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Чем лечат псориаз на ногах

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17 августа 2019

Псориаз относится к наиболее распространенным дерматологическим поражениям, которые носят неинфекционный характер. Высыпания при данной болезни обнаруживаются на ногах, на волосистой части головы и на других частях тела. Для нее также характерно хроническое течение с частыми обострениями и периодами ремиссий. Псориаз на ногах возникает у многих пациентов, и основным симптомом является формирование небольших пятен с белыми или серыми чешуйками на поверхности кожи нижних конечностей. Патология не передается от одного человека другому, поэтому заразиться даже при тесном контакте с больным невозможно.

Причины псориаза

Согласно статистическим данным заболевание развивается в равной степени, как у мужчин, так и у женщин, причем возраст пациента тоже не играет существенной роли. Однако истинные причины псориаза на ногах и на других зонах человеческого тела науке неизвестны, несмотря на множество клинических исследований, посвященных данной теме. Патология очень сложная, поэтому выявить главные источники ее возникновения до сих пор не удалось. Но медики выделили несколько факторов риска, при которых наиболее вероятно развитие псориатической болезни.

Предрасполагающие факторы:

  • Частое травмирование кожи ног, в частности в области пальцев.
  • Наследственная предрасположенность.
  • Изменения гормонального фона.
  • Частые стрессовые ситуации, психоэмоциональные нагрузки.
  • Инфекционные поражения организма.
  • Интоксикационный синдром.
  • Нарушения обменных процессов.
  • Чрезмерная сухость кожи ног.
  • Неправильный уход за ногами, использование некачественных косметических средств.
  • Нарушения в деятельности эндокринной системы.
  • Химические и термические ожоги.
  • Чрезмерная гигиена.
  • Алкогольная интоксикация.
  • Варикозное заболевание вен на ногах.
  • Аллергические реакции.
  • Авитаминоз.
  • Ослабление иммунной защиты организма.
  • Гельминтозы.
  • Патологии липидного обмена.
  • Длительный прием лекарственных препаратов.

Нередко наблюдается сезонное развитие болезни. Причины псориаза, возникающего на ногах, в зависимости от времени года:

  • Обострение под воздействием ультрафиолетового излучения – это летний псориаз.
  • Обострение под воздействием мороза – это зимний псориаз.
  • Несезонная или круглогодичная форма заболевания, протекающая без периодов ремиссий.

Разновидности болезни

Встречается несколько видов и форм псориаза ног:

  1. Бляшковидный или обыкновенный псориаз. Это наиболее часто встречающаяся патология, при которой на коже ног формируются серебристые или серые бляшки, которые объединяются между собой, образуя крупные очаги воспаления. Обычно болезнь поражает ступни, голени и колени.
  2. Пустулезный генерализованный псориаз – это самая тяжелая форма болезни, которую еще называют экссудативным псориазом, болезнью Цумбуша. Пузырьковые образования, наполненные красной жидкостью, обычно вскрываются, а при проникновении инфекции возникает риск нагноения. Такой вид патологии чаще всего поражает нижние части ног (ступни, голени, область коленей).
  3. Подошвенный пустулез, при котором на ступнях появляются гнойные образования, склонные к разрастанию и распространению. Основной неблагоприятный момент – это постоянное механическое повреждение гнойников при ходьбе.
  4. Акродерматит – неинфекционная форма псориаза, возникающая на пальцах ног, на ступнях и других частях нижних конечностей. Заболевание может послужить причиной расслаивания ногтевых пластин.
  5. Каплевидный псориаз часто возникает вследствие перенесенной стрептококковой инфекции. Характеризуется мелкоточечной сыпью.
  6. Псориатическая артропатия – это внутренняя форма болезни, при которой происходит поражение коленных и тазобедренных суставов, соединительной ткани. Основной симптом – распухание пальцев ног, при данной патологии высока вероятность обездвиживания и инвалидности.
  7. Псориаз сгибательных областей коленей и бедер.

Если судить по клиническим проявлениям, то псориаз подразделяется на:

  • Вульгарный или обыкновенный.
  • Эритродермический.
  • Пустулезный.
  • Экссудативный.
  • Артропатический.

Признаки и стадии болезни

Псориаз на подошвах и на других участках ног доставляет множество неудобств, так как происходит растрескивание кожи, которая зудит и чешется, конечности отекают и болят. Для рассматриваемой патологии характерна частая смена периодов ремиссий и обострений, когда все симптомы сначала стихают, а потом возвращаются с новой силой.

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Болезнь обычно поражает следующие области:

Возникают характерные симптомы:

  • На начальной стадии проявления псориаза на ногах незначительны. Обычно появляются небольшие прыщики, которые впоследствии разрастаются, начинают шелушиться, покрываясь чешуйками и сливаясь в характерные псориатические бляшки.
  • При прогрессировании патологии происходит стремительное распространение сыпи, развитие воспалительного процесса в сопровождении интенсивного зуда. Особенно активно высыпания образуются в местах, где нарушена целостность кожного покрова. Образовавшиеся ранее бляшки начинают сильно шелушиться, огрубевают. Тяжелее всего протекает псориаз на ступнях, так как кожа в данной области постоянно подвергается механическому воздействию в результате ходьбы.
  • При стационарной стадии заболевание не прогрессирует, но и не проходит, наблюдается лишь интенсивное отшелушивание кожи и зуд.
  • Регрессивная стадия характеризуется исчезновением сыпи и пигментацией эпидермиса в местах поражения.

Особенности псориаза на ногах можно увидеть и внимательно рассмотреть на соответствующем фото.

Методы лечения

Грамотное лечение псориаза предполагает осуществление целого комплекса терапевтических мероприятий, направленных на снижение патологической симптоматики. Большое значение имеет тщательная гигиена ног, своевременная замена носков, дезинфицирование и увлажнение кожного покрова, а также выбор подходящей обуви, которая не давит, не сковывает движения и не травмирует.

Примерная схема лечения псориаза на ногах:

  1. Наружная терапия, которая подразумевает применение мазей, гелей и других местных средств для противовоспалительного и регенерирующего эффектов.
  2. Системная терапия – это прием лекарственных препаратов внутрь. Обычно назначаются иммуностимулирующие средства, антигистаминные препараты, гормональные медикаменты, успокоительные, витаминные комплексы, цитостатики и т.д.
  3. Народное лечение – это использование натуральных средств для снижения симптомов псориаза.
  4. Физиотерапевтические процедуры – фототерапия, лазерное облучение, криолечение и др.
  5. Соблюдение лечебной диеты.

Наружная терапия

Мази от псориаза подразделяются на гормональные и негормональные. Гормональные средства оказывают более быстрое воздействие и избавляют от патологической клинической картины, но при их использовании очень высока вероятность возникновения побочных действий, например, синдром отмены.

Курс лечения негормональными препаратами более длительный, но нежелательные эффекты почти отсутствуют.

По мнению дерматологов, псориаз на ногах встречается всё чаще. Он относится к системным воспалительным заболеваниям. Начальная стадия псориаза на ногах может напоминать другие кожные патологии, или аллергические болезни.

Как выглядит псориаз на ногах

Псориаз на ногах (фото 1) – это хроническое дерматологическое заболевание, проявляющееся различными кожными высыпаниями. У взрослого населения чаще встречается распространённый бляшечный псориаз, который сопровождается сухостью кожи. Элементы сыпи могут локализоваться где угодно, в большинстве случаев отмечается псориаз на голенях ног, коленных суставах, подошве.

Симптомы псориаза на ногах развиваются постепенно, течение болезни – волнообразное. Высыпания при данном заболевании имеют воспалительный характер. Как выглядит псориаз на ногах – зависит от стадии процесса. Характерным признаком считается сухость участков кожи по типу бляшек. Псориаз на ногах у детей (фото в галерее) считается редкостью, так как патология обычно поражает людей среднего возраста.

Псориаз в начальной стадии на ногах

Начальная стадия псориаза на ногах (фото 2) характеризуется возникновением воспалительных пятен на коже. Они имеют розовый оттенок, четкие границы и слегка возвышаются над поверхностью кожного покрова. Псориаз на коленях (фото в гал) сопровождается зудом, болезненными ощущениями при расчесывании. Отеки на ногах при псориазе свидетельствуют о тяжелом течении и развитии осложнений. Начинается псориаз на ногах чаще в холодное время года, при обострении вирусных патологий, авитаминозе.

Помимо воспалительных реакций и высыпаний развивается артрит. Признаки псориаза у женщин на ногах могут быть связаны с гормональными изменениями, стрессом. Ранняя стадия псориаза на ногах часто напоминает другие кожные поражения. Особо сложно диагностируется начальная стадия псориаза у детей, ведь врачи редко подозревают эту патологию.

Чем лечить псориаз на ногах

Псориаз на коленях поддаётся лечению, однако заболевание редко полностью исчезает. Зачастую, удлиняется период ремиссии. С лечебной целью применяется мазь от псориаза на коже в период обострения патологии. Лечение псориаза на ногах должен назначать и контролировать дерматолог. В комплексную терапию входят:

  1. Гормональные противовоспалительные средства. К ним относятся медикаменты Преднизолон, Гидрокортизон.
  2. Антигистаминные средства. Среди них – препараты Супрастин, Кларитин.
  3. Иммуномодуляторы – лекарственные средства Раптива, Хумира.
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Чтобы эффективно лечить псориаз на ногах, применяют фототерапию, цитостатические препараты. Назначается и местное лечение – применяется мазь от псориаза на ногах. Эффективными препаратами считаются Триамцинолон, Синалар, Гидрокортизоновая мазь. Лечение псориаза на коленях мазями проводится в период появления высыпаний. Эффективное средство от псориаза на ногах должно иметь в составе гормональный компонент. Оно помогает быстро снять воспалительную реакцию. Мазать псориаз на ногах необходимо тонким слоем, в течение 5-7 дней. Длительная терапия гормональными медикаментами может привести к возникновению побочных реакций.

Народные средства от псориаза на ногах

Лекарство псориаза на ногах назначают и во время ремиссии. В это время симптомы болезни отсутствуют. Чтобы обострения возникали как можно реже, рекомендуются народные средства от псориаза на ногах. Они помогают укрепить иммунитет, оказывают противовоспалительное действие. Народные средства для лечения псориаза на ногах включают: травяные отвары, мази на основе натуральных продуктов, ванночки для ног.

Что делать, если развился псориаз на ногах? Лечение в домашних условиях проводится по следующим рецептам:

  • Отвар из лавровых листов. 10 сухих листов необходимо залить кипящей водой и настаивать в течение получаса. После процеживания отвар употребляют по полстакана 2-3 раза в день. Курс лечения составляет 1 неделю.
  • Отвар из перемолотых семян укропа. 2 столовые ложки заливают 1 стаканом воды и настаивают в течение часа.
  • Отвар из травяной смеси. Включает: перечную мяту, цветы календулы и бессмертника, семена расторопши и пастернака.

Лечение псориаза начальной стадии на ногах может включать лишь натуральные средства. Однако при прогрессировании необходимо применение медикаментов. Для местного лечения народными средствами готовят мази на основе трав и аспирина, прополиса, меда. Также, рекомендуется прием ванн с добавлением медного купороса.

Псориаз на стопах ног

Псориаз на стопе в начальной стадии патологии можно перепутать с грибковыми поражениями. Болезнь протекает в 4 стадии. Псориаз на стопах ног (фото 3) начинается с неприятных ощущений и зуда. Прогрессирующая стадия характеризуется слиянием пятен и узелков и возникновением чешуек. В острой фазе отмечается шелушение бляшек. Псориаз на ступнях ног (фото в гал) переходит в стационарную стадию постепенно. В этом периоде новые элементы не появляются, однако ороговение сохраняется. Лечение псориаза на стопах ног способствует переходу болезни в регрессивную стадию.

Псориаз на пальцах и подошвах ног

Псориаз на пальцах ног сопровождается постоянным зудом из-за повышенной потливости в этом месте. Помимо поражения кожи, отмечается псориаз ногтей на ногах, которые деформируются и истончаются. Псориаз на подошвах ног (фото 4) доставляет неприятные ощущения. Кожа на этих участках грубая, поэтому при повреждении бляшек приводит к возникновению глубоких трещин, кровоточивости. Дифференцируют подошвенный псориаз со склеродермией. С системными патологиями соединительной ткани можно спутать и псориаз на икрах ног. Для диагностики производят соскоб с пораженных участков кожи.

Все фотографии псориаза на ногах

Псориаз на ногах – это хронический дерматит кожи, характеризующийся появлением воспалительных высыпаний, которые со временем образуют псориатические бляшки. Заболевание имеет волнообразное течение, при котором острые фазы чередуются с периодами ремиссии. Сыпь может поражать любые части тела, однако наиболее часто локализуется на локтях, коленях и волосистой части головы. Псориаз на ногах может сопровождаться некоторыми осложнениями. В частности: отеком нижних конечностей, псориатическим артритом, поражением ногтевых пластин. Пациенты, как правило, испытывают значительный дискомфорт, поскольку появление высыпаний сопровождается сильным зудом. Однако при правильно подобранной терапии эти неприятные ощущения пропадают.

Причины возникновения псориаза

На сегодняшний день доподлинные причины возникновения псориаза на ногах неизвестны. Существует лишь несколько теорий, однако ни одна из них не получила официального подтверждения. Наиболее вероятными причинами возникновения псориаза на ногах считаются:

  • Нарушение обмена веществ (липидного).
  • Стрессовые ситуации. Дело в том, что психологические расстройства приводят к нарушению многих функций в организме. У большинства пациентов воспалительные высыпания на коже появляются именно после нервных потрясений. По этой причине стрессы рассматривают как возможную причину возникновения псориаза.
  • Нарушения в работе гормональной системы.
  • Генетическая предрасположенность.
  • Перенесенные вирусные/инфекционные заболевания.
  • Механические повреждения кожи.
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Симптомы псориаза на ногах

Первичные псориатические элементы представляют собой одиночные воспаленные папулы – красновато-розовые уплотнения, возвышающиеся над поверхностью кожи и имеющие четкий контур. Их поверхность покрыта серебристо-белыми чешуйками, которые легко удаляются при соскобе. Поверхность воспалительных элементов рыхлая, а сами бляшки имеют своеобразную морфологическую структуру. При соскобе наблюдается псориатическая триада:

  • Стеариновое пятно, которое возникает вследствие дробления чешуек.
  • Псориатическая пленка, возникающей вследствие того, что между шиповым и роговым слоем отсутствует связующий – зернистый. В результате этого роговые пластинки отделяются в виде пленки, обнажая мокнущую поверхность шиповатого слоя.
  • Симптом кровяной росы (точечного кровотечения), возникающий в результате повреждения капилляров в удлиненных сосочках.

Поражение кожи начинается с появления мелких папул, которые постепенно увеличиваются в размерах, сливаясь с друг другом, и образуя псориатические бляшки различного диаметра. В развитии заболевания можно выделить четыре стадии:
Прогрессирующая.
Данная стадия характеризуется появлением новых папул, которые увеличиваются в размерах, и образованием вокруг уже существующих высыпаний эритематозного бордюра (зоны периферического роста). При этом шелушение наблюдается только в центральной части бляшки. Краевая зона свободна от псориатических чешуек.
Острая фаза.
В острой фазе развития псориатической болезни папулы могут появляться в местах даже незначительного повреждения кожи (симптом Кебнера), ожоге, инъекции либо химическом воздействии на кожу. К тому же при неверно подобранной терапии могут возникнуть осложнения (например, псориатическая эритродермия). Шелушение усиливается. Тенденция роста псориатических элементов уменьшается.
Стационарный период.
Появление новых воспалительных элементов прекращается (однако размеры папул и бляшек могут оставаться прежними). Нередко вокруг папул образуется складчатость рогового слоя, шириной 2-7мм. После полного исчезновения псориатических очагов на их месте образуются депигментированные участки, реже – гиперпигментированные.
Регрессивная стадия.
Постепенное исчезновение псориатических очагов. Это процесс начинается с образования ободка Воронова (белесоватой каймы). Зуд постепенно исчезает. Разрушение воспалений начинается с центральной части.

Кроме внешних изменений, пациент испытывает значительный дискомфорт от постоянного зуда и болезненных ощущений при образовании трещин. При псориазе на ногах, участки высыпаний весьма плотные на ощупь, что является особенностью данной формы.

Псориаз на ногах — лечение

Как лечить псориаз на ногах?

При лечении псориаза на ногах необходим комплексный подход и назначение препаратов, которые подбираются индивидуально. Как правило, это гормональные мази, купирующие развитие болезни в сочетании с физиотерапевтическими процедурами, а также фотохимиотерапия и альтернативные методы лечения. К тому же, пациенту показана специальная диета и соблюдение определенных правил ухода за кожей ног.

Псориаз на ступнях

Иногда у больных псориазом наблюдается поражение ладоней и ступней – ладонно-подошвенный псориаз. Для данной формы характерен гиперкератоз (значительное утолщение кожи), сопровождающийся появлением трещин. Кожа приобретает ярко-красный оттенок, а заболевание по клиническим проявлениям схоже с экземой и микозами. Дифференциальная диагностика заключается в проведении визуального осмотра, биопсии и серологических исследований.

Псориаз ступней ног доставляет пациенту не только физический, но и психологических дискомфорт. Бляшки, возникающие на ступнях, имеют округлую форму и четкие границы. Поверхность бляшек покрыта чешуйками, которые легко отшелушиваются. В некоторых случаях при данной форме псориаза наблюдаются желтоватые пустулы (пустулез), которые отслаиваются самостоятельно.

Псориаз на ступнях может быть изолированным, без воспалительных высыпаний на других участках кожи.
Пораженная кожа стоп становится сухой и воспаленной, а само заболевание значительно снижает качество жизни пациента. Диагностика может осложняться тем, что это заболевание легко спутать с экземой, поскольку она также может сопровождаться возникновение пустул.

Пациентам следует избегать контакта с химическими веществами и особенно тщательно следить за гигиеной. Для уменьшения болезненных ощущений рекомендуют носить толстые носки и открытую обувь.

Псориаз на ступнях — лечение

Прежде всего, следует избегать механического повреждения кожи, а также контакта с химическими веществами. При лечении используется комплексная терапия, которая включает в себя использование лосьонов и мазей, фототерапию, физиотерапевтические процедуры. Дерматологи также рекомендуют гидроколлоидное покрытие, которое заживляет раны и значительно уменьшает зуд.

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