Varieties and atypical forms
There are several types of the disease, which differ in their symptoms:
- typical shape
- ring-shaped,
- erythematous,
- warty (sometimes called verrucous),
- pemphigoid,
- atrophic,
- erosive-ulcerative.
There are also very rare types - obtuse, serpiginous, erythematous.
Lichen planus is changing, and now the pathology has characteristics that did not exist several decades ago. This is due to environmental changes, frequent use of antibiotics and other factors.
The disease today has the following features:
- relapses occur faster;
- Atypical variants of the disease occur more often;
- cases of malignant transformation of affected cells have become more frequent (up to 10-12%).
Reasons for appearance
The disease was first identified in 1860, but since then doctors have not been able to determine exactly what the prerequisites for its appearance are. Today, doctors do not have a common opinion about the origin of lichen. This is partly why there are no therapeutic agents that eliminate the cause of this disease and cure it completely.
Scientists can identify only a certain group of factors that contribute to the occurrence of the disease:
- Genetic predisposition (genetically predetermined characteristics of immunity).
- Internal disorders (immune problems, neurological problems).
- External influences (the influence of viruses, allergens, side effects of using certain drugs).
On the surface of the body there are characteristic places that are most susceptible to lichen planus - the joint area of the wrist, forearm, lower leg, sacrum, skin of the penis. Speaking of mucous membranes, plaques appear in the mouth and genitals.
Is lichen ruber contagious?
There is no definite answer to this question, since all theories about the occurrence of this dermatosis are currently unproven. However, there are known cases of lichen planus occurring in members of the same family, including both spouses. In addition, an episode of infection of a doctor who took tissue from a patient’s lesion (biopsy) for further research is described. A month after the manipulation, his first single lesion appeared, and three weeks later, new numerous rashes, identical to those that his patient had.
Therefore, we should not forget that infection is probably still possible, but most likely through close contact. And if you live with a sick person, then make it a rule: do not share scissors, a razor, a toothbrush cup, underwear, a towel, clothes or shoes with him.
Why is it dangerous?
A complication of lichen can be stomatitis.
If you identify the red form of lichen in a child in time and carry out treatment, the outcome is favorable. Otherwise, the usual form of the disease turns into erosive-ulcerative and a significant part of the oral mucosa is injured. In this case, secondary bacterial infection is often observed, aggravating the situation. The following complications of advanced lichen planus in a child are possible:
- development of an advanced form of pathology, which increases symptoms and treatment time;
- accession of stomatitis.
Is it contagious
This disease is not transmitted. So you may not have to worry about sex or domestic contacts. However, it is worth considering that if a man suffers from such lichen, it means that not everything is in order with the immune system. Therefore, there may be other infections and viruses present in the body.
And we should not forget that research and statistics indicate that this infection is not contagious. However, humanity is changing, becoming resistant to what was previously ill, and vice versa.
That is why, if such a problem occurs on the penis, it is better to refrain from sexual intercourse until the problem is completely eliminated. Otherwise, there is a risk that the partner will no longer be immune to such a disease due to some genetic mutations.
Localization
Lichen planus differs significantly from other forms of this disease. As a rule, the inflammatory process manifests itself in the following places:
- joints and forearms in the flexion area;
- neck area;
- shin;
- external genitalia in men.
As for the mucous membrane, the infection manifests itself in the following places:
- mucous membrane of the genital organs;
- oral mucosa.
Pathology most often manifests itself in the mouth. At the initial stage of development, lichen planus symptoms resemble ordinary stomatitis. However, medications to treat stomatitis do not provide any relief.
Symptoms of lichen planus
Lichen planus in humans, despite the peculiarities of its course in various forms, has common features that help distinguish it from other skin diseases.
Group of symptoms | Specific manifestations |
Localization | Often: elbow bends, surfaces of the forearms, in the armpits, on the abdomen, on the thighs, near or directly on the genitals, on the legs and lower back. Uncommon: all mucous membranes. Very rare: scalp. |
The patient's feelings | Often: accompanied by itching, which is difficult to control. Not often: in addition to severe itching, painful sensations are present, especially with the development of erosions and ulcers. Rarely: there are no unpleasant sensations at all. |
Additional symptoms | In most cases, even if typical lichen rashes do not affect the oral mucosa, there are subtle white rashes on it. They can be identified by their location - close proximity in a line. |
Residual effects | Often: after all the plaques have healed, spots of increased pigmentation remain in their place. Rarely: severe damage to the skin can cause areas of hyperkeratosis and thickening to appear after healing. |
Inflammatory component | Lichen planus occurs without an inflammatory process. Cases of inflammation are possible if infection occurs through open wounds. |
Symptoms
Signs of lichen planus are spots on the skin of varying sizes. They are mainly localized on the arms, legs, hips and elbows.
Symptoms of the disease:
- the appearance of a rash;
- malaise;
- in case of injury to the oral cavity – pain, discomfort;
- lack of appetite.
Spots with scales and a rough surface measuring more than 1 centimeter form on human skin. Slightly raised lumps of a shiny color appear on the skin. After some time, they acquire a bluish-red color, so they can be easily seen. There is a small dent in the center.
The spots can become larger and larger over time, resulting in the formation of a large plaque. After the rashes disappear, brown pigment spots remain in their place.
Symptoms for each person can be varied, it all depends on the location of the formations and the course of the disease. Some people have fever, chills or chills. Lichen planus can form on the hands near the nail plate. Some people may have constant relapses. Lichen planus can last from one month to six months.
Lichen planus is divided into five types:
- Lichen vulgaris manifests itself as plaques of an indeterminate shape and pinkish color.
- Hypertrophic appearance, when large wart nodules appear.
- Atrophic form, spots on the skin similar to pigmentation.
- The bullous form consists of blistering formations.
- An erythematous appearance where spots form and the skin turns red.
Only an experienced specialist can diagnose the disease, so at the first sign of a rash you should consult a dermatologist or infectious disease specialist. Diagnosis is usually made by visual examination, but in some cases a skin biopsy may be required.
Unfortunately, dermatosis is a chronic disease and cannot be cured. But with timely and correct treatment, long remission can be achieved.
Stages and degrees of lichen planus
Depending on the form of the disease, the course of the disease will change.
Typical shape
It has a classic scenario for the course of the disease:
- It starts with the appearance of small spots from 2 to 3 mm on the skin. They are pink-violet or crimson-red in color. The surface is always shiny. They have slight depressions in the middle and rise above the surface of the skin.
- After some time, the spots increase and merge into plaques. The surface begins to peel off. Severe pain and itching occurs. In 25% of patients, there are no rashes on the skin, they are observed only on the mucous membrane - the mouth, the vestibule of the vagina, the glans penis. When nails are affected, cloudy spots appear and the nail bed takes on a red tint.
- Gradually, the plaques fade, heal, and the skin surface is restored. In place of the plaques, barely noticeable spots remain, which differ in color from the surrounding skin. They pass with time.
Ring shape
More often found near the genital organs, mainly in men:
- The formed plaques continue to increase and merge into a single large spot.
- After some time, the middle plaques begin to heal and a patch of healthy skin appears in the center of the spot, which has a brighter color than the color of the normal healthy skin of this person. This is how half rings and arcs of the affected skin can form.
Due to the proximity of the genitals, this form is often confused with syphilis. In this case, differential diagnosis is very important.
Bullous form
A rare form of the disease, occurring in approximately 3% of patients. It appears in the form of nodules and bubbles of different sizes rising above the surface.
They are often localized on the lateral surface of the tongue and in the area of the palatine arches. The bubbles persist for several hours, after which they open, forming erosive areas. Erosions are sensitive and easily injured; if damaged, they can bleed.
Hypertrophic form
This form of lichen is most often located on the front surface of the lower leg. Violet or brown-brown rashes appear. Already formed plaques are covered on top with wart inclusions.
There are small rashes around that occur during a typical course. This form is the most difficult to treat.
Pemphigoid form
Otherwise called bubbly:
- Instead of the classic rash and plaques, blisters filled with liquid appear. In some cases, an admixture of blood is found in the blisters.
- Often this form is combined with a typical one or occurs independently.
- The blisters heal over time, decreasing in size and taking on the appearance of a classic rash.
Moliniform form
This variety can be called nodular.
Affects the forehead, neck, buttocks, back of the neck and ears, elbow bends, back of the hands, abdomen:
- Round nodules are formed, slightly raised above the surface of the skin. They are the size of a cherry bone. They appear one after another and form dense chains or stripes.
- Over time, the nodes shrink, taking on the appearance of a normal rash. The disease ends according to the classical type.
Hyperkeratotic
This form is observed in rare cases. Its peculiarity is the different outlines of the grayish plaques. Hyperkeratotic nodules rise significantly above the surface of the mucous membrane and have pronounced boundaries.
Lesions are mainly observed on the tongue and inner cheeks.
Atrophic form
This is a rare type of development of lichen ruber as it affects the scalp.
We can say that it leaves behind the most consequences:
- The onset of the disease is similar to the typical form. A rash appears, then plaques form.
- But after the plaques heal, what remains is not clean skin, but areas of atrophy and tissue compaction. The affected areas of the head lose hair, and patchy baldness occurs.
Pointed shape
The second name for this form is perifollicular.
Often affects the scalp:
- The onset of the disease is typical; first, rashes characteristic of the typical course appear.
- Then cone-shaped nodules appear, with a spike at the top. This cone is formed from the affected hair follicle.
- After the cones heal, minor depressions appear in their place, and miniature nodules may remain in some of them.
Exudative-hyperemic form
This form of the disease is quite rare. Symptoms are expressed in the appearance of nodular formations, redness and swelling of the oral mucosa. Papules often develop into small plaques. The main complaints of patients include pain during conversation and burning sensation when eating food.
Erosive-ulcerative form
It is considered the most dangerous form of the disease, since characteristic open wounds can become a path for infection. Also, this form, if left untreated, can degenerate into a skin neoplasm.
Mainly, mucous membranes are affected by erosions and ulcers:
- A plaque immediately forms on the mucous membrane, which is covered with a thin film. When the covering of the plaque is damaged, bleeding begins.
- The skin surrounding the affected area becomes inflamed, and additional small rashes may appear.
- In place of the plaques, ulcers appear that require treatment. If all rules are followed, ulcers heal successfully without leaving marks.
This form of the disease is the most painless - the affected mucous membrane at all stages does not cause concern to the patient.
Atypical form
A common location for this form is the upper lip and mucous membrane of the gums. It appears in the form of nodular formations rising above the surface, covered with a gray coating. When eating food, the patient often experiences a feeling of discomfort and pain.
Shingles
Herpes zoster (shingles, Herpes zoster) is based on the reactivation of chickenpox infection.
Since the virus persists after the primary infection in childhood throughout life. Reactivation may be caused by stress or immunodeficiency. Shingles (Herpes zoster) on the penis is not uncommon.
The disease is accompanied by the formation of a rash in the form of blisters the size of a pinhead. After this, burning, itching and soreness occur in the skin area.
Approximately 4 days after the onset of the disease, erythema with uniform vesicles and papules is observed. After 7-12 days, the rashes dry out and form brown crusts. After 2-4 weeks, complete healing of the skin can be observed.
Shingles in the genital area requires special attention. To eliminate the risk of complications, it is necessary to begin a course of antiviral therapy as soon as possible.
Experts recommend starting to take antiviral drugs in the first 72 hours after the rash appears. Therapy is aimed at relieving symptoms and shortening the duration of the disease.
Herpes zoster (shingles, Herpes zoster) is based on the reactivation of chickenpox infection.
Since the virus persists after the primary infection in childhood throughout life. Reactivation may be caused by stress or immunodeficiency. Shingles (Herpes zoster) on the penis is not uncommon.
Diagnosis of lichen planus
The diagnosis is made on the basis of clinical data and histological examination - examination of the affected tissue using a dermatoscope or analysis of material taken during a biopsy.
To select the correct treatment tactics, you must pass:
- detailed blood test - clarifies the diagnosis, excludes inflammatory and allergic processes in the body;
- biochemical blood test - evaluates the functioning of the liver and kidneys;
- General urinalysis - excludes inflammatory diseases of the urinary tract.
To identify or exclude pathologies of internal organs, consultations with other specialists are prescribed:
- ophthalmologist, endocrinologist, therapist, gynecologist - exclude contraindications;
- dentist - evaluates isolated lesions of the oral mucosa.
To do this, a thorough medical history is taken, during which it is important to exclude contact with viruses and taking medications, the reaction to which in terms of symptoms is similar to lichen planus.
Differential diagnosis is carried out with diseases such as secondary syphilis, atopic dermatitis, psoriasis, pityriasis pilaris.
With syphilis, the rash is diverse, represented by dark red papules of the same size, dense at the base, oval in shape, painful when pressed (Jadassohn's symptom). Peeling of the Biette collar type is noted - the appearance of scales along the edges of the papules, when the peeling in the center has already ended. This disease is also characterized by positive serological reactions - the presence of antibodies in the blood serum. With lichen planus, all these signs are not observed; the papules are reddish-violet in color with an umbilical depression in the center, and are distinguished by itching.
In atopic dermatitis, the mucous membranes are not affected. The rash is usually localized on the face, knees and elbows. The skin around the rash thickens.
In psoriasis, the process is represented by red papules, on the surface of which there are white scales.
With pityriasis pilaris (Devergie's disease), yellowish-red papules appear on the skin of the extensor part of the arms and legs, and the back of the fingers (Beignet's symptom - fine peeling when scraped). When the papules merge, a surface resembling a grater is formed, the skin becomes dense and rough. This picture is not typical for lichen planus.
Treatment of lichen planus
Most approaches to the treatment of lichen planus consist of eliminating the symptoms of the disease, that is, most of its external manifestations. This means that in each specific case the treatment will be different, since everyone’s disease manifests itself individually.
So, if the main symptom of lichen planus is severe itching, then doctors prescribe the patient antihistamines, sedatives to calm the nervous system, local glucocorticosteroids, and sleeping pills.
If a secondary bacterial infection appears in the area of the rash, it is necessary to start using antibiotics in an average dosage. This must be done, since a protracted fight against microbes leads to a significant weakening of the immune system, which further contributes to the development of skin disease.
Further, the lichen can spread to large areas of the skin or mucous membrane. In this case, its successful treatment is possible only with the use of strong quinolone immunosuppressants, in particular Delagil, Plaquenil and others.
If the disease progresses, glucocorticosteroids, which have an immunosuppressive effect, are also prescribed. They give very quick results regardless of the dosage form.
There are other types of therapeutic effects, in particular, the administration of vitamins, electrosleep, acupuncture, etc. In combination with classical methods of treatment, they give a stable result, which can improve the prognosis of the disease.
Features of therapy
For LP, complex treatment is prescribed, aimed at eliminating unpleasant symptoms and normalizing the functioning of the central nervous system. Depending on the patient's health, the severity of symptoms and the reasons for their occurrence, therapy may vary. It is very important to eliminate the causative factors that provoked the pathology. It is necessary to get rid of internal and external factors.
Principles of treatment for LP
To eliminate lichen on the mucous membrane, local remedies are used in the form of extracts, ointments and oils. Doctors prescribe sedatives and antihistamines only when treating severe forms of the disease. The same applies to antibiotics, which are used in rare cases and only as prescribed by a doctor. It is recommended to supplement drug treatment with physiotherapy and diet.
Medications
Drug treatment is the best way to alleviate the patient’s condition and speed up the healing process of the affected skin.
Type of drugs and their effect | Name of drugs | Reception scheme | Cost in rubles |
Herbal sedatives to combat anxiety during itching, help improve disturbed sleep | Valerian tincture | Before meals, 20 to 30 drops with a small amount of water, 3 times a day, course – 7 days. | From 17 |
Motherwort forte | With meals, 1 tablet, 3 times a day, course – up to 3 weeks. | From 43 | |
Antihistamines will help relieve inflammation and swelling of affected tissues, reduce an allergic reaction, and reduce itching | Suprastin | During meals, 1 tablet, 3 times a day, course – from 5 days. | From 114 |
Zodak | 20 drops, 1 time per day, course – from 7 days. | From 205 | |
Fenistil | 60 drops divided into 3 doses per day, course – from 5 days. | From 390 | |
Enterosorbents will help cleanse the intestines, improve its functioning, remove toxic substances, and strengthen the immune system. | Zosterin-ultra-60% | 1 sachet in the morning 30 minutes before meals, 1 sachet in the evening 2 hours after meals, course – 10 days. | From 430 |
Enterosgel | 1 or 2 hours after or before meals, 1 tablespoon should be diluted in water at room temperature. | From 433 | |
Antiseptics for open wounds to prevent infection | Chlorhexidine (not suitable for oral use) | Treatment of the affected surface using applications with the drug 3 times a day | From 15 |
Miramistin | From 250 | ||
Corticosteroid ointments are prescribed in difficult cases when the skin does not recover on its own, when inflammation occurs | Advantan | Apply a thin layer to the affected areas of the skin, 1 time per day, for a course of no more than 10 weeks. | From 525 |
Ointments
Typically, topical medications are not used. But there are situations in which inflammation or its individual manifestations (for example, severe itching) manifest themselves clearly, therefore the use of steroid ointments (prednisolone, hydrocortisone ointment), vegetable oils, and products with phytoextracts is indicated. Their use is effective only to suppress itching; in other cases, internal remedies are used, since the cause of the disease lies inside the body.
Pills
The main treatment for lichen are 4-aminoquinoline derivatives (Chloroquine, Hydroxychloroquine) and hormonal therapy. Antidepressants and sedatives are prescribed as auxiliary agents to combat itching. Doctors often prescribe antihistamines if there is a suspicion that an allergen caused the reaction.
These are the following drugs:
- Claritin,
- Tavegil,
- Telfast et al.
To normalize the body's metabolism and quickly restore the healthy appearance of the skin, certain vitamins are prescribed, in particular, vitamin A (it is responsible for the division of skin cells), carotenoids, vitamin E (increases the effectiveness of hormonal therapy). If the disease is accompanied by frequent relapses, it is possible to use tablets that increase oxygen supply to tissues - Actovegin, Cyto-Mac.
Antibiotics and vitamin complexes
Antibiotics are used exclusively for complicated cases of lichen ruber. They fight pathogenic microflora well. As a rule, tablets from the group of macrolides (Erythromycin, Sumamed) and tetracyclines (Metacycline) are prescribed. Such drugs are not taken in other dosage forms. If there is a progressive infection in the body, Ceftriaxone solution is injected intramuscularly and 3-3.5 g of Amoxicillin is taken. After completing the course of treatment, the patient must take antifungal and immunomodulatory drugs.
To maintain the functioning of the immune system, vitamin complexes (vitamins B, C, D, Tocopherol and Retinol) must be included in the course of therapy. In cases of moderate severity of the disease, they are used in the form of tablets, and in complicated cases - in the form of injections. The complex drug Neovir has proven itself well. Its course use helps reduce vascular permeability and improve protein synthesis in soft tissues.
Antihistamines
Antihistamines are used to relieve itching and reduce the activity of allergens. After their use, epithelization of lesions is observed in some patients. The doctor prescribes antihistamines only if the cause of lichen ruber is direct contact with an allergen. When a pathological process is caused by a malfunction of internal organs, their use is considered inappropriate. The following medications in tablet form are characterized by the greatest effectiveness: Claritin, Erius, Tavegil, Suprastin.
In case of a severe allergic reaction, drugs are prescribed in courses of 7-10 days. Their action is aimed at blocking cellular receptors that are affected by histamine. If after this period it was not possible to overcome lichen ruber, they move on to hormonal therapy. It is highly undesirable to simultaneously use antihistamines and immunomodulatory drugs. This can aggravate the allergenic reaction and cause the Wickham's grid symptom.
Sedatives
Sedative medications are prescribed only in cases of urgent need, when the patient has been tense for a long time. Among the most popular drugs are Medazepam and Phenazepam; the course of treatment lasts approximately 10-14 days.
Corticosteroids
Highly effective corticosteroid drugs, such as Clobetasol, Triamcinolone, used 2-3 times a day for 2 weeks. The drug "Clobetasol" can be purchased for 400 rubles, "Triamcinolone" costs 250-350 rubles.
Diet
There is no special diet for the treatment of lichen planus. However, nutrition plays an important role, because it is impossible to cure lichen planus by abusing foods harmful to the body. In addition, taking some drinks can reduce the effectiveness of drugs, and a number of products can cause allergic reactions and provoke a sharp increase in blood sugar levels.
During the treatment period, you should avoid drinking alcohol and confectionery. Products that it is advisable to limit your consumption include:
- citrus;
- products containing cocoa;
- products containing purine: meat and dishes prepared on its basis (broth, meat sauce, jelly); fatty fish, fish soup, fried and salted fish, canned fish; meat by-products; mushrooms;
- legumes: peas, beans, soybeans, lentils;
- eggs;
- strong brewed tea or coffee;
- products with a high content of preservatives, dyes, flavoring additives: sausages, canned food, carbonated drinks.
The following products will benefit the body:
- dairy;
- green vegetables;
- healing mineral water;
- iron-containing products;
- honey.
A diet for lichen planus is necessary if the disease often recurs and is difficult to treat.
It is better to introduce each new product into the diet gradually. If the condition worsens, the diet should be extended.
Immunotherapy
In the process of complex treatment of lichen planus, supporting the patient's immune defense is of considerable importance. For this purpose, exogenous immunomodulatory drugs of interferon and its inducers are used:
- "Ridostin";
- "Neovir";
- "Reoferon".
For more complex cases of the disease, Cyclosporine may be prescribed. Chronic pathology, accompanied by frequent relapses, requires drugs that fill the tissues with oxygen.
Folk remedies
There are several folk recipes for eliminating lichen planus:
- Herbal collection. Mix chamomile, string and sage (1:1:1) and brew 1 tbsp. l. per glass of boiling water. The product is taken three times a day, it relieves inflammation, calms the nervous system, and strengthens the body.
- To strengthen the fight against skin irritation, prepare cold lotions from a decoction of the string (20 g of herb per 1 cup of boiling water).
- To treat plaques directly, crush 50 g of garlic cloves and infuse in a glass of vodka. Wipe the affected areas of the skin with the product.
- A cabbage leaf has a good effect, the surface of which is smeared with sour cream, after which it is applied to the rash. It alleviates the symptoms of the disease and accelerates skin healing. Traditional methods of treatment cannot be considered as the main ones. They only complement drug therapy prescribed by a doctor, but on their own cannot effectively cope with the disease. Moreover, it is recommended to consult a dermatologist about the self-treatment methods you choose to make sure that they will not harm the body.
Sea buckthorn oil applications
Soak a piece of gauze in sea buckthorn oil and apply it to the affected area of the body for 30-40 minutes. Repeat the procedure daily for 14 days. After just a few days of treatment, the itching will go away, and the size of the lichen will begin to decrease.
Herbal compresses
Mix 1 tbsp in one bowl. l. celandine and willow bark with 3 spoons of mullein flowers. Pour the resulting mixture with 1 liter of boiling water and leave for 40 minutes. Strain the broth and make compresses from it twice a day.
General recommendations
Experts highlight several recommendations for patients prone to relapses of lichen planus in order to combat the disease as successfully as possible:
- eliminate all carious cavities in the mouth using filling;
- visit your dentist regularly;
- find out if you are allergic to something and avoid contact with allergens;
- do not allow the exacerbation of chronic internal diseases, especially those of an infectious nature;
- practice regular rest, eliminate stress at work.
Treatment methods
By taking comprehensive measures, you can cure the disease in a short time. First of all, you need to calm down and not worry, so the doctor may prescribe sedatives. These are valerian, motherwort, and various pharmaceutical preparations based on medicinal herbs.
Treatment of lichen planus also includes antihistamines. They eliminate severe itching on the skin and help to calmly endure the disease.
These include:
- Suprastin.
- Zyrtec.
- Fenistil gel and solution in drops.
- Clemastine.
If you suffer from insomnia, then tablets are prescribed to improve sleep and relieve pain symptoms: Diphenhydramine, Suprastin.
The main method of treatment is external agents. They are applied to the lesions in a thin layer. These are corticosteroids in the form of ointments or gels, water mixtures with diphenhydramine to soothe itching. When the mucous membranes are affected, dibunol ointment 1% is needed.
If the rashes are allergic in nature, then non-hormonal ointments are used: Gistan, Fenistil gel. Salicylic ointment has an exfoliating effect, which relieves inflammation and removes dead skin cells. As a result, healthy cells grow and the skin heals.
When a bacterial infection occurs and purulent processes appear, antibacterial drugs and antibiotics are prescribed. Vitamin therapy is required to boost immunity. Vitamin A is especially necessary; it accelerates the death of affected cells, reduces their division and promotes skin healing. Preparations containing this vitamin include: Acitrin, Tigazon.
Stains can be treated with hydrogen peroxide 3%; it will not only disinfect the skin, but also help restore the epidermis.
If there is no result within a certain time, the doctor prescribes hormonal drugs. But you should not abuse them, they will only hide the external signs of the disease and after a while a relapse of the disease may occur. In addition, side effects may occur: itching, redness, increased rashes. Therefore, it is not recommended to use hormonal drugs without a doctor’s prescription.
The most effective are considered:
- Hydrocortisone.
- Flumethasone.
- Cloveit.
An effective remedy for severe rashes is physiotherapy. PUVA therapy, UVA irradiation, laser and magnetic therapy are used. It promotes rapid skin restoration.
Diet is of no small importance in treatment. It is observed for a long time until the disease recedes. Despite some restrictions, nutrition should be balanced and nutritious. A strict diet is necessary if the oral mucosa is affected. Since spicy and hard foods can cause irritation and increase in lesions.
When the disease worsens, some foods should be excluded:
- containing dyes and stabilizers: these are sweets, sausages, chocolate, sweet pastries;
- hot seasonings, fatty foods;
- exclude allergens from the diet;
- eggs, chicken;
- juices, carbonated drinks, alcohol.
The diet should contain only natural products:
These include:
- cereals;
- pasta;
- fish and meat (boiled, stewed, but not fried);
- dairy products: cottage cheese, kefir;
- green fruits and vegetables. Citrus fruits are prohibited.
Diet promotes rapid recovery. Often, the cause of lichen planus can be an allergic reaction to some foods, vegetables, fruits or berries.
Treatment of lichen planus is also possible using folk methods along with drug therapy. It is recommended to lubricate the spots on the skin with various oils. They reduce swelling, soften papules and promote rapid healing of lichen.
The following oils are considered effective:
- Calendula.
- Sea buckthorn.
- St. John's wort.
- Rosehip.
- Birch tar.
You can relieve the symptoms of inflammation with a compress:
- any oil must be heated in a water bath so that it is not cold;
- it is applied in a thin layer to the affected area and gauze soaked in this oil is placed on top;
- wrap the top with cling film;
- secure with a bandage or adhesive plaster, you can wrap it with a scarf;
- leave for several hours.
The compress should be on the skin for 24 hours. But after 3-4 hours, it needs to be replaced with a new one, this is the only way to achieve results.
It is imperative to monitor the skin; if its condition worsens, then compress procedures should be canceled.
If lichen appears in the oral area, then apply a cotton pad soaked in warm oil to the affected skin. You should periodically change the cotton wool soaked in oil.
You can prepare decoctions for drinking. Effective herbs for the fight against lichen planus are: string, oregano, yarrow, horsetail. In some cases, it is recommended to take herbal baths. Only the water in it should be warm, no more than 37 degrees.
Traditional methods can be used only after consultation with a doctor. After all, some recipes can cause an allergic reaction and aggravate the situation. Swelling, enlarged papules, and nausea may appear. Which methods are allowed to be used can only be advised by a doctor, depending on the severity of the disease.
What not to do
When treating lichen planus, you should not:
- take medications without the knowledge of a doctor;
- use shower gel that contains chemicals;
- take antibacterial drugs;
- mechanically influence the skin rash (rub or scratch);
- visit a bathhouse, sauna or swimming pool;
- drink alcoholic beverages;
- eat sweets, spicy and fatty foods. If you have lichen, you should not swim
Failure to comply with these rules can lead to negative consequences, for example, self-administration of medications will cause side effects. Therefore, when diagnosing LP, all your actions must be coordinated with your doctor.
Complications
Lichen planus is especially unpleasant in the genital area, in the vagina. The disease leads to pain and disrupts sex life. Scars may remain in place of the elements. Sexual dysfunction may subsequently persist for a long time.
There is evidence that lichen planus, although to a small extent, may increase the risk of squamous cell carcinoma. Your dermatologist may recommend that you be screened for cancer cells in the lesions.
Skin pigmentation in places where nodules and plaques were located persists for a long time.
Pityriasis rosea
Zhiber's lichen or pityriasis rosea refers to infectious-allergic dermatous pathologies. Pityriasis rosea or Pityriasis rosea on the penis is characterized by the development of patchy rashes that can last up to 6 weeks on average.
There is an opinion that this type of lichen is contagious (infectious), but this judgment is erroneous. Pityriasis rosea can go away on its own, even without drug treatment. In some patients, scaly redness on the penis may persist for several months. Until they completely begin to regress over time.
In almost 90% of cases, the disease is asymptomatic, sometimes accompanied by itching. The development of pityriasis rosea can be facilitated by a decrease in immunity due to a viral or infectious pathology. More often the disease is diagnosed in men aged 10 to 40 years.
Zhiber's lichen or pityriasis rosea refers to infectious-allergic dermatous pathologies. Pityriasis rosea or Pityriasis rosea on the penis is characterized by the development of patchy rashes that can last up to 6 weeks on average.
Prevention
As you know, it is better to prevent any disease than to treat it. A number of simple recommendations will greatly reduce the risk of developing the disease.
- To prevent the risk of developing the disease, you should carefully monitor the health of your body and consult a doctor in a timely manner. Carefully monitor and exclude from circulation items that constantly injure the skin and mucous membranes.
- Proper nutrition, adherence to a routine and maintaining personal hygiene can significantly reduce the likelihood of acquiring pathology.
- It is recommended to lead a healthy lifestyle, play sports and give up bad habits.
- Hardening will help to avoid many diseases, including lichen red.
Ringworm is a fairly serious disease that can lead to dangerous complications. But with proper and timely treatment, the prognosis is very favorable and a complete recovery of the patient is possible.
What preventive measures should be taken?
As part of the prevention of lichen planus of the oral mucosa, it is necessary to follow a number of the following recommendations:
- It is very important to practice good hygiene when caring for your mouth.
- It is advisable to choose a good toothpaste that should have an anti-inflammatory effect.
- It is necessary to fill carious cavities in a timely manner.
- Dentures should be installed only from high-quality materials that do not cause allergic reactions. It is very important to avoid metal structures.
- It is also necessary to check the quality of the master’s work. Do not wear dentures with uneven surfaces or sharp edges.
- It is recommended to take vitamins regularly and strengthen your immune system.
- It is necessary to minimize relapses of chronic diseases as much as possible.
- It is equally important to monitor the functioning of the digestive system. The stomach and intestines must be healthy.
The appearance of plaques in the mouth, along with the development of inflammation, discomfort and pain, is a reason for an early visit to a dermatologist. In addition, you may need the help of a dentist, and at the same time a specialist in dental prosthetics. Taking comprehensive measures will certainly help every person get rid of such a problem as lichen ruber in the oral cavity.
Treatment with folk remedies: where to start?
Before starting treatment using traditional methods, try to establish the root cause of the rash and how to properly eliminate it.
Very often, the appearance of lichen planus is associated with gastrointestinal diseases such as chronic gastritis, duodenal or gastric ulcers, cirrhosis of the liver, as well as with some endocrine pathologies, including diabetes mellitus.
Often, characteristic dermatitis appears as a reaction to the re-prescription of medications - in this case, you just need to find a replacement for them.
Before starting treatment for oral lichen rubra caused by injuries to the mucous membrane, it is necessary to eliminate the factors that led to its appearance: cure caries, change dentures, grind sharp edges of teeth, stop eating spicy foods and smoking.
Question answer
Is lichen planus transmitted in any way?
This disease is not contagious. It is not transmitted either through household or sexual contact.
If the lichen goes away on its own, does that mean I’m cured?
Often, lichen planus lesions disappear spontaneously. But after a while they recur. Pay attention to existing chronic diseases. Strengthen your immune system.
I discovered lichen planus on my leg. Can I start treatment with hormonal ointments and dexamethasone on my own?
Self-prescribing treatment with corticosteroids, which includes dexamethasone, is strictly contraindicated. With long-term use of the drug, it is necessary to gradually reduce its dosage to avoid withdrawal syndrome.
I turned to a dermatologist with the problem of red lichen. As a result, I was referred to a dentist and a gastroenterologist. Why do I need additional examination? Or is this a scam for money in a private clinic?
A referral to a dentist is mandatory if there are manifestations of lichen on the oral mucosa. An appointment with a gastroenterologist is necessary to treat the underlying disease if there is a history of gastrointestinal problems.
Diagnostics
If skin rashes appear, you should consult a dermatologist. The diagnosis of lichen planus is made by a dermatologist and does not present much difficulty, since it is almost always possible to detect typical polygonal plaques with a characteristic color, smooth surface, umbilical depressions, and transverse striations.
A differentiated diagnosis is made to exclude leukoplakia, lupus erythematosus or syphilis. The main direction is to identify underlying diseases that provoke the disease. Detailed questioning of the patient may determine a precipitating factor or heredity.
What to remember:
- Lichen planus is not a contagious disease; it does not have a specific pathogen. You can't even get infected through sexual contact.
- This disease is a consequence of immune disorders, a reaction to one’s own cells as if they were something foreign. An important role is played by genetic predisposition, chronic viral infections (mycoplasmosis, chlamydia) or functional diseases (gastritis, colitis, pancreatitis, cholecystitis).
- Lichen has many forms and can be localized in various parts of the body, mucous membranes of the mouth, penis and vagina. Rarely the scalp and nails are affected.
- Lichen is diagnosed by a dermatologist based on an examination; in difficult cases, a section of the affected skin is taken for examination (biopsy for histology).
- Drug treatment must be consistent. It is prescribed individually, depending on the shape and location of the lesions.
- For local treatment, hormonal ointments are used (for example, Celestoderm).
- It is almost impossible to cure lichen planus completely; the disease will appear again and again. Therefore, pay attention to the prevention and timely treatment of major diseases (allergies, viral infections, gastrointestinal diseases).
Causes
This type of lichen belongs to the so-called dermatoses, that is, skin lesions as a result of multifactorial effects. It is characterized by fairly extensive damage to the skin. It should be noted that the definitive causes of the formation of lichen planus have not been established. Currently, there are a number of scientific theories that substantiate the relationship between the development of symptoms of lichen planus and various systemic pathologies, nervous stress and immune disorders.
Various dysfunctions of the immune system cause the long-term nature of the disease, as well as a non-standard reaction of the skin to various external and internal damaging factors. Cases of red lichen in members of the same family have been repeatedly described. This proves a certain genetic predisposition, since a person with such lichen is not contagious and not dangerous to others.
Numerous studies prove the existence of a direct relationship between the primary occurrence or new exacerbation of lichen ruber and various stresses (both positive and negative), hypnotic effects, and segmental reflex therapy.
There is an undoubted relationship between this skin disease and chronic therapeutic pathology, such as:
- diabetes;
- chronic inflammatory-dystrophic processes of the gastrointestinal tract;
- hypertonic disease.
Currently, lichen planus is considered as a kind of pathological toxic-allergic reaction of the body to various chemical compounds. These include:
- photographic film developer;
- tetracycline antibiotics;
- gold compounds;
- anti-tuberculosis drug PAS.
This type of lichen is characterized by a long and persistent course. A complete cure for lichen planus is almost impossible. With certain long-term treatment, it is possible to achieve a long period of remission.