Complex therapy of psoriasis and multidisciplinary correction of maladjustment against the background of psychodermatological changes

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ACTUALIZATION

Over the past decades, the number of detected cases of psoriasis has increased. In its course, a psychosomatic component is increasingly noted. An alarming change in the central nervous system causes a change in the relationship of important mediator systems, while the manifestations of general maladjustment sharply increase.

OBJECTIVE

Changes in the dynamics of general clinical indicators and homeostasis data in the adaptation system when prescribing a cream containing herbal components with anti-inflammatory, antipruritic and keratolytic effects in combination with local dynamic therapy (LDM) in patients with psoriasis, taking into account psychodermatological changes.

MATERIAL AND METHODS

The data of 48 patients (30 men and 18 women) aged from 18 to 65 years were studied. Group 1 included 24 patients who underwent LDM-therapy for rashes with the application of the investigated external agent. To compare the results of the study, the 2^nd group included 24 patients who underwent complex treatment with the application of only the studied external agent to the foci. Additionally, the clinical and psychological status was assessed in all patients.

RESULTS

The inclusion of a cream containing herbal ingredients with anti-inflammatory, antipruritic and keratolytic effects in the complex (with LDM) therapy of patients led to a significant increase in the clinical effect (91.8% in the main group) and proved the need for its use in patients with psoriasis as an option to restore maladjustment organism and neuropsychic adaptation of the patient’s status.

CONCLUSION

Combined LDM therapy with the application to the lesions of a cream containing herbal components with anti-inflammatory, antipruritic and keratolytic effects, showed a multidisciplinary effect on the normalization of maladjustment of the body, which is important when considering psoriasis as a psychosomatic disorder.

Keywords:

psoriasis

herbal components with anti-inflammatory

antipruritic and keratolytic effects

external therapy

local dynamic therapy

psychological maladjustment

Authors:

Zuev A.V.

Center for Expertise and Quality Control of Medical Care;
Russian Medical Academy of Continuous Professional Education

ORCID: 0000-0002-1608-7089

Reverchuk I.V.

Immanuel Kant Baltic Federal University

Gontar A.A.

Immanuel Kant Baltic Federal University

Received:

29.10.2020

Accepted:

14.12.2020

List of references:

Matushevskaya EV, Konovalova MV, Vladimirova EV, Svirshchevskaya EV. Pathogenesis and therapy of psoriasis and psoriatic arthritis. Russian Journal of Clinical Dermatology and Venereology = Klinichaskaya dermatologiya i venerologiya. 2019;18(5):634-643. (In Russ.). https://doi.org/10.17116/klinderma201918051634
Potekaev NN, Kruglova LS. Psoriaticheskaya bolezn’. M. 2014. (In Russ.).
Raznatovskii KI, Terletskii OV. Psoriaticheskaya bolezn’. Diagnostika, terapiya, profilaktika. M.: GEOTAR-Media; 2017. (In Russ.).
Parisi R, Symmons DP, Griffiths CE, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol. 2013;133:377-385. https://doi.org/10.1038/jid.2012.339
Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, Gelfand JM. Psoriasis and comorbid diseases: Implications for management. J Am Acad Dermatol. 2017;76:393-403. https://doi.org/10.1016/j.jaad.2016.07.065
Karapetyan ShV. The evaluation of correlation between quality of life, clinical efficiency of treatment of psoriasis and age, sex, duration of disease. Russian Journal of Clinical Dermatology and Venereology = Klinichaskaya dermatologiya i venerologiya. 2019;18(6):797-803. (In Russ.). https://doi.org/10.17116/klinderma201918061797
Smulevich AB, L’vov AN, Ivanov OL. Patomimii: psihopatologija autoagressii v dermatologicheskoj praktike. Izdatel’stvo MIA; 2012;160. (In Russ.).
Ammar M, Souissi-Bouchlaka C, Gati A, et al. Psoriasis: physiopathology and immunogenetics. Pathol Biol (Paris). 2014;62(1):10-23. https://doi.org/10.1016/j.patbio.2013.07.014
Bolt T, Kobayashi H, Mahlich J. Patient and Physician Preferences for Therapy Characteristics for Psoriasis: A Discrete Choice Experiment in Japan. Pharmacoecon Open. 2019;3(2):255-264. https://doi.org/10.1007/s41669-018-0104-1
Cakmur H, Derviş E. The relationship between quality of life and the severity of psoriasis in Turkey. Eur J Dermatol. 201;25(2):169-176. https://doi.org/10.1684/ejd.2014.2511
Yang EJ, Beck KM, Sanchez IM, et al. The impact of genital psoriasis on quality of life: a systematic review. Psoriasis (Auckl). 2018;8:41-47.
Khlebnikova AN. The role of epidermal lipids in the pathogenesis of psoriasis. Russian Journal of Clinical Dermatology and Venereology = Klinichaskaya dermatologiya i venerologiya. 2020;19(2):231-234. (In Russ.). https://doi.org/10.17116/klinderma202019021231
Vegetativnye rasstroistva. Klinika. Diagnostika. Lechenie. Pod red. Veina A.M. M. 2000. (In Russ.).
Borodjuk NR. Adaptacija i gumoral’naja reguljacija. M. 2003. (In Russ.).
Shagieva DR, Gatin FF, Yusupova LA. Clinical effectiveness of medical-social prophylaxis of concomitant chronic dermatosis in patients with psychic disorders. Obshchestvennoe zdorov’ye i zdravookhranenie. 2011;1:71-75. (In Russ.).
Nicholas MN, Gooderham M. Psoriasis, Depression, and Suicidality. Skin Therapy Lett. 2017;22(3):1-4. PMID:28486717.
Shah VP, et al. A science based approach to topical drug classification system (TCS). Int J Pharm. 2015;491:21-25. https://doi.org/10.1016/j.ijpharm.2015.06.011
Chi CC, Chen TH, Wang SH, et al. Risk of Suicidality in People with Psoriasis: A Systematic Review and Meta-Analysis of Cohort Studies. Am J Clin Dermatol. 2017;18(5):621-627. https://doi.org/10.1007/s40257-017-0281-1
Mohammad Jafferany, Ann Vander Stoep, Alin Dumitrescu, Robin L Hornung. The Knowledge, Awareness, and Practice Patterns of Dermatologists Toward Psychocutaneous Disorders: Results of a Survey Study. Int J Dermatol. 2010;49(7):784-789.
Mrowietz U, de Jong EM, Kragballe K, et al. A consensus report on appropriate treatment optimization and transitioning in the management of moderate-to-severe plaque psoriasis. J Eur Acad Dermatol Venerol. 2013;168(4): 825-836. https://doi.org/10.1111/jdv.12118
Ustinov MV, Chaplygin AV. Micronization and other ways to improve the efficiency and safety of topical drugs in dermatology. Russian Journal of Clinical Dermatology and Venereology = Klinichaskaya dermatologiya i venerologiya. 2019;18(4):418-427. (In Russ.). https://doi.org/10.17116/klinderma201918041418
Levin AA, Gottlieb AB, Au SC. A comparison of psoriasis drug failure rates and reasons for discontinuation in biologics vs conventional systemic therapies. J Drugs Dermatol. 2014;13(7):848-853.
Evstigneeva IS, Kulikov AG, Yarustovskaya OV, Shakhova AS, Lutoshkina MG. Physical therapy of psoriasis. The modern methodological approaches. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul’tury. 2018;95(1):53-58. (In Russ.). https://doi.org/10.17116/kurort201895153-58
Zuev AV, Gontar’ AA. Experience with the use of Kartalin in the treatment of psoriasis onychodystrophy. Sibirskij zhurnal dermatologii i venerologii. 2015;16:2528. (In Russ.).
Lykova SG, Nemchaninova OB, Pavlova TG, Pozdnyakova ON, Svechnikova EV. Special considerations of methodical approach in the development of therapeutic and preventive measures to optimize the diet and some aspects of the lifestyle of patients with psoriasis. Russian Journal of Clinical Dermatology and Venereology = Klinichaskaya dermatologiya i venerologiya. 2018; 17(2):108-113. (In Russ.). https://doi.org/10.17116/klinderma2018172108-113

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