The purpose of the study was to establish the influence of smoking on the course of psoriasis by studying the tone and reactivity of the autonomic nervous system (ANS) in tobacco smoking patients with psoriasis. Materials and methods. 85 patients with psoriasis aged 25-55 (50 men, 35 women) were examined, 33 of them did not smoke, and 52 – smoked 10 years and more. The comparison group consisted of 50 tobacco smokers without dermatosis. The patients were examined by AM Vein using questioning, as well as registration of dermographism and heart rate variability with the help of «Cardio Lab». Results and discussion. According to the questionnaire data, we revealed significant violations of ANS in tobacco smoking patients with psoriasis in comparison with patients who did not smoke, which caused torpidity of the therapy. When studying dermographism and heart rate variability in tobacco smokers, we noted a delayed reaction of the microcirculatory bed with the predominant participation of the sympathetic department of the ANS, in contrast to psoriasis patients who did not smoke tobacco and had prevalence the parasympathetic department of the ANS. Changes in autonomic regulation depended not only on the severity of psoriasis, but also on the addiction to smoking tobacco. In accordance with the obtained data, in the studies of the tone, reactivity of ANS in the presence of the dysfunction syndrome, patients who smoked absolutely dominated both control groups in the presence of the ANS pathology. In contrast to patients who did not smoke, hypersympathicotonia predominated in the main group and humoral-metabolic influences on cardiac rhythm regulation were reduced with decreasing overall intensity of the spectrum, which was also characteristic of smokers without dermatosis. In the study of the reactivity of ANS in patients with smokers, in contrast to the control groups, the reactivity and tone of the parasympathetic department of the ANS decreased and the influence of humoral metabolic mechanisms was increased, which was also characteristic of smokers without manifestations of dermatosis. Conclusions. The peculiarities of local dermographism in tobacco smoking patients with psoriasis allow thinking about the important role of the peripheral nervous system in the pathogenesis of psoriasis. Initiation of inflammation in smoking patients begins predominantly from the peripheral parts of the ANS upon stimulation of the neuroreceptors by appropriate mediators or after contact of the immune system with a foreign agent. The increase in intensity and duration of smoking in tobacco smoking patients with psoriasis causes changes in the receptor sensitivity of immunocompetent cells in the influence of the sympathetic department of the ANS, the change in their proliferative and functional properties that can influence the direction of the course of the underlying disease, causing clinical features, leading to the formation of concomitant pathology in their organisms. Such a state of the cardiovascular system contributes to the preservation and progression of the psoriatic process, and therefore has an unfavorable prognosis for recovery and needs specific pathogenetic therapy.
Keywords: vegetative nervous system, psoriasis, tobacco, dermatografism, skin, questionnaire, response, anamnesis
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