the area affected. Local therapy is carried out with ointments: with salicylic acid, corticosteroid, vitamin D3. It is also quite difficult, since they are constantly in contact with clothing. Pustular psoriasis treatment also requires such drugs:

immunosuppressants;
vitamin complexes;
antihistamines;
cytostatic agents;
mild sedatives.

Exudative psoriasis and its treatment

Treatment of exudative psoriasis involves the use of phytotherapeutic sessions. Many experts admit, but under vigilant supervision. In severe cases of exudative psoriasis, treatment requires immunomodulators, a strict diet is prescribed. The remission stage involves special spa treatment and rehabilitation.

One of the rare forms of endocrine diseases is pustular psoriasis. Consider its features, symptoms, methods of diagnosis, treatment and prevention.

Exudative or pustular psoriasis, according to many scientists, is a contact dermatitis of allergic etiology. According to the international classification of diseases of the 10th revision, it belongs to this category:

XII Diseases of the skin and subcutaneous tissue (L00-L99)

Papulosquamous disorders (L40-L45)

Psoriasis L40

L40.0 Psoriasis vulgaris
L40.1 Generalized pustular psoriasis
L40.2 Acrodermatitis, persistent
L40.3 Pustulosis palmar and plantar
L40.4 Guttate psoriasis
L40.5 Psoriasis, arthropathic
L40.8 Other psoriasis
L40.9 Psoriasis, unspecified

In most cases, the defect develops spontaneously or against the background of the use of strong medications. Pathology is included in the category of chronic and incurable, manifested by round rashes of red or pink color with peeling. It can occur on any part of the body, but most commonly affects the scalp, elbows, knees, palms, and soles.

The disease affects people between the ages of 10 and 50. It refers to systemic disorders, as it affects not only the skin, but also the mucous membranes, nails, musculoskeletal system, and hair. The disease is not contagious and is not transmitted by contact, but may be associated with hereditary factors.

ICD-10 code

L40 Psoriasis

Epidemiology

Psoriasis is a polyetiological disease, a huge role in its development is played by genetic predisposition and disorders of the immune system. Epidemiology indicates its widespread occurrence. According to medical statistics, about 3% of people worldwide suffer from this defect.

Most often, the disease is diagnosed at a young age, that is, up to 30 years: in women before 16, and in men after 22. Very often it develops in people with diabetes, obesity, hypothyroidism. The number of patients is higher among the population with a high atherogenic nutritional profile. That is why psoriasis is rarely found in countries where a large amount of omega 3 polyunsaturated fatty acids (fish, seafood), which have an antiatherogenic effect, are consumed in food.

Causes of pustular psoriasis

The disease is one of the most severe pathologies of the epidermis, but the exact causes of pustular psoriasis are unknown. There are many theories about its etiology and pathogenesis. It is associated with genetic factors and a number of other reasons. Let's consider the main ones:

Diseases of the endocrine system
Diseases of the digestive tract
Nerve strain
Decreased calcium levels in the blood
Jaundice
Psychoneurological disorders
Allergic reactions of various etiologies
Dysfunction of endocrine glands
Immune system disorders

To establish the exact cause of the defect and the factors that provoke it, the patient is waiting for a complex of various diagnostic studies. The type of treatment and its duration depend on their results.

Risk factors

Exudative psoriasis is a multifactorial disease. A huge role in its development is played by hereditary predisposition, a weakened immune system and metabolic disorders. There are exogenous and endogenous risk factors, consider them:

Hormonal disbalance
Infectious diseases
Pregnancy
The use of potent topical preparations
Nervous strain and stressful situations
Contact with chemicals
Prolonged exposure to ultraviolet radiation
Irrational use of drugs

According to medical statistics, about 40% of cases occur suddenly. But most often, the disorder develops due to aggressive therapy of the vulgar form of pathology and other chronic pathological processes in the body.

Pathogenesis

The mechanism of the development of the disease is based on a violation of the proliferation and differentiation of keratinocytes. The pathogenesis indicates shortening of the cell cycle and increased production of keratinocytes. Because of this, the epidermis layer thickens and many scales form. There are several theories of the origin of pustular psoriasis:

hereditary
Viral
neurogenic
Hypothesis of congenital instability of lysosomes, defects in epidermal capillaries, disorders of keratinization and lipid metabolism.

Due to hyperproliferation, skin inflammation is exacerbated. In lesions, cells produce interleukin-1, which is similar to the activating factor of T-lymphocytes of the epidermis produced by keratinocytes. Interleukins and interferons can act as mediators of inflammation, contributing to the chronicization of the pathological process.

Pathogenesis is directly related to the cause and factors that provoked the disorder. It depends on the tactics of treatment. The course of the disease is significantly aggravated by emotional overstrain, taking medications, epidermal injuries, streptococcal infections, alcohol abuse and malnutrition.

Symptoms of pustular psoriasis

Pustular lesion of the epidermis is observed in 1% of patients with psoriasis and is most often localized in the palms and soles. Symptoms of pustular psoriasis are cyclical and depend on the form of the disease, its type and stage.

At first, hyperemia and inflammation appear. After that, symmetrical rashes-pustules gradually appear on the skin. The patient complains of itching and burning. Unpleasant symptoms are aggravated at night and when using household chemicals (soap, shampoo).
The pustules contain a sterile fluid, some of them merge, forming extensive foci. When the blisters burst, the open wound becomes infected. Because of this, the disease becomes purulent in nature.
Against this background, erythroderma may begin. Some patients develop ring-shaped, serpiginous and other types of erythematous-pustular rashes on the skin and mucous membranes. Dystrophic changes can capture nails, face, scalp, joints and even kidneys.

The disease develops over several months with constant exacerbations of symptoms. During this period, the patient suffers from general malaise, weakness, chills and fever.

First signs

According to its symptoms, the exudative form differs from the clinical picture of a simple type of rash. The first signs are manifested as focal inflammation, itching and burning. Gradually, papules with fluid form on the surface of the epidermis, which burst, forming large wound areas. When you try to remove them, a bleeding surface appears, which, when healed, turns into scales.

In the classical manifestation, the disease is characterized by a triad of such signs:

"Stearin spot" - with a slight scraping of the skin, peeling intensifies, which makes the papules look like a drop of stearin.
"Thermal film" - is formed after the removal of scales, leaving a wet, thin surface.
"Blood Dew" - appears when the thermal film is damaged. Point drops of blood appear on the skin, caused by trauma to the full-blooded papillae of the dermis.

The pathological condition is characterized by increased rashes with mechanical or chemical irritation. The rash appears within two weeks. On the elbows, knees, scalp, it persists for a long period of time, without spreading to other areas.

stages

Pustular psoriasis has several stages of development, which differ in their symptoms. Consider them:

Initial - a rash appears on the body, which grows rapidly. The plaques are oval or round in shape and pink in color, covered with whitish scales on top.
Stationary - occurs 7-21 days after the onset of the pathological process. The plaques are light in color, ring-shaped, their surface is covered with silvery scales.
Fading - plaques acquire a skin tone, itching is less intense, a ring of keratinized skin forms around the rashes. This period lasts from several months to a year or more.

Depending on the stage of the disease, the nature of the rashes and their localization, a treatment plan is drawn up.

Forms

Many dermatological diseases have several stages, forms and types. Types of pustular psoriasis depend on the location of the rash and their nature. The disease is divided into two large types: generalized and localized, consider them:

Generalized - occurs both in healthy people and in those who already suffer from other forms of the disorder. It is characterized by a sharp formation of erythema with severe itching and burning.

Tsubmusha - most often occurs in absolutely healthy people. Erythema appears on the body - inflamed areas, hot to the touch. Gradually, they turn into pustules that unite with each other, affecting large areas of the body. This type is recurrent.
Acrodermatitis Allopo - dermatosis with pustules of unknown origin. The rash is localized in the acral regions, that is, on the soles of the feet and hands. The disease proceeds in the form of small rashes with clear boundaries. As the pustules grow, they open up, forming erosive areas with purulent crusts. The disease is chronic, progressive with scleroderma-like changes and atrophy of the epidermis.
Herpetiform impetigo - in most cases occurs in pregnant women, less often in children and men. It develops abruptly, rashes are painful pustules, localized in the groin area, on the inner thigh, in the armpits.

Localized (limited) - affects up to 10% of the total body surface. It is strictly localized on certain parts of the body, for example, on the soles of the feet or palms. It flows more easily than the generalized view.

Localized form Acrodermatitis Allopo - occurs in the pubic area, can occur with psoriasis vulgaris.
Barber's psoriasis is a chronic, relapsing form. It affects the hands and feet. The pustules gradually dry out, forming dense brown crusts.

A limited view is treated much easier, topical agents are enough to eliminate it. While with a generalized form, the patient is waiting for a long-term complex therapy with various forms of medication, diet therapy, physiotherapy.

Pustular psoriasis of the palms

Exudative rashes on the palms indicate a serious dermatological disease. Pustular psoriasis of the palms is quite common. It can occur both locally and combined with rashes in other parts of the body, including joint damage. The peculiarity of this form is that due to the lack of diagnosis, it is very often accepted and treated as a fungal disease.

The disease affects people of all ages, but most often occurs in patients 30-50 years old. It is based on hereditary predisposition. The provoking factors are regular mechanical or chemical hand irritations, prolonged contact with water, various infectious diseases (scarlet fever, sinusitis, tonsillitis), intoxication, endocrine system damage and a number of other factors.

The palmar form of psoriasis has two types:

Plaque-fan-shaped - a red rash, fan-shaped, clearly standing out among healthy tissues. Gradually, silvery scales appear on the papules, which merge into plaques, creating the appearance of cracks.
Calloused - characterized by excessive growth of the stratum corneum of the skin, that is, the layering of the epidermis on the palms. Layering areas are most often located on the lateral surfaces of the palms, they can merge with each other.
Circular - manifests itself as large foci of peeling in the form of rings and circles.

Nails may be involved in the pathological process. Patients complain of severe itching and burning, which cause insomnia and neuroses. Treatment is long and difficult. Difficulties begin in the process of diagnosis, since the disease must be differentiated from pathologies similar in symptoms.

In the process of therapy, ointments with corticosteroids are used, but the body very quickly gets used to such drugs, making the treatment ineffective. Therefore, patients are prescribed means of combined action, which include several active components. After the acute period is stopped, I prescribe drugs to the patients to accelerate tissue regeneration, that is, skin restoration.

Pustular psoriasis of the soles

A dermatological disease characterized by the formation of pustular pustules on the feet is pustular psoriasis of the soles. The disease is cyclical, periods of exacerbation are often followed by complete remission. Most often it affects people aged 25 to 50 years. Pathology develops due to inflammatory processes in the body, various allergic reactions and intoxication. At risk are smokers and people with chronic alcoholism.

Peculiarities:

The rash affects the arches of the feet, gradually spreading over their entire surface. Small yellow vesicles with an inflamed rim appear on the skin, filled with exudate.
Pustules exfoliate involuntarily, provoking suppuration due to the addition of a microbial infection. An unopened rash dries out, forming brown crusts that peel off and form cracks.
The skin on the affected surfaces turns pink, and then red-blue. The patient complains of severe itching and pain due to the fact that the pustules are constantly injured.
If the defect captures the toes, then the nail plate peels off, but the interdigital folds and the skin on the folds of the fingers remain healthy.

Excessive growth of rough skin on the feet leads to calluses, which are located randomly. Calluses can merge with each other, forming large wound surfaces. But the lesion has certain boundaries that separate it from pure skin. Treatment is long and begins with the removal of foci of infection, the use of corticosteroids and broad-spectrum antibiotics.

Generalized pustular psoriasis

One of the most severe forms of skin pathologies is generalized pustular psoriasis. Rashes affect almost the entire body, including nails, accompanied by itching, burning and pain. The disorder begins abruptly, at first erythema, that is, psoriatic foci, is formed. The inflamed areas are quite large, rise above healthy tissues and cause a burning sensation.

A large number of rashes are localized in the perineum, genitals and joints. Against the background of dermatological changes, the general condition of the patient worsens. The temperature rises, muscle and joint pains, weakness and malaise occur. In the blood test, leukocytosis and an increase in ESR values are detected.
Gradually, vesicles and pustules with pus and exudate appear on the inflamed areas. They form very quickly, layering and forming weeping surfaces and solid brown crusts. Such areas are easily injured, turning into erosion with gradual epithelization.

The acute phase lasts from 2 weeks to 2 months. During this period, some crusts dry out, others heal, but the process of formation of new pustules is still ongoing. A bright picture occurs on the skin: weeping erosion and brownish crusts. During the period of remission, the epidermis is gradually restored, the former areas of the rash have a bluish-red color.

Pustular psoriasis Zumbusch

Generalized or pustular Zumbusch psoriasis is a serious and dangerous disease. It is characterized by a rapid onset: large inflamed areas appear on the skin, on which pustules with purulent contents gradually appear. The patient has a fever, weakness, pain in the joints and muscles. In the process of healing, brown crusts form on the skin, if they are injured, they turn into erosions and ulcers that do not heal for a long time.

Most of all rashes in the genital area and skin folds, as well as on the flexor surface of the joints. In some cases, the pathological process captures the mucous membranes, scalp and nails. The treatment is long and rather complicated. The patient is waiting for a course of drug therapy, diet therapy and a course of physiotherapy. But even such an integrated approach to the problem does not guarantee that it does not recur.

Barber's pustular psoriasis

A localized form of rash affecting the palms and soles is Barber's pustular psoriasis. Most often, women suffer from this type of disorder. In the acute period, red spots appear on the skin with peeling and clear boundaries. Gradually, pustules form on the rash, which are located in the thickness of the epidermis with sterile contents.

Bubbles are localized on the lateral surface of the feet and hands, under the fingers, and can also affect the nail plate. The disease is long-term, undulating and difficult to treat. Very often in the process of diagnosis, it is confused with eczema or a fungal infection. To eliminate the acute symptoms of the bacteride, a special diet, various topical agents with a softening effect, temporary steroid hormones and a number of other drugs are indicated.

Complications and consequences

Pustular psoriasis is severe, causing discomfort and pain. Its consequences and complications arise when medical recommendations are not followed and during an exacerbation. Most often, patients face problems such as:

Malabsorption is a violation of the processes of digestion, absorption of nutrients in the small intestine. Accompanied by such symptoms: diarrhea, sudden weight loss, anemia, hypovitaminosis, electrolyte imbalance.
Hypocalcemia is a decrease in the level of ionized calcium in the blood serum. It is manifested by a disorder of electrophysiological processes on cell membranes, proceeds in acute and chronic forms.
Pyoderma is a purulent lesion of the epidermis due to infection with pyogenic cocci.
Onycholysis is a pathological disease of the nails, which is characterized by detachment of the nail plate from the tissues of the finger.
Alopecia is a complete or partial loss of hair on the head and body, a violation of the growth of new hair.
Necrosis of the tubules of the kidneys in the case of oligemia is a violation of the separation of cytoplasmic proteins, causing cell destruction. Appears due to the action of pathogens and in violation of the blood supply.

If the pathological condition proceeds with fever and intoxication, then without appropriate therapy it quickly turns into an acute form, which is fatal.

Diagnosis of pustular psoriasis

Such a dermatological disease as psoriasis has an acute onset and a number of painful symptoms. Diagnosis of pustular psoriasis consists of many different procedures aimed at identifying the cause, factors that provoked the pathology, establishing its form and type. The examination begins with a visit to a dermatologist, a visual examination and an anamnesis.

When making a diagnosis, the following aspects are taken into account:

Clinical picture of the disorder.
The presence of the psoriatic triad (the phenomenon of stearin stain, terminal film, pinpoint bleeding).
The Koebner phenomenon in an advanced stage.

If the picture of the pathological condition is ambiguous, then it is necessary to establish whether there are relatives who suffered from this defect, that is, a hereditary predisposition.

Analyzes

In most cases, psoriatic rashes are identified after a visual examination. Analyzes are prescribed in the case when it is impossible to make a diagnosis by external signs.

Laboratory diagnostics consists of:

Complete blood count - performed to exclude allergic reactions. The appearance of the disease may be associated with leukocytosis and anemia. With extensive lesions, the disorder affects the salt balance of the blood, causing dehydration. During the study, the emphasis is on leukocytes and the erythrocyte sedimentation rate.
A biochemical blood test is necessary to identify possible causes of rashes and draw up a treatment plan.
Urinalysis - assessment of water-salt balance
Fecal analysis - detection of helminth eggs and infectious lesions of the intestine.
Antibodies to HIV - the human immunodeficiency virus can trigger psoriasis.
The study of rheumatoid factor - the analysis is aimed at identifying a protein that accompanies inflammatory processes. In psoriasis, it should be negative; positive values indicate rheumatoid arthritis.
Analysis of liver enzymes - GTT, AST, alkaline phosphatase, ALT.

After this set of tests, additional studies may be prescribed, according to their results, the doctor draws up a treatment plan.

Instrumental diagnostics

Examination for psoriasis using various mechanical devices and devices is instrumental diagnostics. During the study, the following procedures can be carried out:

Skin biopsy is one of the most accurate methods. The doctor makes a sampling of damaged tissues (no more than 6 mm) and examines at the microscopic level.
X-ray - the procedure is necessary to detect psoriatic arthritis. The doctor conducts an examination of the joints, determining the degree of damage to bone tissue, since it can occur with any form of psoriasis.

In addition to the two main instrumental methods, the doctor can prescribe tissue histology to determine such changes: increased vascularization, absence of a granular layer, thinning of the germ layer of the epidermis over elongated ones, Munro microabscesses.

Differential Diagnosis

Since psoriasis is similar in its symptoms to many other skin diseases, differential diagnosis is used to identify it. The disease is most often compared with such pathologies:

Pustular bacterium Andrews - develops against the background of chronic bacterial infections: tonsillitis, dental diseases and gallbladder lesions.
Lichen planus - papules have a polygonal shape, an umbilical indentation in the center, a waxy sheen and a mesh pattern.
Syphilis - papular syphilides are hemispherical, copper-red in color and occur due to pale treponema.
Seborrheic dermatitis - does not have a clear infiltration, Kartamyshev's technique is indicated for differentiation.
Atopic dermatitis is a mild erythema with peeling, severe itching, excoriations on the face, neck, antecubital and popliteal fossae, and upper chest.

If the patient has a localized form, that is, Barber's pustular psoriasis, affecting the palms and soles, then this condition is differentiated with dermatophytosis of the feet, hands, dyshidrotic eczema. The generalized form is compared with bacteremia and sepsis through blood cultures. An HIV test is mandatory, since the sudden onset and acute course can be caused by the human immunodeficiency virus.

Treatment of pustular psoriasis

Complete recovery from psoriasis, and especially with its pustular form, is almost impossible. The treatment plan is made by a doctor, individually for each patient. The results of diagnostics, the stage of the disease, the form and other features of the pathology are taken into account.

Treatment of pustular psoriasis is a complex of such procedures:

Drug therapy - the patient is prescribed drugs of various forms and effects. Treatment begins with topical preparations, since their main goal is to clear the skin of pustules, soften it and prevent peeling. Systemic agents are also used: corticosteroids, retinoids, cyclosporins, antibiotics.
Physiotherapy - the affected areas are irradiated with ultraviolet light, in combination with the use of tablets, ointments, therapeutic baths and other procedures.
Sanatorium-resort treatment - is carried out in a state of remission, that is, when the rashes practically disappear. Patients are prescribed the following procedures: aerotherapy, balneotherapy, heliotherapy.
Dietary nutrition is a very important part of treatment. In the diet of the patient should be products of plant origin, low-fat dairy products and cereals. During the diet, it is necessary to abandon sweets, smoked meats, pickles, fatty and fried foods. The diet is shown both in a state of exacerbation and remission.

Regardless of the treatment method, the whole process is quite long and complicated. The success of recovery depends on the relentless implementation of medical indications.

Medications

Pustular psoriasis is severe, accompanied by extensive skin lesions and deterioration of the general condition. Medicines are used at all stages of the disease, to reduce its unpleasant symptoms. With a generalized form, hospitalization is possible. In any case, the patient will have a long and difficult complex therapy.

Medicines for internal use:

Antihistamines - used in the acute course of pathology, reduce the intensity of itching and swelling. They help with a deterioration in general well-being (sleep disturbances, headaches, irritability), as they have a sedative effect.

Diazolin

Blocker of H1-histamine receptors. It has antiallergic, antipruritic, antiexudative and sedative properties. It is used for severe skin itching, various allergic reactions, eczema, urticaria, hay fever. It is prescribed for adults and children over 10 years old. The daily dosage should not exceed 300 mg, the duration of use is determined by the doctor.

Tablets are contraindicated in case of intolerance to the active components, during lactation pregnancy, with gastric ulcer, inflammation in the gastrointestinal tract, prostatic hypertrophy and heart rhythm disturbances. With prolonged use, adverse reactions and overdose symptoms are possible: dry mouth, irritation of the gastric mucosa, dizziness, paresthesia, drowsiness, dysuria, tremor. To eliminate them, you need to stop taking the medicine and consult a doctor.

Suprastin

A drug that acts on the peripheral nervous system. It is used for various allergic diseases and reactions. Effectively relieves itching, burning and other unpleasant symptoms. The dosage depends on the severity of the pathological reactions. As a rule, patients are prescribed 250 mg 2-3 times a day, in especially severe cases, intramuscular administration of the drug is indicated.

Main contraindications: glaucoma, pregnancy and lactation, prostatic hypertrophy. Side effects: drowsiness, general weakness. In case of an overdose, nausea, epigastric pain, dizziness appear.

Claritin

Selective blocker of H1 receptors with an active ingredient - loratadine. It is used for seasonal allergic diseases of various localization (rhinitis, urticaria, dermatitis, eczema). To reduce painful symptoms, it is recommended to take 0.5-1.5 tablets per day. The main contraindications: intolerance to active substances, breastfeeding and the age of patients under 2 years of age. Use during pregnancy is possible only if absolutely necessary.

Main side effects: nausea, vomiting, dry mouth, fatigue, headaches and dizziness, drowsiness. In case of an overdose, the above reactions have a more pronounced effect. To eliminate them, gastrointestinal lavage is indicated.

If the disorder is accompanied by severe inflammatory processes, then the doctor prescribes desensitizing drugs for intravenous administration (blocking H1-histamine receptors and suppressing mediators of allergic reactions). Most often it is calcium chloride or sodium thiosulfate.

Hepatoprotectors and enzymes - have immunomodulatory properties, are used in severe inflammation and disruption of the gastrointestinal tract.

Festal

A drug that promotes the breakdown and absorption of foods high in fat, carbohydrates and proteins. It is used for inflammatory processes in the gastrointestinal tract, secretory insufficiency, flatulence, indigestion. The recommended dosage is 1-3 tablets 2-3 times a day after meals. It is contraindicated to use in hepatitis and obstructive jaundice.

Likopid

An immunomodulator with an active substance - glucosaminylmuramyl dipeptide. Stimulates the activity of neutrophils and macrophages, enhances cytotoxic and bactericidal activity. It is used for the complex treatment of immunodeficiency states, acute and chronic forms of purulent-inflammatory lesions of the skin and soft tissues, infectious diseases of various localization, chronic viral hepatitis B, C. The medicine is intended for oral and sublingual administration. The dosage regimen and duration of therapy is determined depending on the symptoms of the disease, therefore it is individual for each patient.

It is contraindicated to use with intolerance to the active components, malabsorption syndrome, during pregnancy and lactation. It is not prescribed for patients with hyperthermia and with exacerbation of autoimmune thyroiditis. Side effects are manifested in the form of hyperemia and mild allergic reactions. Cancellation of the drug is not required.

Antibiotics are necessary in the acute course of the disease, when the pustules are filled with purulent contents, as well as in extensive weeping wounds. Antibiotics are prescribed when inflammation (tonsillitis, pyelonephritis, sinusitis) is detected that supports the course of the disorder. The choice of drugs depends on the localization of pathological rashes, penicillins, macrolides, cephalosporins are most often prescribed.
Non-steroidal anti-inflammatory drugs (NSAIDs) - stop the inflammatory process and reduce pain.

Ketorol

A drug with analgesic properties with an active ingredient - ketorolac. After entering the body, it has an anti-inflammatory, pronounced analgesic and antipyretic effect. It is used to reduce pain syndrome of severe or moderate severity caused by any cause. Available in the form of injections (10-30 mg once) and tablets (4 pieces per day). The course of treatment should not exceed 5 days.

Adverse reactions are manifested by many organs of the systems, but most often patients experience such reactions: nausea, vomiting, dizziness, muscle pain and weakness, drowsiness, nervousness, tremor. Contraindications: pregnancy and lactation, patients under 16 years of age, intolerance to the components of the drug, bronchospasm, erosive and ulcerative pathologies of the digestive system, dehydration, peptic ulcers, impaired hematopoiesis.

Nurofen

An effective anti-inflammatory, analgesic and antipyretic agent. It is used for severe pain syndrome, rheumatoid diseases, infectious and inflammatory lesions. Available in the form of tablets and cream. Tablets are taken 200-800 mg 3-4 times a day, the ointment is applied to the affected area 2-3 times a day. Side effects are rare, manifested by such symptoms: disorders of the gastrointestinal tract, swelling, increased blood pressure, bronchospastic and allergic skin reactions. Contraindicated for use in heart failure, ulcerative colitis, gastric ulcers and extensive wound surfaces on the skin.

Enterosorbents - are indicated for a long-term defect. They have a detoxifying effect, absorbing harmful microflora and its metabolic products. Such drugs reduce the risk of allergic reactions in the body, have a positive effect on the immune system. Most often, patients are prescribed: Hemodez, Polysorb, Enterodez.
Immunosuppressors - the development of the disease is associated with damage to T-lymphocytes, that is, cells of the immune system. To restore them, immunosuppressors are used (Cyclosporin-A, Sandimmun). These drugs have increased toxicity, so their use is possible only in a hospital setting.

External drugs:

Corticosteroids - hormonal drugs for external use, are considered the most effective in psoriasis. They quickly relieve inflammation, eliminate itching and burning, and facilitate general well-being. Means from this pharmacological group must be used for a short period of time. This is due to the fact that with prolonged application, skin atrophy begins, striae appear. Cancellation of the drug should occur gradually, since the opposite effect is possible, when the signs of the disease return and appear much stronger.

Elocom

Synthetic topical glucocorticosteroid with the active substance - mometasone furoate. It has anti-inflammatory, vasoconstrictive, antipruritic, anti-allergic and anti-exudative action. It is used for the symptomatic treatment of inflammation, itching and burning in dermatological and allergic diseases, psoriasis, seborrheic dermatitis, lichen planus. The ointment is applied in a thin layer to the affected areas of the skin 1 time per day. The duration of treatment depends on the severity of the disease.

It is contraindicated to use in case of intolerance to the components and with extreme caution for the treatment of the face. Side effects are manifested in the form of a temporary loss of sensitivity, itching and burning. Nausea, dizziness, dry skin, striae are also possible. Long-term use causes an overdose - skin atrophy, depression of the pituitary-adrenal system. Correction of water and electrolyte balance is indicated for treatment.

Advantan

Local anti-inflammatory agent. It is used for dermatitis, eczema and psoriasis of various etiologies. The agent is applied to the skin 1 time per day, the course of treatment is up to 12 weeks for adults and no more than 4 weeks for children. It is contraindicated to use in case of hypersensitivity to active ingredients, viral infections, tuberculosis or syphilis of the skin. Side effects are manifested in the form of hyperemia of the skin, itching and burning at the site of application.

Locoid

Medication with hydrocortisone. It is used for superficial pathological processes in the epidermis without infection. Helps with psoriasis, eczema and dermatitis. The ointment is applied in a thin layer to the site of the rash, 1-3 times a day. The tool can be used for exudative and weeping wounds. Effectively dries, cools, moisturizes and disinfects.

To improve the results of therapy, combination drugs can be used. They include hormones with salicylic acid: Ecol C, Belosarik or an analogue of vitamin D3 (calcipotriol). Lorinden C and Diprosalik ointments are also popular.

Non-hormonal anti-inflammatory drugs - are used to treat all forms and stages of rashes. Most often, patients are prescribed such ointments: sulfuric, sulfur-tar, dermatol, ichthyol, zinc. They have disinfecting, resolving, anti-inflammatory and regeneration-accelerating properties.

Tar - the use of ointments with tar allows you to completely cleanse the skin of pustules within a month. In this case, local application can be combined with tar baths. Tar is a natural cure for dermatological diseases. It has no contraindications and does not cause adverse reactions. Its only drawback is a pungent odor and an increase in skin photosensitivity with prolonged use.
Solidol - ointments based on this substance have analgesic, exfoliating, wound healing, antipruritic, antibacterial, anti-inflammatory properties. The composition of ointments includes not only grease, but also various vegetable oils, plant extracts, bee honey and wax. This allows you to normalize metabolic processes in cells, improve blood microcirculation.

Also from non-hormonal drugs can be prescribed: Cytopsor, Psorium, Ivanov's ointment, Magnipsor. To eliminate itching and burning, soften the skin, reduce the number of plaques and pustules, urea-based products are prescribed (it has moisturizing properties): Lokopeyz, Mustela, Topic 10. Advanced stages are treated with herbal remedies that have restorative and softening properties: Plantozan B, Psoriloma, Lomo psoriasis.

Keratolytics are a group of substances that accelerate the process of exfoliation of dead cells. Their activity is associated with the destruction of the connection between the epidermis and keratinized cells. Preparations with keratolytics are effective for dermatitis, neurodermatitis, echthyosis, various mycoses and other dermatological diseases.

The most popular and affordable keratolytic is salicylic acid. Lactic acid medications, aromatic retinoids (Isotretinoin, Differin) and glycolic acid may also be used. For the treatment of psoriasis, drugs such as Baziron AS, Solcoderm, Belosalik, Vipsogal, Lorinden A are most often prescribed. They accelerate the healing of damaged skin by softening scaly plaques. Treatment should not be longer than 20 days, as the active ingredients have a cumulative effect and can enter the systemic circulation, causing side effects.

Shampoos are another type of psoriasis medication. They are used for rashes on the scalp. Most often, agents with tar (Psoril, Friderm), antifungal and antimicrobial (Nizoral, Skin-Cap) are used. Shampoos stop the flaking of the scalp, relieve irritation and itching, and speed up the healing process.

All of the above medicines for pustular psoriasis should be used only after consultation and appointment of a dermatologist. Self-medication can aggravate the course of the disease, provoking its exacerbation and a number of painful symptoms.

vitamins

Psoriasis is a chronic disease that significantly debilitates and weakens the protective properties of the immune system. Vitamins are aimed at restoring the normal functioning of the body, alleviating the symptoms of the disease and its treatment. Vitamins are taken both internally and externally.

Vitamin-containing ointments and creams

The composition of such drugs includes synthetic analogues of vitamin A, D3, E and others. They have a moderately low activity, so long-term use from 2-3 months to a year is required to achieve a therapeutic effect. Most often, patients are prescribed such drugs: Daivonex, Kremgen, Tazorak, Zorak. Their action is aimed at suppressing the active division of epidermal cells, moisturizing the skin, stopping itching and burning.

Vitamins for oral administration

Useful trace elements must be obtained from food. For example, vitamin E is an antioxidant that improves skin condition, vitamin A is involved in the synthesis of proteins and lipids, maintaining the normal condition of the skin and mucous membranes.

It is also possible to use special vitamin complexes: Aevit (improves lipid metabolism and blood supply to the epidermis), Omega-3 (regulates the exchange of calcium and phosphorus in the body, has an anti-inflammatory effect), Hexavit (stimulates regeneration processes), Undevit (activates metabolic processes in tissues, accelerates healing), Complevit (complex of vitamins and minerals for skin and nails), ascorbic acid and others.

Physiotherapy treatment

Complex therapy of psoriasis allows you to achieve good results in a short time. Physiotherapy treatment is aimed at restoring the skin and alleviating painful symptoms. Physiotherapy is carried out at the stationary stage and during remission, that is, with an acute course and the appearance of rashes, it is not used.

Consider the most popular and effective methods:

Ultraviolet irradiation - the affected areas are treated with ultraviolet radiation. This method is well tolerated and allows you to achieve stable remission from several months to several years.
PUVA therapy - the skin is treated with UV rays and photosensitizers (drugs for oral use). Improves skin condition and promotes remission. Contraindicated in diabetes mellitus, during pregnancy, intolerance to solar radiation, with renal or liver failure. May cause side effects: allergic reactions, headaches, nausea.
X-ray therapy - wound areas are treated with x-rays. It has antipruritic, anti-inflammatory properties, accelerates the process of resolution of pustules.
Cryotherapy - reduces the intensity of itching and pain, improves metabolic processes. The skin is treated with a medicinal mixture, the temperature of which is -160°C. To achieve a positive result, 20-25 procedures are required with a frequency of 1-2 times a day, the duration of one procedure is 2-3 minutes.
Hirudotherapy - leeches are used for treatment. They improve local blood circulation and normalize immune responses.
Doctor fish - this technique is aimed at cleansing the skin from psoriatic rashes. For this, the patient is placed in water with fish, which during the procedure eat a layer of plaques, eliminating psoriasis.

The use of the above methods depends on the location of the rash, the form of the disease and the general health of the patient.

Alternative treatment

Very often, with psoriasis, not only traditional medicine methods are used, but also alternative treatment. Consider several effective recipes for minimizing painful symptoms:

Mix in equal proportions birch tar and any vegetable oil. The resulting mixture must be applied to wound surfaces 1-3 times a day.
Rinse 50 g of celandine grass and grind to a porridge-like state. Mix the plant with goose fat and boil in a water bath for 40-60 minutes. As soon as the ointment has cooled, it can be used to treat rashes, including on the scalp.
Take 50 g of propolis and 500 g of butter. Grind the propolis, melt the butter in a water bath and mix both ingredients. The resulting mixture must be boiled over low heat until a viscous mass of a homogeneous consistency is obtained. Ointment accelerates the healing of ulcers and erosions.
Mix 300 g of milk and 30 g of flax seeds, crushed grape leaves and burdock root thoroughly. The mixture should be boiled over low heat for 7-10 minutes. As soon as the broth has cooled, it is filtered and used for lotions. Gauze bandages and cotton swabs are applied to the wounds, the procedure is carried out 1-2 times a day.

The above folk recipes are effective in many forms of psoriasis, and especially in pustular. But before using them, you should consult a dermatologist.

Herbal treatment

Plant components are part of many effective preparations for eliminating pustules and other rashes. Herbal treatment belongs to non-traditional medicine, therefore, it should be agreed with the attending physician.

Mix 100 g of a string with valerian root, St. John's wort and celandine leaves, 30 g each. All components must be poured with 500 ml of boiling water and let it brew for 15 minutes. After cooling, take the medicine ½ cup 2 times a day.
Pour 100 g of celandine grass into 4 liters of water and boil in a saucepan with a closed lid for 40-60 minutes. Strain the resulting broth and add during water procedures. The water temperature during bathing should be 38°C, procedures are recommended to be carried out every day for 15-20 minutes.
Take in equal proportions licorice root, celandine and oregano leaves. Ingredients need to pour 200 ml of boiling water and boil in a water bath for 10-15 minutes. Strain the broth, cool and take no more than 100 ml 2-3 times a day.
Take equal proportions of celandine, sage, string, valerian and St. John's wort. 50 g of herbal collection, pour 200 ml of boiling water and let it brew for 15-20 minutes. Once the infusion has cooled, it should be filtered and added to the bath while bathing.

The above recipes help to minimize the painful symptoms of the disease, speed up the healing process and can be used during remission.

Homeopathy

For the treatment of psoriasis, various techniques are used in terms of effectiveness and principle of action. Homeopathy is alternative medicine. It has a cumulative effect and helps to strengthen the immune system. Consider the popular homeopathic remedies:

Arsenicum iodatum - used for large pustules and scales. Relieves itching, burning and pain.
Sepia - the remedy is indicated for psoriasis with diaper rash, the formation of areas with altered pigmentation, cracks and erosions of the skin.
Arsenicum album - suitable for the treatment of children and elderly patients. Effectively copes with rashes on the scalp, eliminates itching, burning, dry skin. It has a beneficial effect on general well-being and the state of the nervous system.
Sulfur - pustules with purulent contents, itching, burning, frequent relapses of the disease.
Protect your skin from mechanical and chemical damage. To prevent allergic reactions, give preference to clothing and bedding made from natural fabrics.
In a residential area, it is necessary to provide high humidity. The use of conditioner is contraindicated, as it causes dry skin.
Conduct seasonal prevention of colds and infectious diseases. Avoid nervous strain, stress and hypothermia.
Stick to a dietary diet, which implies the rejection of fatty, sweet, salty, smoked, flour. Avoid alcohol and other bad habits.

Forecast

Psoriasis is an incurable disease that occurs throughout life. The prognosis depends on its form, stage and characteristics of the patient's body. According to medical statistics, about 17% of patients complain of complications of varying severity, and 2% of cases of the disease end in death.

Pustular psoriasis does not pose a danger to others, that is, the disease is not transmitted by contact or airborne droplets. But for the patient, the pathological condition is associated with a high risk of diseases of the cardiovascular system and various inflammatory processes. The disorder has a bad effect on the psycho-emotional state, increasing the risk of exacerbation of chronic disorders, the appearance of diabetes, hypertension, and even oncology.

Pustular psoriasis is a fairly rare skin disease. Its first manifestation is a rash on the body, hands and soles of the feet. However, the nature of the rash is not similar to the papules typical of simpler forms of the disease; pustules appear on the skin of a person - small swollen seals filled with pus. The appearance of pustules is the most important symptom of this disease.

What is pustular psoriasis?

Pustular psoriasis is one of the severe forms of an incurable disease. At first glance, it may seem to many that rashes and plaques on the skin cannot cause serious harm to the patient, and even more so they are not capable of provoking serious consequences.

But in fact, the clinical picture looks completely different. This disease occurs in two completely different cases: as the next stage in the development of the disease in patients already suffering from psoriasis vulgaris and in absolutely healthy people who previously could not complain of either skin problems or health problems.

With mild form in patients, about 3-4% of the skin is affected, with severe- from 10% and more.

Severe form without timely treatment, it can go to another stage - erythroderma. Recently, there is an opinion among specialists that the development of this type of disease is provoked by aggressive methods of treating already existing lichen.

However, why it progresses with complete confidence no one can answer you. In the same way, no one can explain why in some people the disease is in a state of constant remission, while in others it develops and is difficult to treat.

Doctors identify a number of reasons that can affect the development of pustular psoriasis:

long stay in direct sunlight;
bad habits: smoking and alcohol, stress, infections, antibiotic treatment, weakened immunity, hormonal changes, improper treatment of psoriasis vulgaris.

Forms and types of pustular psoriasis

According to the place of localization, this dermatological disease is divided into two types: Barber and Zumbush psoriasis.

The first is localized on the palms and feet, and the second throughout the body.

Sometimes a third type is also distinguished - exudative. Due to the poor permeability of the walls of the vessels, the components of the blood begin to come out of them, which fall directly into the focus of inflammation.

This leaking fluid is called exudate. The exudate impregnates the scales and provokes the formation of crusts, after the removal of which there are open, wet wounds, which greatly complicates the treatment process.

This type develops in people with increased body weight, diabetics, allergies and those suffering from pressure drops.

Barber's pustular psoriasis

This type of disease is also called palmoplantar, was first studied and described by the English dermatologist Berber.

This type of disease is characterized the appearance of a rash on the palms and soles of the feet: especially on the folds of the fingers and in the recesses of the palms.

It is in these places that the skin has a slightly different structure, it is more dense, so the pustules are located in the deep skin layers.

Exacerbations of this type diseases are not tied to the seasons, as is often the case in patients with simpler forms of the disease, but pass into the chronic stage.

Pustular tsumbush psoriasis

The generalized type was named after the Austrian dermatologist Zumbusch, who diagnosed this form of the disease in his relatives. Thanks to this illustrative example, he was the first to be able to describe in detail the nature and course of the disease.

This type of disease is characterized very rapid onset of a rash all over the body, up to a few hours.

Pustules can appear anywhere, but their location in the genital area prevails and in areas of skin folds: around the mouth, near the eyes, under the armpits, between the buttocks. The rash does not bypass the hands.

Often, pustules are located on the fingers and can even provoke detachment of the nail plates. The death rate is about 2%.

Symptoms

The rash is the primary symptom, the type of disease is determined by the place of its localization. For Zumbush psoriasis In addition to the rash, the symptoms are fever and headache.

Palmar-plantar form characterized by an increased percentage of relapses, however, in addition to rashes and burning in their place, the general health of the patient remains practically unchanged.

Diagnostics

It is possible to diagnose this disease only after the appearance of rashes. Primary symptoms are so mild that they practically exclude early diagnosis.

A mild headache and a slight fever for a person who has encountered this disease for the first time are unlikely to be a good enough reason to go to a dermatologist.

For those patients who already suffer from the vulgar form and are constantly diagnosed by their specialist, it is somewhat easier to identify the progression of the disease.

Treatment of pustular psoriasis

It is currently impossible to completely cure lichen, therefore it is recommended to follow .

Now the most effective is considered a combined type of treatment, involving the use of drugs and folk recipes.

Patients with this form of the disease are often hospitalized. Each patient is prescribed an individual course of treatment, depending on the combination of many factors.

Pustular psoriasis of the palms and feet, due to the high resistance to many types of drugs, is treated with a complex method using a course of medications and herbal medicine.

Patients are prescribed a course of treatment, including:

vitamins;
immunomodulators;
antihistamines.

sedatives. Most often, patients take acitretin, methotrexate, cyclosporine and calcipotriol.

The most popular home remedies are celandine, nettle, oak bark and chamomile.

Herbs insist and lubricate with a solution of crusts and pustules several times a day. Tinctures have a calming effect and relieve skin irritation. Some advise taking baths with these herbs, in which you can additionally add a couple of drops of lavender essential oil.

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