Red lichen is a type of dermatosis of a chronic course. The main symptoms of the disease are itchy rashes with papules on the mucous membranes, skin surface, and nails. Irritation is accompanied by severe itching. According to statistics, the majority of patients suffer from mucosal lesions. In 12% of cases, the pathology degenerates into an oncological disease. The least at risk are older and younger people.
Causes
In medicine, the course of the disease has been well studied, but it is not completely known why a person has lichen red. The causes of the pathology are numerous, scientists consider them as factors that cause the body's reaction.
The most common theories of the occurrence of the disease:
- Neurogenic. It is believed that the lesion occurs due to psychological trauma, as a reaction of the nervous and immune systems to shock. When examining some patients diagnosed with red lichen, it turned out that they suffered from some kind of central nervous system disorder. It was often observed that dermatosis spread along the course of nerve fibers, the disease was acute when the patient had neuritis. Also at risk are people with lesions of the spinal nerve processes (hernia of the intervertebral disc, trauma, sciatica, etc.).
- Viral, infectious. According to this theory of the origin of dermatosis, the virus is in an inactive state in human skin, under the influence of provoking factors it activates and provokes the growth of the upper layer of the skin, the immune system begins to produce antibodies and as a result “devours” not only hostile, but also cells of its own epidermis.
- Inherited. In favor of the theory is the fact that in the family several generations suffered from this form of dermatosis. In children with a hereditary predisposition, damage manifests itself at an early age. The course of the disease takes a long time in acute form, periods of remission are short, and relapses occur frequently.
- Intoxication. There are more than 25 drugs that cause red lichen, some of them are used to combat the defeat. In some cases, an opposite reaction of the body is observed, and instead of positive dynamics, an additional lesion occurs.
- Autointoxication. In part of the tests performed, many patients had impaired liver function, while there was some disease that damages the internal organs with toxins (cirrhosis, diabetes mellitus, hepatitis, etc.). Some patients with dermatosis had carbohydrate metabolism disorders.
- Immunoallergic is the most promising theory of the origin of the disease. According to her, the immune system cannot recognize the cells of her body, perceives them as foreign and attacks, resulting in a global damage to the epidermis, mucous membranes.
Forms
Red lichen has the following forms of the disease:
- Typical. External manifestations are spots of saturated pink color, polygonal shape. The color of the lesion may acquire a purple hue.
- Hypertrophic. This form of lesion looks like plaques and nodules, the surface of the lesion is similar to layering of warts. The color of the affected area is red or brown. Most often localized on the front surface of the legs.
- Atrophic. It develops in places where the development of sclerotic, atrophic changes caused by the appearance of papules is observed.
- Bubble The manifestation of this form is the formation of vesicles filled with serous or serous-bloody fluid. Rashes of this kind can appear both on healthy skin and on the surface of plaques. Typical places of distribution are the lower legs and feet. If large bubbles appear, then a bullous form of pathology is diagnosed.
- Moniliform. The rash appears on the forehead, behind the ears, on the back of the palms, stomach, bends of the elbows, on the neck, buttocks. The shape has a rounded, shingles like a necklace.
- Pigmented. In addition to the usual itching for red, itchy spots appear on the body, brown shades filled with nodules. They are often a harbinger of the appearance of a common lesion.
- Spiky. Characteristic rashes are papules with a horny spike. It spreads in the neck, lower extremities, shoulder blades.
- Ring-shaped. This form is formed due to the expansion of the lesion area due to the periphery and regression of the lesion in the center. It has the appearance of an arc, ring, half ring. Most often affects men (genital area, inner thighs).
- Erosive and ulcerative. Place of localization - mucous membranes of the oral cavity. It manifests itself in the form of ulcers, erosion with swelling of tissues and standard manifestations of red lichen. It is treated with great difficulty, relapses occur very often.
In addition to the above manifestations, rare forms of pathology are diagnosed - erythromatous, serpigiosis or obtosis.
Stages of the disease
Red lichen disease has a chronic form with periods of remission, exacerbation can be repeated up to 5 times a year. Clinical practice distinguishes several stages of the course of the disease:
- Sharp. The duration of the period is 30 days.
- Subacute. It proceeds for six months.
- Progressive. Against the background of the current exacerbation, new foci of inflammation appear, covered with papules, erosions or ulcers. Also, previously healthy tissues swell, change color, which is a sign of the beginning of the lesion process. During this period, the patient experiences severe itching, accompanied by combing with an isomorphic reaction.
- Stationary. The process of development of pathology stops.
- Remission.
- Chronic It can last for many years. The patient experiences bouts of acute illness and periods of remission.
Symptoms
A dermatologist quickly determines red lichen. Symptoms have a characteristic course and are rather narrowly expressed. The disease begins in all patients in different ways, depending on the provoking factors.
Common signs:
- The first symptoms are often mistaken for signs of malaise, colds - a slight fever, weakness, nervous excitement. After a week or ten days, the first rash appears.
- Skin lesions can begin without any noticeable preliminary symptoms. In this case, the rash immediately covers significant areas of the skin or gradually spreads, starting with a minor formation.
- Dermatosis of this type is often accompanied by poorly tolerated itching, which in many patients causes insomnia, severe irritability.
- In about 20% of patients, red lichen affects the nail plates, a particularly acute course is observed with bullous and erosive-ulcerative forms of pathology. The nails become thinner, the surface is covered with tubercles, longitudinal stripes, cracks. In some cases, the nail may disappear.
- Dermatosis often appears on the mucous membranes of the oral cavity, genitals of men and women. The first manifestation is the appearance of serous papules, clearly visible during visual examination. Gradually progressing, the rash becomes covered with plaques, capturing new sections of the mucosa and forming bizarre patterns. With a typical course of pathology, rashes do not cause pain, but itching is present.
Red lichen in a person is a serious illness that needs professional treatment and constant monitoring by a doctor. Letting it go and waiting for the disease to pass is empty hopes, so it is necessary to take measures at the first manifestations of the pathology.
In addition to the symptoms of red lichen, the main places of its localization are identified:
- The inner surfaces of the thighs, forearms, and wrist joints.
- Elbow fold, fossa under knees.
- Lower abdomen, lower back.
- Palms and soles.
- Armpit area, ankle joints.
- Often covers the body on the sides.
Diagnostics
A dermatologist makes a diagnosis based on an external examination of the affected skin of the patient. The characteristic visual manifestations do not leave a specialist doubt that in front of him is a patient affected by red lichen. A typical sign is always plaques with numerous angles, a bright color of the rash, transverse striation, a developed pattern, etc.
A lot of information about the nature of the pathology is provided by the location of the dermatosis, its spread and the general condition of the patient. An evidence-based diagnostic method is a biopsy of the affected area of the skin.
Drug therapy
An effective treatment for red lichen is based on the theory that this type of dermatitis is an immune inflammation that destroys skin cells.
In therapy, the following groups of drugs are used:
- Immunosuppressants. The drugs inhibit the migration of cells of the immune system, thereby eliminating the mechanism of damage to skin cells ("Chloroquine", "Cyclosporin A", "Hydroxychloroquine,"). Funds are prescribed in the form of tablets or injections. To achieve the result requires a long period of admission.
- Corticosteroids. They suppress immunity, which significantly reduces the productivity of lymphocytes, and inhibit the release of the main allergen - histamine (Prednisolone, Metipred).
- Interferons, interphenogens - a group of drugs is prescribed for severe pathology. Means normalize the production of lymphocytes, suppress viruses ("Interferon-alpha 2b", "Neovir", etc.).
- Systemic retinoids. They contribute to the regeneration of the skin, accelerate the exfoliation of the dead layer of the epidermis, stimulate healing (“Acitretin”, “Isotretinoin”, “Tigazone”, “Etretinate”, etc.).
- Antihistamines (Loratadin, Diazolin, Suprastin, Hydroxyzine, etc.).
- Antibiotics indicated. Resist pathogenic bacteria, microorganisms (tetracycline group, "Azithromycin", "Sumamed", etc.).
An important factor in effective treatment is the creation of conditions for recovery:
- Stress is eliminated.
- The patient is prescribed a diet.
- Sanitation of the oral cavity, treatment of all lesions, chronic inflammation is carried out.
- Drugs with severe side effects are excluded.
- In professional activities, labor in hazardous industries is excluded.
Therapy is systemic, requires patience from the patient and perseverance from the doctor.
Physiotherapy
The complex of treatments for dermatosis includes physiotherapy methods.
The most effective are:
- PUVA therapy. Ultraviolet irradiation with prior administration of photosensitizers. The method quickly suppresses the division of damaged skin cells. The result is noticeable from the first sessions, for a complete cure 20-30 procedures are necessary, remission lasts several years.
- Laser therapy and magnetotherapy. Significantly reduce peeling, itching, cause a decrease and reverse development of papules, contribute to the healing of injuries (erosion, ulcers). The number of sessions is purely individual and determined by a specialist.
Any dermatosis is a consequence of chronic diseases, red lichen is no exception. Treatment is carried out against the background of therapy for the main pathology (neurosis, stomatitis, diabetes mellitus, etc.). To maintain general condition, the patient is prescribed vitamins with the mandatory inclusion of vitamins C, E, group B. With severe itching and loss of sleep, sedatives are prescribed. To improve blood circulation and blood supply to tissues, vascular preparations are prescribed.
Ointments
Ointment from red lichen is prescribed to eliminate itching, peeling, healing of injuries and restoration of the skin.
Most often, doctors recommend the following drugs:
- Corticosteroids - Hydrocortisone, Betamitazone, Flumetasone, Cloveit, etc. Reduce the activity of the cells of the immune system (white blood cells, lymphocytes), slow down the process of division of pathological cells, and narrow blood vessels.
- Non-hormonal antihistamines - "Gistan." Ointment creates a film that prevents the penetration of moisture, allergens, freely passes oxygen. Stimulates blood circulation, improves tissue nutrition.
- Antiallergic drugs - “Fenistil” (ointment or gel). Prevents the penetration of allergens, anesthetizes, has a cooling effect.
- Non-hormonal ointments - "Tacrolimus", "Pemicrolimus". Deactivate part of the lymphocytes, reduce inflammation, itching, redness, and skin irritation.
- Exfoliating preparations - salicylic ointment, Diprosalik, Belosalik. They reduce the level of inflammation, exfoliate dead skin cells, soften the epidermis, and normalize the permeability of blood vessels.
- Wound healing - Solcoseryl. Stimulates the healing of skin lesions, restores tissue, promotes the formation of blood vessels. The result is noticeable after a few days.
Treatment of red lichen with external agents is used to relieve immune inflammation, heal erosion and ulcerative formations, and improve skin cell nutrition. The use of any ointment is agreed with a specialist, to achieve the effect, a combination of several drugs is required.
Special cases
Red lichen in the mouth brings a lot of trouble. More often this ailment affects women. Treatment is aimed at eliminating the causes of dermatosis and therapy of manifestations of pathology.
What needs to be done:
- Cure inflammation of the oral cavity (caries, stomatitis, etc.).
- During remission, replace existing prostheses with better ones.
- Cure gastrointestinal diseases.
- Identify hidden allergies (food, medications, etc.) and take measures to stop them.
Treatment is carried out according to the doctor’s recommendations using the general rules of treatment for the identified disease, in addition to them, the following is recommended:
- Taking medications to suppress immune allergies, antihistamines (Tsetrin, Zirtek, Loratidin, etc.).
- Treatment of ulcers on the mucous membrane (Solcoseryl, sea buckthorn oil, etc.).
- Reception of vitamins with retinol, carotenoids ("Tigazon", "Fenoro", "Neotigazone", etc.).
Red lichen in a person with damage to the mucous membranes is difficult, often returns. The patient experiences pain during eating, therefore, a diet is recommended, the basis of which is dishes that are steamed or boiled. Excluded products that irritate the mucous membrane, spicy, sour, salty, hot, cold. Preference is given to liquid cereals, mashed soups, a variety of mashed potatoes.
Red lichen in a child most often occurs due to a genetic predisposition. Why the defeat develops in the absence of close relatives with such a pathology, medicine does not yet know. A mild form of the disease does not require treatment, irritation will disappear after 1-2 months. In this case, only external agents are used, preference is given to natural oils (sea buckthorn, olive, etc.).
In cases where dermatitis progresses, the child complains of severe itching, treatment of the lesion is carried out by the same methods as in the case of an adult disease. With appointments, the dosage of the drugs is adjusted, folk remedies are used in the absence of allergies. Traditional medicine methods are more welcome than pharmacological drugs.
Folk remedies
Most dermatologists give a positive prognosis in the treatment of dermatitis such as red lichen. Folk remedies in many ways help to overcome the ailment and its consequences.
Some effective recipes:
- Calendula oil. Plant flowers are poured with vegetable oil in a glass bottle. Insist 1-1.5 months with dimming, periodically shake. Affected areas are lubricated several times a day. The effect is a decrease in irritation and lichen area, the reverse development of papules, antimicrobial action, and mitigation of the epidermis.
- Birch tar. The tool is purchased at the pharmacy. Dressings from tar gauze impregnated with tar are applied to places of localization of rashes. The action time gradually increases from 10 to 30 minutes. It reduces the severity of inflammation, stimulates regeneration, and disinfects wounds.
- Sea buckthorn oil is a finished drug. It is used in the form of compresses for the skin (they impregnate the tissue and apply several times a day), the mucous membranes are lubricated. Accelerates wound healing, relieves inflammation.
Since it is not known what causes red lichen, doctors can not clearly say whether dermatosis is transmitted from person to person. Some experts call for prudence and avoid close contact with a person who is diagnosed with a pathology.
Confirmation of infectivity are numerous examples of family failure, when both spouses and children sequentially fall ill with lichen. Also, cases of infection of doctors who performed biopsies of the skin of the patient are known. As a precaution, do not use with the patient one towel, hygiene items, a razor, tweezers, clothes, shoes, etc.