Scleroatrophic lichen is a very unpleasant and at the same time widespread disease of the skin, which in its nature resembles lichen. Its distinctive feature is the presence of dense white spots.
general information
Lichen is the name of a whole complex of various skin diseases, and regardless of their origin. All of them are characterized by the appearance of small rashes. From the Greek language, the term "lichen" is translated as lichen or infection. In the XIX century, F. Gebra brought clarity to one of the most complicated issues in the field of dermatology, introducing lichen into the category of skin ailments.
Currently, several types of this disease are distinguished: brilliant, tropical, spike-like, scleroatrophic and linear lichen. All these pathologies have one thing in common - the appearance of a rash on the body in the form of white tubercles. On the other hand, they may differ in location, seasonality (the tropical variant of the disease is most often diagnosed in the summer). In this article we will consider in more detail what constitutes scleroatrophic (sclerosing) lichen. This pathology occurs in women aged approximately 45-50 years, and in men at 40 years of age. Representatives of the fair sex suffer from this disease 10 times more often. In children, pathology is extremely rarely diagnosed, mainly in girls from one year to 13 years old.
The main causes of the disease
Currently, specialists from around the world, including the Institute of Dermatology and Cosmetology in Moscow, continue to actively study this pathology, its development mechanisms. Scientists have been able to identify several factors that several times increase the likelihood of a disease. These include the following:
- Hereditary predisposition.
- Autoimmune diseases of nature (psoriasis, lupus erythematosus, etc.).
- Various infections directly affecting the genitourinary system. Scleroatrophic lichen can develop against the background of genital herpes.
- Disruption of the endocrine system (diabetes mellitus).
Clinical picture
The disease manifests itself with the appearance of spots and so-called papules. Elements of the rash are distinguished by white color and pronounced outlines. They are localized mainly on the neck, upper chest, shoulders, genitals. Initially, papules do not exceed 5 mm in diameter. Closely located spots over time merge into plaques that rise slightly above the skin. Sometimes bubbles appear on the surface of the plaques. If the scleroatrophic lichen is localized in the genital area, the lesion is characterized by dryness and constant itching.
The disease can develop over several years. Rashes practically do not bother, very rarely accompanied by itching. That is why patients are in no hurry to seek qualified help. The course of the disease is undulating. This means that the area of damage can increase and decrease. Cases of transformation of papules into squamous cell carcinoma are known.
Penis penis
Otherwise, the disease is called kraurosis. In this case, the head of the genital organ is involved in the pathological process. As a rule, the disease develops in adult patients, but is relatively rare.
With kraurosis in men, not only the head of the penis is affected, but also the inside of the leaf of the foreskin. Initially, the disease is manifested by a decrease in elasticity and the appearance of dryness in this zone. In the affected areas, the so-called connective tissue grows. Complications of lichen include the following:
- Phimosis (narrowing of the foreskin, which entails the inability to completely expose the head).
- Reducing the opening of the urethra.
- The appearance of cracks in this area.
With sclerotrophic lichen, the head, as a rule, is affected diffusely. It acquires a white color with a bluish tint.
As the disease progresses, atrophy of the skin sites is observed, so-called telangiectasias appear on its surface. In total, four stages of the development of the disease are distinguished:
- At the first stage, only the foreskin is affected.
- Then, the pathological process spreads to the head.
- The third stage involves the defeat of the entire genital organ, foreskin and the outer region of the urethra.
- The last stage of the disease is also considered precancerous. All patients are assigned a full diagnostic examination to exclude the malignant nature of the disease.
Lichen vulva
In women, the disease manifests itself in the form of uncomfortable itching and the appearance of white spots in the vulva, anus. As a rule, the affected area takes the form of a "figure eight". Then the pathological process smoothly spreads to the vestibule of the vagina, clitoris and labia.
Some patients experience erosion. Due to their gradual healing, scarring of tissues with overgrowth of the labia minora is observed. Bacterial and fungal infections can complicate the course of the disease.
Establishing diagnosis
If primary symptoms appear, it is recommended to seek help from a specialized center (for example, the Institute of Dermatology and Cosmetology in Moscow). At the consultation, a specialist can confirm the diagnosis based on the patient's complaints and the study of the clinical manifestations of the disease. In some cases, an additional biopsy of the affected tissue may be prescribed, followed by examination of the material under a microscope.
What should be the treatment?
Therapy can be prescribed only after the doctor confirms the diagnosis of scleroatrophic lichen. Treatment should be comprehensive. It includes drugs to improve blood microcirculation (Dipyridamole, Retinol Acetate), application ointments (Solcoseryl, Actovegin).
All patients, without exception, are prescribed a course of lymphotropic therapy with subcutaneous injection of “Lidase” with “Heparin” into the shin area.
Scleroatrophic lichen of the penis is treated with medication only in the early stages. Patients are prescribed general strengthening therapy and taking anti-malarial drugs (Delagil, Rezorhin). In the case of low efficiency of conservative therapy, circumcision is indicated. When the pathological process spreads to the urogenital canal, as a rule, an operation on the plastic of the penis is necessary .
For the fair sex, the affected tissues are excised, additionally, plastic of the vulva and anus may be required.
All patients are advised to follow a special diet and bed rest. It is advisable to isolate the patient for some time from healthy family members, since the etiology of the disease has been little studied to date. Such measures are necessary in order to exclude the possible infection of third parties. It is not recommended to try to overcome sclerosing lichen on your own - this is quite dangerous. Pathology will actively progress, which entails the development of rather unpleasant consequences, including oncological nature.
Prevention and prognosis
Skin diseases are easier to prevent than to subsequently engage in therapy. Prevention of this kind of ailment primarily implies the timely treatment of all autoimmune and infectious ailments. If symptoms are found, it is important to immediately seek help from a doctor, not to try to overcome the disease on your own. In addition, whenever possible, the inguinal zone should be protected from mechanical damage and injury, radiation. When playing sports, you must use protection.
The prognosis for lichen is usually uncertain. Due to the high risk of degeneration of the disease into squamous cell carcinoma , regular examinations should be performed.
In conclusion, it should be noted once again that skin diseases always require a qualified approach to treatment. Only a doctor can recommend appropriate therapy for pathology.