Red flat lichen: photos, symptoms and treatment, causes
Lichen red flat is a chronic inflammatory process that affects the skin, as well as mucous membranes.
Its prevalence among dermatological diseases is from 1 to 2.5%, and if we talk about diseases of the oral mucosa, then the share of red flat lichens is about 10%.
For the first time, red lichen planus was described in 1860 by F. Gebra. Somewhat later( in 1869) the clinical picture of this pathological process was described in detail. The author was dermatologist Wilson, who works in England. In Russia, the first cases were recorded by Bekhterev and Polotubnov( 1881).
However, a fairly long history of this disease leaves many more questions as to the cause of its development. Modern dermatology does not have a single point of view of the etiology of red lichen planus. This is probably due to the lack of effective etiotropic treatment, which would once and for all allow to get rid of this disease.
The modern concept of development of red lichen planus looks like a combined effect of three groups of factors:
Each individual form has its own specific symptoms. The main clinical manifestations of red flat lichen are:
Recently there has been an evolution during the red flat lichen, which is explained by various factors( environmental change, frequent and uncontrolled use of antibiotics, immunosuppression, etc.).
The main modern features of the course of this disease are:
Diagnosis of the disease usually does not cause difficulties for dermatologists. It is based on a clinical assessment of the available symptoms that are characteristic of this disease.
In difficult or doubtful cases, a histological examination is performed. In parallel, the dermatologist conducts differential diagnosis with other skin diseases, which may have a similar clinical picture.
This may be psoriasis, some forms of neurodermatitis, papular syphilis and others.
Red lichen planus, in which the dominant symptom is itching, is treated with drugs such as:
If the disease becomes widespread with the defeat of large areas of the skin and mucous membranes, then the use of quinolone immunosuppressants, for example, plaquenil, delagil and others, is required. The course of treatment is usually 21 days.
The acute course of the disease is an indication for the appointment of corticosteroids, which also inhibit the activity of the immune system. The effect of their application develops quickly enough( in comparison with quinolones).Can be used as tablet forms, and injectable, which depends on the activity of the process.
It is also possible to carry out the therapy in two stages:
In the complex treatment of red lichen planus, it is necessary to include such measures as:
Folk methods of treating red flat lichen are an addition to the basic therapy prescribed by a dermatologist. The main methods that folk medicine recommends are:
Its prevalence among dermatological diseases is from 1 to 2.5%, and if we talk about diseases of the oral mucosa, then the share of red flat lichens is about 10%.
Causes of
For the first time, red lichen planus was described in 1860 by F. Gebra. Somewhat later( in 1869) the clinical picture of this pathological process was described in detail. The author was dermatologist Wilson, who works in England. In Russia, the first cases were recorded by Bekhterev and Polotubnov( 1881).
However, a fairly long history of this disease leaves many more questions as to the cause of its development. Modern dermatology does not have a single point of view of the etiology of red lichen planus. This is probably due to the lack of effective etiotropic treatment, which would once and for all allow to get rid of this disease.
The modern concept of development of red lichen planus looks like a combined effect of three groups of factors:
- 1) Genetic predisposition( genetic specificities of the immunity)
- 2) Endogenous factors( neurological disorders, immunity disorders)
- 3) Exogenous factors( viruses,which cause prolonged sluggish infections, toxic-allergic conditions caused by the intake of certain drugs, etc.).
- wrist joints and forearms on the side of the flexor surface
- shin, its front surface
- sacrum
- penis in men.
- mucous mouth
- mucous of genital organs.
Symptoms of red flat lichen
Each individual form has its own specific symptoms. The main clinical manifestations of red flat lichen are:
- 1) Typical. It is characterized by a specific localization of lesions( see above), the appearance of small-sized papules that have a gray-white color. Later the papules merge with the formation of plaques, which have a characteristic luster( they do not shine on the mucous membranes).
- 2) Ring-shaped. Skin rashes in shape resemble rings, which are most often localized on the genitals.
- 3) Erythematous. This form of the disease is characterized by the appearance of bright raspberry-colored rashes. In their area, the skin is edematous and flakes. Also observed are papules that are soft to the touch.
- 4) Warty or verrucous. With this form, the formation of flat warts, which on the outside have a perforated appearance( cellular surface) and are covered with an insignificant number of scales. In the peripheral part of the warts, papules are detected. It is this form of the disease that is accompanied by very pronounced itching.
- 5) Pemphigoid. This form differs from the others in that formation of bubbles is observed, in the place of which pigmentation may remain.
- 6) Atrophic. When it appears white spots that have a pearly hue.
- 7) Erosive-ulcerative, in which epithelial defects are formed with fuzzy contours in some areas, while on others typical skin elements characteristic of red flat lichen are observed.
Recently there has been an evolution during the red flat lichen, which is explained by various factors( environmental change, frequent and uncontrolled use of antibiotics, immunosuppression, etc.).
The main modern features of the course of this disease are:
- 1) Relapses of the disease
- are more common. 2) Clinical forms such as erosive-ulcerative, atrophic and prostucous
- are more often observed. 3) In rare cases, malignization of the pathological process, that is, malignant transformation of skin and mucous membrane cells, can be observed. The malignancy frequency ranges from 10 to 12%.
Treatment of flat red lichen
Diagnosis of the disease usually does not cause difficulties for dermatologists. It is based on a clinical assessment of the available symptoms that are characteristic of this disease.
In difficult or doubtful cases, a histological examination is performed. In parallel, the dermatologist conducts differential diagnosis with other skin diseases, which may have a similar clinical picture.
This may be psoriasis, some forms of neurodermatitis, papular syphilis and others.
In general, treatment with red lichen planus is symptomatic, that is, it is aimed at arresting the main clinical manifestations of the disease. Therefore, the type of medication used will depend on the underlying symptoms of the disease.
Red lichen planus, in which the dominant symptom is itching, is treated with drugs such as:
- antihistamines
- sedative( sedative)
- sleeping pills
- local forms of corticosteroids.
If the disease becomes widespread with the defeat of large areas of the skin and mucous membranes, then the use of quinolone immunosuppressants, for example, plaquenil, delagil and others, is required. The course of treatment is usually 21 days.
The acute course of the disease is an indication for the appointment of corticosteroids, which also inhibit the activity of the immune system. The effect of their application develops quickly enough( in comparison with quinolones).Can be used as tablet forms, and injectable, which depends on the activity of the process.
It is also possible to carry out the therapy in two stages:
- , the first one uses rapid-acting drugs in the form of injections of
- in the second stage - long-acting tablets to maintain the therapeutic effect achieved. Treatment lasts for 14-21 days.
In the complex treatment of red lichen planus, it is necessary to include such measures as:
- vitamin therapy( fat-soluble vitamins, besides vitamin K, as well as B vitamins, nicotinic acid)
- acupuncture
- electrosleep that normalizes the psychoemotional state of
- sanatorium therapy.
Treatment of red flat lichen folk remedies
Folk methods of treating red flat lichen are an addition to the basic therapy prescribed by a dermatologist. The main methods that folk medicine recommends are:
- 1) Herbal collection, which has soothing and anti-inflammatory properties, normalizes the work of the gastrointestinal tract. It consists of a turn, chamomile, sage, which are taken in equal amounts
- 2) To compress the pronounced itch, compresses made from broth( they should be cold) perfectly help.
- 3) It is good to wipe plaques of red flat lichen with tincture of chopped garlic, which is prepared on vodka( 50 grams of garlic and a glass of vodka)
- 4) As a local therapy, a cabbage sheet, greased with natural sour cream, is perfect. He is put to the place of defeat.