Lichen planus on the head. Lichen planus in humans

Red lichen planus refers to chronic skin diseases that are difficult to treat due to the unclear cause of its development. For lichen planus the most effective treatment This is the one that helps a specific patient, since there is no universal treatment regimen; it is selected on an individual basis.

The disease occurs in people over 40 years of age; women are more susceptible to the disease than men. Why such skin lesions appear is still not known. Presumably, the following factors may be the causes of the disease:

• genetic predisposition;
• disruption of the nervous system;
• chronic diseases of the gastrointestinal tract;
• metabolic disorders, including diabetes;
• source of infection in the body;
• immunodeficiency;
• severe allergic reaction.

The disease begins in the forearms or on the inner thighs. Ringworm primarily affects delicate areas of the skin; at first, characteristic rashes may appear in the area inguinal folds or in the armpits.

How to recognize lichen

The disease manifests itself as a rash, the color of which is very different from the natural color of the skin. The rash is usually red, brown or bluish in color. It consists of dense small nodules. Each nodule has a smooth surface and bright color, small dents may form in its center.

The nodules itch and cause discomfort. Over time, they can merge into large islands of a dense rash that looks like plaques. The skin around the plaques is dry and flaky.

In most cases, the disease also affects the mucous membrane of the mouth, and the formation of nodules on the genitals is possible.

Ringworm can also affect the nail beds, causing the nails to peel, thin, and possibly atrophy.

Treatment principle

There is no universal treatment regimen common to all patients. Depending on the intensity of skin damage, treatment can be adjusted and supplemented.

Often used to treat illness following types drugs:

• sedatives;
• antibiotics in tablets and ointments;
• anti-malaria drugs;
• special diet;
• ointments with corticosteroids;
• antihistamine tablets;
• general strengthening drugs to improve immunity

A number of physiotherapeutic methods are often used for treatment.

To remove acute symptoms and swelling of the skin, various tinctures are used, as well as gels and ointments for applications.

Sedatives

One of possible reasons The appearance of a skin disease such as lichen ruber is a disruption of the nervous system. This disease is often encountered by people exposed to frequent stress. The problem in this case can be solved with the help of sedatives.

What medications to take is determined by the doctor, depending on the severity of the symptoms. nervous exhaustion.

For sleep disorders, the patient is shown sedatives herbal, while treating anxiety may require stronger medications, such as tranquilizers or antidepressants.

The safest sedatives are:

• peony tincture;
• tincture of valerian root;
• glycine.

The tincture is easy to purchase at any pharmacy and is quite inexpensive. The dosage of the medicine is selected by the doctor individually for each patient.

The amino acid glycine is a good sedative medicine that is not addictive and does not depress the activity of the nervous system. This drug is available in tablets. A course of treatment with this medicine will relieve symptoms of nervous exhaustion, stress and insomnia.

Patients are often prescribed B vitamins to strengthen the nervous system. For mild deprivation, such treatment, together with ointments for treating the skin, quickly brings results.

Ointments for skin treatment

To treat rashes, patients are prescribed an ointment or cream for local treatment of the affected areas of the skin. Depending on the severity of symptoms, the following drugs are used:

• salicylic ointment;
• corticosteroid ointment;
• dibunol ointment.

At extensive rashes merging into large plaques, an ointment containing corticosteroids is used for treatment. Such treatment should only be prescribed by the attending physician, since these drugs have a number of contraindications and side effects. As a rule, treatment with this remedy is carried out in a short course.

Salicylic ointment helps exfoliate dead skin cells of the affected skin and improves regeneration. It is used for mild rashes and to soften plaques and nodules on the skin.

If the rash is localized on the mucous membranes, patients are prescribed dibunol ointment to treat them. This cream is applied pointwise to the affected areas.

Other drugs

Since the disease is chronic, treatment must be supplemented restorative drugs. Patients must be prescribed vitamins; in some cases, if the disease develops against the background of immunodeficiency, the patient may be prescribed special medications to improve immunity.

Antihistamines can relieve itching, swelling and discomfort in the affected area. Allergy pills are selected by a doctor. Unpleasant sensations Lichen planus is cured the next day after starting antihistamines.

Also, to relieve swelling and itching, the doctor may recommend other drugs, for example, those used to treat malaria.

In case of extensive skin lesions, the patient is indicated for physiotherapy. Most often, patients are prescribed special ultraviolet irradiation affected areas of the skin, which helps accelerate regeneration and prevents further progression of the disease. Phototherapy is carried out in conjunction with drugs that improve the protective functions of the skin.

Nutrition principle

The basis of treatment is diet for lichen planus. Nutrition is based on avoiding the following foods:

• confectionery;
• any products with stabilizers, dyes, sweeteners and flavor enhancers;
• spicy and smoked foods, including seasonings;
• fatty food;
• game;
• chicken eggs;
• caffeinated drinks, alcohol and soda.

How long to follow the diet depends on the degree of skin damage. Often the duration of the diet is from one to three months, especially severe cases You will have to stick to this diet for up to six months.

Folk remedies

Traditional medicine helps reduce unpleasant symptoms, but do not get rid of the problem forever. They can only be used after consulting a doctor, but such treatment should complement, but not replace, diet and drug therapy.

1. Mix one large spoonful of dried and crushed chamomile, calendula and sage, pour boiling water over it and let it brew until it cools. Then a gauze compress is moistened in the resulting decoction and applied to the affected area of ​​the skin.
2. Grind a few aloe leaves, pour boiling water and leave for 24 hours. Then the product is used for compresses.
3. Mix a large spoon of incense with the same amount of juice from aloe leaves, add three cloves of garlic, crushed into a pulp, to the resulting mixture. A compress is moistened in the resulting product and applied to the affected skin area for 20 minutes.
4. Also used in folk medicine Birch tar. This product softens the skin, softens plaques and eliminates itching and flaking. Tar is applied directly to the affected areas of the skin at night under a bandage.
5. It is also recommended to lubricate nodules and plaques with lukewarm sea buckthorn oil. This allows you to speed up skin regeneration and eliminate discomfort.

To treat lichen on the mucous membranes, it is often recommended to use aloe juice. To do this, just cut off one large leaf and wash it thoroughly. Then the cut site is applied to the nodular rash for a few seconds. This treatment of the mucous membrane is repeated twice a day.

It should be remembered that self-treatment problems may not bring the expected result, but only aggravate the patient’s condition. Having noticed the first symptoms of the disease, you should consult a doctor. After a detailed diagnosis, the doctor will prescribe an effective treatment that will help quickly get rid of the problem.

Treatment of lichen planus should be timely. The appearance of this pathology is accompanied by diabetes mellitus, stomach ulcers, and cirrhosis of the liver. Lichen affects the skin and mucous membranes. Most common among older people.

Treatment in adults

When a patient is diagnosed with lichen planus, a course of treatment should be prescribed. But before prescribing drugs, you should carefully understand the overall picture of the disease. That is, take into account all the factors associated with the disease that must be simultaneously eliminated.

Most often the following are used medicines:

• sedative drugs to eliminate disruptions in the functioning of the patient’s nervous system;
• corticosteroids, the dosage regimen is regulated by the prescription of the attending physician;
• multivitamins;
• preparations containing microelements such as potassium and calcium;
• injection with hydrocortisone, applicable in cases ulcerative form illness;
• in case of relapse of a chronic disease, the drugs Actovegin or Cyto-Mac are prescribed; they increase the ability of oxygen to penetrate into tissues.

Causes and symptoms

Reasons for the appearance of this disease quite a lot, but the main one is considered to be a dysfunction of the immune system.

Other causes of this type of lichen:

• presence of tobacco addiction;
• hepatitis C;
• heredity (1st-2nd generation);
• pulmonary tuberculosis;
• diabetes mellitus of any type;
• hypertension;
• dysfunction of the thyroid gland;
• the presence of a predisposition to various forms of allergic reactions;
• frequent exposure to stress;
• excessive nervousness;
• frequent injury to the oral mucosa (bites on the inside of the cheeks, cuts on the edges of the teeth);
• age criterion over 45 years;
• unreasonable use of analgesics and anti-inflammatory drugs;
• problems with the gastrointestinal tract.

Regardless of this list, the patient should contact a medical facility if he exhibits the following symptoms:

• red small rashes, gradually increasing in size to the size of a pea; when examined in the light, it seems that the affected areas are smeared with oil;
• The joint area of ​​the arms and legs is primarily affected, then the rash spreads to other parts of the body;
• in cases of dermatosis of this type nail plates, there is a change in its structure (it becomes uneven, very brittle and thin);
• in the oral cavity inside Shiny, milky rashes can be observed on the cheeks, tongue, gums and palate.

The patient experiences itching of the skin, a burning sensation in the mouth, a feeling of tightness, and in some cases bleeding of the affected areas.

Which doctor should I contact?

Many people think that since lichen is one of a number of skin diseases, it is enough to consult a dermatologist. Of course, this is the first and main point on the path to recovery.

But we should not forget about a number of reasons accompanying its manifestation. It is necessary to find out what factor caused the disease and carry out complex treatment from two, and possibly more, specialists.

Depending on the problem, consultation may be needed:

• gastroenterologist;
• cardiologist;
• endocrinologist;
• allergist-immunologist;
• pulmonologist;
• dentist

Well, in general, if a person is at a loss and does not know which specialist to contact, then the best option is to contact a local therapist. Because no one knows the overall picture of the patient’s illnesses better than him.

Of course, in order to make a correct diagnosis, the doctor must not only visually examine the patient, but also refer him for a number of additional examinations:

• blood test to exclude or confirm the presence of hepatitis C;
• biopsy (scraping a fragment of the skin from the affected areas);
• allergen tests.

Only after receiving all the test results can the correct treatment be prescribed.

Lichen planus is not at all dangerous to others.

Despite the fact that the patient’s appearance becomes far from aesthetic and can cause a feeling of hostility, the disease can be perfectly treated in a fairly short time, especially if the cause of its occurrence is determined.

Ointments

Despite the fact that no one is immune from the disease, its manifestation is still more often recorded among the female population. Doctors associate this fact with disorders in the immune system and disruptions in metabolic processes.

For local treatment of the disease, ointments from the following list can be prescribed:

• hydrocortisone;
• celestoderm;
• flumethasone;
• advantan;
• prednisolone.

All of them, except Advantan, are hormonal drugs, so they must be used with extreme caution and for a short duration. For children, of course, they are prescribed, but on a strictly individual basis and under the supervision of the attending physician.

It is better for a child to use sulfur-based creams rather than ointments. salicylic acid and tar, which have the necessary effect, but are safer to use.

Correctly determine the type of disease and prescribe the necessary conservative treatment can only be a specialist, regardless of age category and gender of the patient. Therefore, you should not self-medicate, as this can only worsen the problem.

Video

The most effective tablets

Of course, one local treatment It will be quite difficult to get rid of the disease using creams or ointments.

Therefore, the doctor prescribes tablet medications that speed up the patient’s recovery process.

The most effective of all known include:

1. Chloroquine. The drug has an anti-inflammatory effect, inhibits DNA synthesis and has increased activity to tissue forms of a pathogenic nature. It can be prescribed either in case of ineffectiveness of previous treatment, or to expand the list of properties active ingredients previously prescribed medications.
2. Telfast, Claritin or Tavegil can be prescribed for severe itching. They relieve excessive nervousness and help normalize sleep. Before use, be sure to read the instructions and pay attention to compatibility with other drugs used in the course of treatment.
3. Plaquenil. The drug has anti-inflammatory, immunosuppressive effects. Has the property of rapid penetration into circulatory system humans, but the elimination period of the drug is quite slow, about 50 calendar days.

You should not prescribe and use medications on an independent basis; all dosages and duration of treatment should be regulated only by a doctor.

Help from folk remedies

As medical practice shows, you can get rid of this deprivation using traditional medicine. Of course, with the exception of individual intolerance to the components of the prescription and after agreement with the treating specialist.

In general, there are many recipes to combat this disease, but the most effective are presented below:

1. Complex treatment using beets (beets) and hardening the body. You will need 1 medium-sized root vegetable, chopped using a grater. The resulting raw material should be applied to problem areas of the skin at the first signs of damage. The time for exposure is 15-20 minutes, followed by a shower procedure (water 20-25 degrees), gradually the water temperature decreases. These steps will help you get rid of severe itching and strengthen the immune system.
2. Tar ointment. To prepare it you will need 2 egg yolks, 100 milliliters of tar, 20% cream – 100 milliliters. All ingredients are mixed and infused for 20 minutes, then applied to the skin in a thin layer where lichen is present. The procedure is carried out 2 times a day. May not be suitable for people who carry out a course of treatment without interruption from work due to the strong, persistent odor.
3. Ointment with calendula. To prepare it, you need to mix the dried flowers of the plant in the amount of 2 tablespoons with 50 grams of regular Vaseline. Let the mixture sit for a day, then you can use it. The ointment is applied to the affected areas of the skin 2 times a day. During the treatment period, you should use the same clothes, since Vaseline may leave greasy stains on their surface.
4. Compresses based on sea buckthorn oil. Gauze or cotton pads are generously moistened with sea buckthorn oil, which can be purchased without any problems at any pharmacy, and are applied to the problem area. Time for exposure is 10-15 minutes.
5. Lotions based on herbal decoction. Chopped burdock root in the amount of 2 tablespoons, hop cones - 2 tablespoons and calendula flowers - 1 tablespoon must be boiled in 1 liter of water for 15 minutes after boiling. Next, the broth should be cooled at room temperature and strained. Use as a lotion on affected areas of the body.
6. Herbal infusion for internal use. All ingredients (St. John's wort, wormwood, horsetail, centaury, plantain, yarrow and juniper) are taken in equal quantities, 1 tablespoon each, poured into 1 liter of boiling water and infused for 3 hours. Next, the mixture is filtered and consumed orally, 2 tablespoons three times a day, 20 minutes before meals.

All of the listed prescriptions should be taken for no more than 14 calendar days; if there is no visible improvement, you should consult a doctor to prescribe more effective drugs.

Features of treatment of pathology in the oral cavity

When this type of dermatosis manifests itself in the patient’s oral cavity, first of all, it is necessary to identify the cause. This could be an allergic reaction to a new toothpaste, intolerance to prosthetic components, or the use of some medications.

Treatment of lichen in the oral cavity is prescribed only by a doctor:

• taking antihistamines (tavegil, suprastin, citrine);
• vitamin therapy;
• in the chronic form (cyto-poppy);
• to get rid of ulcers, topical use of sea buckthorn, rose hip, and viburnum oils.

Proper adherence to course therapy will quickly relieve the patient of lichen planus.

In cases where the disease manifests itself against the backdrop of the body’s reaction to an external stimulus, the patient should try to completely eliminate its presence from his own life. And it is imperative, even if there is progression, to visit a dentist.

The appearance of rashes on the hands

In most cases, lichen planus appears primarily in the extremities. The patient should not delay going to the doctor to prescribe comprehensive treatment.

If you pay attention to the disease in time, you can get rid of it quickly, and it will not be able to spread to other parts of the body.


Most often, treatment for lichen on the hands consists of topical application of ointments:

• mycoseptin, contains zinc and undecylenic acid, relieves irritation and itching from affected areas of the skin;
• miconazole, promotes the death of microorganisms;
• Exoderil has a calming effect.

Despite the local effect of drugs, other forms of drugs can be prescribed, especially in chronic cases of the disease:

• antihistamine medications;
• hormonal drugs;
• vitamin complexes;
• antibiotics if necessary;
• calcium containing medications.

The effect of all the above medical products, when used correctly, does not allow acute form Lichen planus becomes chronic.

Preventive measures for the appearance of

It is easier to prevent any disease than to treat it later.

This is true, and oddly enough, the manifestations of lichen planus can be avoided by following simple rules of measures for its prevention:

• harden your body;
• give up bad habits(smoking and drinking alcohol);
• periodically follow the rules of a salt-free diet;
• carefully monitor your chronic diseases;
• psychological comfort (try to treat all stress from a positive point of view);
• maintain a daily routine (the body should not only stay awake, but also rest);
• Regardless of the type of skin rash, seek advice from a specialist;
• In winter, take medications that strengthen the human immune system.

All these points, if observed without reproach, give each person the opportunity not to encounter a disease of this type.

Lichen planus - treatment, causes

Lichen planus is a chronic, systemic, immune-dependent, inflammatory-dystrophic disease of the skin, mucous membranes, nails, characterized by a multiplicity of forms and clinical manifestations. In the structure of general morbidity in dermatology, chronic lichen planus ranges from 0.78 to 2.5%, among diseases localized on the oral mucosa - up to 35-40%.

Over the past few years, there has been an increase in the number of applications to medical institutions about this disease, and when patients are monitored for from six months to 20 years, transformation into cancer is recorded in 0.4-5%. What are the causes and symptoms, how to treat lichen planus, despite the fact that last years There is also a significant increase in the frequency of rare, difficult to diagnose, severe and atypical forms. In addition, the disease is characterized by a long-term (from 5 to 40 years or more), severe and recurrent course, resistance to traditional methods treatment.

Causes and mechanism of development

There are various theories explaining the causes of lichen planus:

• hereditary, based on cases of the disease in twins, as well as in relatives in the second and third generations;
• neurogenic, or neuroendocrine, considering the main cause emotional stress, long-term neuropsychiatric disorders, sleep disorders and autonomic nervous system function in various diseases(diencephalic syndrome, hypertension, early menopause, hypothyroidism, hypoestrogenism, etc.); the theory is based on the fact that in 65% of patients there is a clear connection between these disorders and disorders with the onset or relapse of the disease;
• viral, which explains the development of the disease by the presence of a filterable virus, which is found in a person’s skin cells and is activated when the body’s defenses decrease under the influence of mental or physical and chemical injuries, prolonged exhaustion, etc.; however, to date the pathogen itself has not been identified and, therefore, there is no incubation period;
• toxic-allergic, which is based on an allergic reaction to certain components of food products or chemicals, vitamin preparations, tetracycline antibiotics and streptomycin, sulfonamides, preparations containing gold, mercury, arsenic, para-aminosalicylic acid and its analogues, diuretics (Furosemide) and antiarrhythmic drugs, and others;
• theory of endocrine and metabolic disorders; it is based on the common mechanisms of development of diabetes mellitus and lichen planus, which often occur together, especially its atypical forms and lesions of the oral mucosa.

All these theories do not so much explain the cause of the development of lichen planus as the presence of various provoking and predisposing factors and their participation in the pathogenesis of the disease (development mechanism).

Contributing factors also include:

• infectious diseases, in particular hepatitis B and, especially, hepatitis C;
• metabolic disorders in the form of dyslipidemia, metabolic syndrome, carbohydrate metabolism disorders with diabetes mellitus etc.;
• primary biliary cirrhosis of the liver;
• xanthomatosis;
• chronic diseases and dysfunction of the digestive system.

Immune-allergic hypothesis for the development of lichen planus

To date, there is no single assumption about what causes lichen planus and no single idea about its development mechanisms. The most acceptable hypothesis is the immuno-allergic one, which considers the disease as multifactorial, which is based on the inferiority of immune regulation.

The skin and mucous membranes in humans, in accordance with modern concepts, are considered an essential part of the immune system. They play a particularly significant role as protectors against the background of the growing influence of external and internal antigenic (allergenic) factors, leading to significant structural and functional disturbances of constancy (homeostasis) internal environment body.

In accordance with the immune theory, lichen planus is considered an acquired systemic inflammatory autoimmune disease that develops as a result of the body's inadequate regulation of metabolic and immune processes. This explains the inadequate pathological reaction, disturbances of enzymatic systems with a decrease in individual enzymes, etc. in response to the effects of injury, viruses, medicines, chemicals and other factors.

Particular importance as triggers is given to the influence of persistent viruses and other infectious agents present in the body in an inactive state, as well as vaccines, serums and other antiviral and antimicrobial drugs, activating an inadequate response of cellular and humoral immunity.

The body's protective reaction in response to exposure to an irritating factor is first expressed adaptive processes, which are developing both at the level of central and peripheral parts, which are represented by the skin and/or mucous membranes. Pathogenic factors lead to a sharp activation of humoral (blood, tissue fluid, lymph, saliva, gastrointestinal juices) and tissue mediators, as well as modulators of inflammation. This reaction is aimed at removing or neutralizing causative factor. If, as a result of the resulting inflammatory reaction, the damaging agent is not completely eliminated or neutralized, maladaptation occurs defense mechanisms, and the inflammation becomes chronic.

Subsequently, the presence of pathogenic or conditionally pathogenic microorganisms that have the quality of antigens sensitizes (increases the sensitivity) of tissues, which leads to further damage and the formation of autoantigens (antigens that become their own tissues), as well as complexes consisting of a combination of microorganisms with damaged cells fabrics.

A normal protective response of the immune system develops to this process, which does not disrupt homeostasis in the body as long as the functional state of specific lymphocytes is maintained. As the suppressive function of the latter is depleted due to constant long-term antigenic exposure, disintegration of the main protective function of tissues occurs, an uncontrolled immune response to antigens by the body with damage to its own healthy tissues under any provoking factors.

These immunoallergic disorders can be provoked by almost any disorder of the function of neurovegetative regulation, vascular and metabolic disorders, various intoxications, hereditary factors, infectious bacterial and viral pathogens. At the same time, the disorder itself in the function of all body systems occurs as a result immune disorders, forming a vicious circle.

The formation of erosive and ulcerative processes not only on the skin and in the oral cavity, but also in the esophagus, stomach, intestines, rectum, on the mucous membrane of the vestibule of the vagina, also testifies in favor of the systemic nature of the pathology and an inadequate immunoallergic response. urethra and bladder, on the head of the penis.

Is lichen planus contagious or not?

Taking into account these concepts of the causes and mechanisms of disease development, the answer to this question easily becomes clear. Despite the fact that the disease is not dangerous in terms of infection, unlike, for example, from, it must be remembered that it is often combined with chronic viral hepatitis “C”, the causative agent of which, under certain conditions, is transmitted from person to person.

Clinic and diagnostics

Lichen planus can occur at any age, but the maximum incidence occurs in people aged 30-60 years. Women get sick 2 times more often than men, especially in the perimenopausal period. Usually the skin is affected, but cases (from 3 to 27%) of isolated damage to the mucous membranes are also possible. Based on the nature of the manifestations and course, typical and atypical forms of the disease are distinguished.

Typical shape

Symptoms of lichen planus in its classic form, which occurs most often, are characterized by rashes accompanied by itching, general malaise, weakness, discomfort, and neuropsychic instability. Small monomorphic (same type) rashes with polygonal (multifaceted) outlines and a small umbilical depression are dermoepidermal papules with a diameter of 1 to 3 mm. The elements are lilac, violet, bluish-red or red-pink with a lilac tint.

When illuminated from the side, the papules appear polished to a pearlescent sheen. They are not prone to peripheral growth. After applying glycerin or water to their surface, the characteristic Witham network can be determined in depth.

The papules gradually increase in diameter to a maximum of 4 mm, after which their growth stops, but there is a pronounced tendency to merge elements, resulting in the formation of rather large plaques in the form of rings and various figures, covered with small epithelial scales.

No longer at depth, but on the surface of the plaques, a noticeable Witham's network is formed in the form of whitish, web-like intertwined lines and small dots that are visible through the layer of horny epithelium. This “pattern” of the surface of the plaques is due to the unevenness of the excessive thickening of the epidermal granular (granulosa) layer.

Skin rashes with lichen planus are usually accompanied by intense, sometimes painful itching, which can deprive the sick person of rest and even sleep. They can be local and widespread (generalized). The most common localization is symmetrical lesions in the area of ​​the flexor surface of the forearms and the extensor surface of the legs, in the area wrist joints, side surfaces chest, abdomen, inner thighs, axillary and groin areas. Rashes on lower limbs may have a linear shape.

As a rule, pathological elements do not occur in the scalp area, on the palmar and plantar surfaces. On the face, purple plaques are located only in the area of ​​the red border of the lips, usually the lower one. Their slightly flaky surface is covered with a grayish-white network.

The emergence of new elements is of a “push-like” nature. Also characteristic of this disease is the Koebner phenomenon, or the so-called provoking isomorphic reaction: in the acute period, fresh typical rashes appear at the site of linear scratching or exposure to other mechanical, chemical and other irritants.

Some people experience damage to the nails with their changes in the form of longitudinal striations, ridge-like protrusions, redness of the nail bed with foci of cloudiness, possible destruction of the nail fold, splitting of the nail plates or their loss.

Manifestations on mucous membranes

Lichen planus in the oral cavity is localized against the background of unchanged mucous membranes of the cheeks, hard palate, gums, and tonsils. Pinpoint papular rashes that do not rise above the surrounding surface have a grayish-waxy color, merge and group into a network, a lacy “pattern” in the form of a fern, rings, subsequently forming plaques. On the tongue, they look like flat whitish-opal nodules, plaques with jagged, clear contours, located on the back and lateral surfaces of the tongue.

Rashes on the mucous membranes may be accompanied by a slight burning sensation, a feeling of “tightness,” roughness and dryness. But often no subjective sensations arise, and pathological elements can be an accidental finding during a dental examination or examination of the oral cavity by a therapist during a respiratory viral infection.

Stages of the disease

Lichen planus as a chronic disease occurs with periods of remission and relapses, which can be repeated from 1 to 5 times during the year, despite the treatment. The clinical course of the disease is divided into stages , lasting for months:

1. Acute or subacute.
2. Progressive, when against the background of already existing and increasing in size elements, more and more new papular rashes or erosions and ulcers, swelling and redness, etc. appear (depending on the form of the disease), accompanied by intense itching and the Koebner phenomenon.
3. Stationary - cessation of progression.
4. Resolution, sometimes with the formation of spots of excess pigmentation.
5. Remissions.

Atypical forms of lichen planus

Existing classifications are based on the nature, location and shape of the primary lesions. In accordance with these signs, more than 15 atypical forms of the disease are distinguished. The main ones are:

1. Atrophic.
2. Verrucous.
3. Bullous or cystic.
4. Follicular
5. Erosive-ulcerative.
6. Pigmented.

Atrophic lichen

This species accounts for 2 to 10% and occurs predominantly among adults. The rashes look like spots that are located at the level of the surrounding surface (exanthema). They have a round or oval shape with a purple color typical of lichen planus.

Against this background, both in the central and peripheral parts of the elements there may be inclusions of a darker color, and on their surface there may be pearlescent or waxy lines. In the zone of pathological elements, due to superficial atrophic processes, the epidermal layer is thinned and has the appearance of parchment. The most typical location of the rash for this form is the neck area, shoulder joints, mammary glands, external genitalia, as well as the oral mucosa.

Varieties of the atrophic form are:

• ring-shaped atrophic, represented by papular elements, in the center of which the skin atrophies; the rashes merge with each other, forming continuous lesions in the form of plaques with scalloped edges, surrounded along the periphery by a slightly raised ridge of infiltration (edema); most of these plaques are located in isolation;
• keloid-like lichen, which is quite rare; its manifestations are sclerosis of tissue in the affected area; The rash lasts for many months or years before other symptoms of the disease may appear.

Verrucous form of lichen planus

The verrucous, or warty, hypertrophic form occurs on average in 15% of patients with lichen planus. The elements are papules and plaques of a pinkish-red color, less often bluish in color. Their surface has a spongy, cellular appearance, it appears to be pricked with a pin and is slightly covered with small scales.

The lesions are characterized by an oval, round or uneven shape, clear boundaries and moderate hyperkeratosis, due to which they resemble warts. Distinctive features warty form - high resistance of rashes to treatment and their long-term existence, intense painful itching. In exceptional cases, elements of the hypertrophic form appear on the trunk and limbs, taking on a disseminated (widespread) character.

A rare variant is hyperkeratotic, or horny lichen, in which excessive formation of the horny epithelium is expressed. With this type, plaques appear that have irregular outlines and are covered with asbestos-like scales. Their occurrence is often accompanied by intense itching.

Bullous form

The cystic variety occurs in 2-4%; even more often it affects the mucous membranes. It is manifested by the appearance of small blisters and large blisters under the epidermal layer of the skin in areas of redness (erythema), on plaques and papules, and less often in unchanged areas of the skin. Bubbles up to 2-3 mm in size have a “flaccid” tire and contain clear serous or serous-hemorrhagic fluid.

After their rupture, an erosive or erosive-ulcerative surface is exposed, which is limited by the contours of a plaque or papule. After opening, a hemorrhagic (bloody) crust forms.

Follicular lichen ruber

Lichen planus of this variety is much less common compared to its other forms, and can be combined with the latter. Distinctive features follicular-shaped elements - small pointed papules located in the area of ​​the mouths of the hair follicles. Often they have a bluish or deep red color, characteristic of the elements of this pathology in general. They are often combined with typical erosive and ulcerative elements of lichen, both on the skin and on the oral mucosa. After resolution of the rash, superficial atrophic scars may form.

The usual localization of rashes is the skin of the extremities, less often - the torso and scalp. When the elements of the rash are located on the head, alopecia of a limited nature develops (in half of the cases).

Erosive-ulcerative form

It is characterized, in contrast to the bullous form, by an indefinitely long course, special resistance to therapeutic effects and a frequent combination with diabetes mellitus and hypertension (Grinshpan-Potekayev syndrome), as well as with diseases digestive tract. In 5% of cases, erosive-ulcerative forms are precancerous, and with long-term observation, almost all atrophic and erosive forms degenerate into cancer.

Erosions and small ulcers are very painful, usually with irregular outlines and a “velvety” pink-red bottom. Ulcerative and erosive lesions are combined, as a rule, with the usual characteristic elements located nearby or distantly on the skin or mucous membranes. The infiltrate around the plaques has pronounced boundaries and bizarre outlines.

They appear mainly on the legs, sacrum, red border of the lips and oral mucosa. Along the peripheral zone of lesions and at their base long time Severe swelling with sharp borders and bizarre outlines may persist.

Lichen pigmentosa

The main symptom of this form is the predominance of a pronounced dark brown background of the lesions, in which slightly glittering islands of bluish-colored rash elements are barely visible. They are localized mainly on the skin of the abdomen, limbs and buttocks. These lesions are combined with rashes in the oral cavity characteristic of the disease, which can sometimes be overly pigmented.

Diagnostics

Diagnosis of lichen planus with typical manifestations is not difficult for dermatologists and is based on characteristic symptoms. Difficulties in carrying out differential diagnosis with other skin diseases occur in atypical and rare forms of the disease. In these cases, a tissue biopsy is performed from the lesion, followed by histological examination of the biopsy.

Treatment of lichen planus

Selecting a comprehensive therapeutic effects always has an individual character. The most effective treatment can only be obtained through a detailed study of the patient, since it depends on the form of the disease and the location of the rash, its duration, the degree of connection with the patient’s neuropsychic state and acute viral infections, the presence of diseases of the oral cavity, digestive organs, liver and diabetes mellitus , with the presence of chronic foci of infection in the body, the state of the immune system, and the effectiveness of previous treatment.

Do you need a diet?

Nutrition for lichen planus should be regular, taking into account food tolerance and allergic reactions to them. It is necessary to exclude from the diet, especially during an exacerbation, hot seasonings, spices, smoked and pickled foods, strongly brewed tea or coffee, chocolate, and citrus fruits. In addition, it is recommended to limit foods with a significant content of carbohydrates, fats, hard-to-digest meats, and salty seafood.

It is recommended to consume mainly boiled or stewed fish, lean poultry, young beef, vegetables, fruits, except citrus fruits, and avoid drinking alcohol and carbonated drinks. In addition, it is advisable (if possible) to limit physical and psycho-emotional stress and quit smoking.

Drug therapy for lichen planus

For erosions or ulcers, additional treatment is carried out with hydrogen peroxide (1% solution), which has cleansing and bactericidal properties. It can also be used to treat ulcerative and erosive surfaces in the oral cavity. At home, during the stationary stage and the resolution stage, in agreement with a dermatologist, it is possible to use baths at room temperature with infusions of calendula, chamomile, celandine, eucalyptus, and St. John's wort. To normalize the neuropsychic state and reduce itching, it is possible to take tinctures of valerian, motherwort, and hawthorn orally.

Clinical treatment includes local exposure to lesions and systemic exposure to the body. As local therapy in the form of applications, the most effective ointment for lichen planus contains corticosteroids (Advantan, Celestoderm, Elokom, Flucinar, etc.), which affect local immune processes, reducing swelling and inflammation, normalizing cellular ratio. For persistent verrucous form, corticosteroids (Dexamethasone, Hydrocortisone, Diprospan) are administered by injection into the area of ​​the lesions. They have immunosuppressive, anti-edematous, anti-allergic and anti-inflammatory effects.

Talkers and solutions with antihistamines, menthol, and citric acid are also used to help reduce the intensity of itching. In order to accelerate epithelization and healing of ulcerative lesions, Solcoseryl, rosehip oil, sea buckthorn are used, and to facilitate the separation of crusts and accelerate healing, salicylic ointment, which has antiseptic and keratolytic properties, is used.

If there are ulcerative and erosive elements on the mucous membranes, they are treated with gels or pastes with glucocorticoids (Triamcinolone, Fluocinolone) in combination with Chlorhexidine, and rinses with Betamethasone are used.

Carrying out systemic therapy Lichen planus is necessary in cases of generalized spread of the rash, persistent and prolonged course of the disease. For these purposes, tablets are used orally, the main components of which are glucocorticosteroids - Prednisolone, Dexamethasone, Presotsil, etc., as well as Diprospan intramuscularly, which has a prolonged glucocorticosteroid effect.

Another method of treating a common process, especially with a persistent course or the presence of erosions and ulcers, is the combined use of Metronidazole, quinolines (Delagil, Plaquenil), which have anti-inflammatory, moderate immunosuppressive and immunomodulatory properties, with glucocorticoids, as a result of which the effectiveness of both is significantly increased .

In cases of predominance of an allergic background, antihistamines and histoglobulin courses are prescribed according to a certain scheme.

In addition, for the treatment of lichen planus, means and methods are necessarily used to help normalize sleep and correct the psychosomatic state - mild antidepressants, sleeping pills and sedatives, massage of the collar area and head, electrosleep, iontophoresis with sedative electrolytes, Darsonval procedures. A certain effect in the composition complex therapy provide vitamins “A”, “E”, “D”, group “B”, immunomodulators Neovir, Dekaris.

In severe generalized process in some cases high efficiency has the use of photochemotherapy ().

Despite the fact that the prognosis of the disease for the life of the patient is favorable, in most cases it lasts a long time, with relapses and is largely capable of disrupting a person’s psychological and social adaptation.

Lichen planus is an inflammatory skin disease. It manifests itself as rashes on the mucous membranes and dermis. Another name for the disease is Wilson's disease. It was named after the English scientist E. Wilson, who described the disease, determined its differences from other dermatoses and identified the main forms. The disease has existed for more than a hundred years, but the exact causes leading to its occurrence have not yet been established. In this article we will try to find out why the disease occurs, what are the signs of lichen planus and how to treat it.

Common symptoms of Wilson's disease

The manifestations of the pathology are varied, but all rashes consist of the same small flat papules (pimples that look like balls or dense nodules), the diameter of which can be up to five millimeters. Main characteristic manifestations:

• The color of the rash is red-crimson or red with purple tint. Papules have a shiny surface with a retracted center.
• Peeling of the skin is slight; scales are difficult to separate.
• The rashes form in groups and can unite into circles, stripes and garlands, merging to form plaques. After healing, a red pigment spot remains on the affected area.
• The rash causes severe itching, causing problems sleeping. Sometimes, the appearance of symptoms of lichen planus on the fingers is perceived by the patient as scabies.
• In most cases, the rash appears on the elbows and knees, in the groin area, on the inner thigh, and on the oral mucosa.
• The soles of the feet, palms, face and head are less susceptible to the disease, but sometimes dark red lumps appear on them, causing severe itching.
• Ringworm in women, located in the genital area, interferes with urination and intimacy, causing pain. In addition, there is constant irritation.
• When lichen ruber appears in the oral cavity, at the entrance to the vagina, on the head of the penis, the dermis remains clean. The resulting nodules have grey colour, grouping, form circles, a grid or rings. Flat plaques with jagged edges usually appear on the tongue, and the lips are affected by papules purple with slight peeling.
• Large papules are covered with a special pattern called the Wickham grid.
• With an exacerbation of the disease, the formation of new vesicles occurs in damaged areas of the skin after injury. This symptom is called Koebner syndrome.

Forms of development of pathology

A feature of Wilson's disease is its different manifestation and localization. Based on this, clinical forms of lichen planus are distinguished, which have some differences in the development of the disease:

• Warty. The disease begins with the appearance of a rash, which subsequently develops into wart-like growths. Their structure is denser than that of standard bubbles. The rash is accompanied by severe itching, which is difficult to relieve. This disease mainly affects only the lower legs.
• Atrophic. At the beginning of the disease, standard papules appear. After the rash disappears, areas of keratinized skin remain in the damaged areas. The elbows and knee joints and the scalp, where pinpoint baldness occurs.
• Pigmented. Along with the rash, spots form on the dermis Brown. The limbs, face and trunk are often affected.

• Bubbly. On human skin, lichen planus appears as characteristic blisters - vesicles that contain serous matter, in some cases mixed with blood. Bubbles form on their own or on top of papules and plaques. The disease affects the feet and legs.
• Moniliform. These are round, waxy eruptions that are grouped in the form of a necklace. The rash affects the forehead, ears, back of the hands, abdomen and elbows. The skin of the cheeks, nose, soles and interscapular area is never affected.
• Pointed. Papules mainly appear on the head. Rash covers hair follicles with the formation of a spike-shaped growth. After healing, scars form on the damaged area.
• Erosive-ulcerative. It manifests itself as ulcers and erosions, which are surrounded by swollen red areas of the mucous membrane. This form of lichen planus occurs in the oral cavity. The affected mucosa becomes covered with fibrinous plaque, which, when removed, causes bleeding. Erosions can form into numerous groups that are painful. Healing is slow and difficult, and then relapses occur again.
• Ring-shaped. This type of disease develops very quickly. A characteristic feature is the tightening of the center of the plaque, giving it a ring shape. The male genital organs are affected. Sometimes the ring form of lichen ruber is mistaken for signs of syphilis.

Factors provoking the disease

Scientists continue to study the causes of lichen planus to this day. It was found that the disease develops due to a combination of several unfavorable factors, the most likely being the following:

• Neurogenic. The occurrence of pathology or relapse coincides in the patient with the psychological trauma that he suffered the day before. In addition to the skin disease, he is also diagnosed with mental disorders.
• Viral. Penetrating into the upper layer of the dermis, microorganisms remain in a balanced state until a certain point, until the immune system weakens. When activated, they cause the acute stage of the disease.
• Genetic. The existing theory states that the hereditary factor in the transmission of the disease from generation to generation cannot be denied.
• Intoxicating. Certain medications can provoke lichen planus in humans: quinine, arsenic, iodine, gold and antimony preparations, as well as antibacterial and antituberculosis drugs.
• Autointoxication. Associated with the accumulation of large amounts of toxins in the body. This can occur with diabetes mellitus, liver cirrhosis, gastritis, and gastric ulcers.
• Immunoallergic. This factor is considered the main one. Failure of the immune system leads to all sorts of diseases, including lichen planus.
• Mechanical. A new focus of inflammation easily arises when mechanical damage dermis or mucous membranes: friction with clothing, jewelry, damage from dentures, biting the cheeks.

Diagnosis of Wilson's disease

Diagnosis of lichen planus is established on the basis of:

• conversations with the patient;
• visual inspection. In most cases, a doctor can easily make a diagnosis based on the patient’s clinical picture and complaints.

In doubtful cases, the following is prescribed:

• general blood test and urine test - with lichen ruber, there should be no deviations from the norm in the urine and blood, with the exception of ESR and an increase in leukocytes;
• blood biochemistry;
• consultation with a gynecologist, therapist, dentist;
• biopsy analysis - the dermis is taken from the affected area and histological examination is carried out.

After conducting research and excluding syphilis, psoriasis and lupus erythematosus, a final diagnosis is made, on the basis of which treatment of lichen planus will be carried out.

Treatment of Wilson's disease

If the patient is in satisfactory condition, he or she does not require hospitalization; treatment is carried out on an outpatient basis. The course of therapy is prescribed taking into account the form of lichen, but must include:

• Sedatives, antidepressants, tranquilizers. With their help, they normalize the activity of the nervous system.
• Vitamin complexes - the body needs vitamins B, PP, C, E, A, calcium and nicotinic acid. Vitamin therapy is carried out for sixty days.
• Corticosteroid drugs- they, as a rule, play a key role in the treatment of lichen planus. To avoid side effects, the attending physician should select the treatment regimen and dosage. Hormonal agents prescribed together with medications containing potassium, calcium and multivitamins. In addition, a low-salt diet is indicated.
• "Histaglobulin" - used in injections instead of corticosteroids, given individual characteristics a specific individual.
• Hormonal ointments - used for external use: “Sinaflan”, “Ftorokort”, “Flucinar”. They relieve irritation and itching and are used for rashes that occupy limited areas of the skin.

Reception hormonal drugs must be under the supervision of a physician. Side effects are possible, so keep treatment courses short and monitor changes blood pressure and blood components. Lichen planus in the oral cavity of the erosive-ulcerative form is treated by injecting a suspension of hydrocortisone.

To eliminate the symptoms of recurrent chronic lichen, drugs are used that increase the supply of oxygen to the tissues.

Physiotherapeutic treatment

The impact of physical factors on the manifestations of red lichen increases the effectiveness drug treatment.

• PUVA therapy is a combined effect on the dermis of medicinal substances of plant origin: psoralens (P) and ultraviolet rays (UVA).
• Iductothermy is based on the use of a high frequency magnetic field. The procedure is performed on the lumbar region. As a result, the adrenal cortex produces glucocorticoid hormones.
• Reflexology - in the treatment of lichen planus, eliminates symptoms such as burning and itching.
• Diadynamic therapy is a pulse therapy that uses currents of different frequencies to reduce swelling, redness and itching.

• Magnetotherapy - exposure to a traveling magnetic field helps normalize the nervous system and reduce itching.
• Electrosleep therapy - reduces excitability and has an analgesic effect.
• Electrophoresis is carried out on the affected area using the drug “Hydrocortisone”.
• Phonophoresis - has medicinal and ultrasound effects.
• Ozokerite applications help to relax and have an anti-inflammatory effect.

Treatment of lichen planus with folk remedies

To treat many diseases, they resort to the use of folk remedies, the recipes of which are time-tested. The following folk remedies are suitable to assist in drug and physiotherapeutic treatment:

• Hop, fir cones, calendula. This raw material is used to prepare ointment. To do this, make a strong decoction and mix it with Vaseline. The resulting drug is applied to the papules once a day.
• Sea buckthorn oil. It is applied to the affected surface in the form of applications. The oil is widely used in the treatment of mucous membranes. Can be used orally, take a teaspoon daily on an empty stomach.
• Calendula. To prepare the infusion, take a tablespoon of raw materials and pour a glass of boiling water. Used for lotions.
• Sequence and chamomile. Each herb is taken in equal quantities of 100 g, poured into a bucket of water, brought to a boil and after three minutes removed from the heat. Infuse for half an hour, filter and add to the bath for bathing.

Before you start using folk remedies, you should consult your doctor.

Diet for illness

When treating lichen planus, a set of measures is required, in which diet plays an important role. Meals should be rationed and regular.

• lean meat;
• vegetables;
• greens (parsley, dill, lettuce);
• porridge (rice, buckwheat, oatmeal, corn);
• dairy products;
• mineral water without gas.

• alcohol;
• smoked meats;
• fatty fish and meat;
• concentrated juices;
• spicy seasonings;
• sweets;
• canned food;
• coffee;
• pickles;
• carbonated drinks.

The main goal of the diet is to provide proper nutrition that helps the body fight disease.

Can you get Wilson's disease?

Is lichen planus contagious or not? There is no clear answer. Some argue that this disease is not infectious, and therefore cannot be transmitted from a sick person to a healthy person. Others say that with prolonged and close contact there is a small chance of infection. This happens when there is a genetic predisposition and weakened immunity. Conclusion - everyone decides for themselves how to behave with an individual suffering from this disease.

Frequently used ointments for the treatment of pathology

When treating for external use, ointments for lichen planus are often used. They are used as independent agents and combined with solutions and various mixtures that contain citric acid, menthol, anesthesin. For severe itching, medications with antihistamine properties are prescribed. Salicylic ointment is prescribed to exfoliate the skin. It helps reduce inflammation and strengthen the walls of small vessels. Papules soften, swelling decreases, and healthy cells form in place of the keratinized surface.

The ointment is applied to the damaged area and a bandage is applied; after a day it is changed. The course of treatment is continued for up to twenty days. For papules that are combed, use Solcoseryl ointment. It supplies tissues with glucose and oxygen, protects against the appearance of erosions and ulcers. Use up to two weeks. Fenistil ointment or gel has an analgesic and antipruritic effect. It has a strengthening effect on capillaries and relieves pain. The product is applied up to four times a day. The effect appears after 20 minutes. Each of the ointments plays its role and provides relief by healing the damaged surface of the dermis.

The most effective treatment for lichen planus of the oral mucosa

This disease is chronic and often recurrent, therefore it is a complex and urgent problem for dentists. Scientists and dental practitioners consider the use of complex treatment to be the most appropriate. It simultaneously affects the symptoms of the disease, physiological processes in the body and includes the following activities:

• Complete sanitation of the oral cavity and advice on its care, a nutritious diet, exclusion of irritating foods and alcohol.
• For local drug treatment, drugs are prescribed depending on the form of the disease. For therapy use: antimicrobial, painkillers, antiviral, antimicrobial agents. In severe cases, corticosteroid suspensions are used to inject damaged areas.
• For general treatment, vitamin complexes, neurotropic, antiviral and sedative drugs, corticosteroids, antibiotics, immunomodulators and cytostatics are recommended.
• Application physical methods- galvanization, phonophoresis, laser acupuncture.

By using all these activities and connecting traditional medicine, the patient receives the most effective treatment for lichen planus, after which relief occurs.

Prevention

To take preventive measures, you should follow simple rules:

• lead a healthy lifestyle;
• have a daily physical activity;
• carry out regular hardening of the body;
• exclude if possible stressful situations at work and at home;
• wear comfortable clothes;
• carefully observe oral hygiene;
• have proper nutrition;
• to refuse from bad habits;
• undergo preventive medical examination.

Lichen planus is a quite serious disease, it causes a lot of inconvenience, but if you consult a doctor in a timely manner and proper treatment has a favorable prognosis.

Conclusion

Wilson's disease, often associated with chronic form, manifests itself in the form of a nodular rash and severe itching. It affects people of all ages, but most often it affects females aged 40 to 60 years. With properly selected therapy and timely treatment, the rashes disappear after two months, and pigment spots form on the skin, which disappear after some time. Some forms are difficult to treat, and a prolonged ulcerative process on the mucous membranes can degenerate into a malignant tumor. According to the International Classification of Diseases, a general code has been assigned to lichen planus ICD-10/L43, the frequency of formation is about one percent of all skin diseases. To prevent consequences, you should immediately contact your local doctor at the first symptoms of the disease, who will refer you to the appropriate specialist.

Lichen planus is an unpleasant dermatological disease that affects the skin. It rarely touches mucous membranes, and even less often it affects nails. It appears as itchy papules that look like a rash of large purple, pink or red spots. This skin disease can occur at any age in both men and women, but statistically women suffer from it more often. In addition to papules, which are striking and require precautions, LP is dangerous due to its oncogenicity. According to statistics, up to 2% of cases lead to the development of malignant tumors.

What is lichen planus

LLP is a chronic inflammatory dermatological disease. It is characterized by skin rashes that can last for many months, up to 1-2 years (even if treated). The exact causative agent has not yet been determined. According to various assumptions, it could be an immune inflammation, a subtype of allergy, a hereditary disease, or a virus.

The disease is common - according to various sources, it occurs in 2.4% of cases of all dermatological diseases, among diseases of the oral mucosa - up to 10%.

In the mouth, LLP is most often detected at the age of 50-60 years, skin lesions often appear at the age of 40-45. Children can also get sick, but it happens less often than in adults.

Causes of the disease

Why and where CPL comes from is not known exactly. There are several supposed reasons, each of which has evidence and compelling arguments:

1. Heredity. The fact that lichen ruber is transmitted by heredity is partially confirmed by statistics: up to 1.2% of cases of the disease manifested themselves in patients over several generations. It is impossible to determine whether the disease will be transmitted from mother to child during pregnancy.
2. Psychological factors: stress, disorders, sleep disorders, dysfunctions of the nervous system. Approximately 65% ​​of patients have some kind of nervous disorder. Lichen ruber can either appear because of it or worsen.
3. Action of the virus. According to the assumption, there is a virus in human skin cells that lies dormant when the immune system is working normally. When a disruption occurs in the immune system, the virus becomes active. The assumption has not been proven, since the causative agent has not yet been identified.
4. Immunoallergic cause. It is believed that there are disturbances in the relationship between immune cells in the blood of patients and in the places where the rash appears different types(one type provides an active immune response, the other, on the contrary, reduces it). As a result, the immune system ceases to normally recognize own cells, and begins to produce antibodies against them. This leads to damage to skin tissue and red rashes.
5. Intoxication. Divided into 2 assumptions. First: the disease is caused by taking certain medications (dermatoses can be caused by 27 medications, some of which are used precisely to treat such problems). Second: due to the accumulation of toxic substances in the body. They can accumulate due to gastrointestinal diseases, liver damage, hypertension, and diabetes.

Predisposing factors include:

• metabolic problems: impaired carbohydrate metabolism in diabetes mellitus, metabolic syndrome, dyslipidemia;
• xanthomatosis (metabolic disorder);
• gastrointestinal diseases;
• infectious diseases;
• cirrhosis of the liver.

Regarding contagiousness, people usually believe that lichen planus, like other similar diseases, is contagious and easily transmitted from person to person. By the way, this is one of the main problems for patients. It is more difficult for them to be in society - others may avoid patients because of the bright red rashes.

In practice, it has not been proven that the disease is contagious. However, there are cases where the disease developed in several family members (including husband and wife). A situation is also described when LP was infected by a dermatologist who performed a tissue biopsy of a patient with such a diagnosis. Therefore, shingles is likely to be transmitted, and it is recommended to avoid contact with people who are sick. The following safety rules must be observed:

• avoid physical contact (including handshakes);
• do not use the same clothes and shoes, personal hygiene items (towels), bedding, and dishes.

What does lichen look like and what are the different types of the disease?

The only symptom of skin lesions with this type of lichen is the appearance of a red rash. It looks like this:

• rises slightly above the surface of the skin;
• the surface of the nodules consists of single points, densely collected in one place, and sometimes merging;
• the size of the rashes is small;
• the affected area may have a slight shine, like wax;
• after the peak of exacerbation has passed, the papules may dry out and peel off (if peeling, this lichen can be confused with psoriasis);
• the color of the rash is purple, crimson-red or pinkish.

After the rash subsides, a pigment trace remains - pale spots that disappear completely over time. If the rash is severe or if you scratch it, scars may appear in its place.

Most often, rashes appear:

• on the front surface of the lower leg;
• on the inner surface of the forearms;
• on the wrists;
• in men - on the penis, in women - at the entrance to the vagina;
• in the groin area and inner thighs;
• armpits;
• on the body (less often);
• on the scalp - in addition, hair falls out irrevocably in this area.

Less commonly, damage to the mucous membranes is possible, in which a red rash appears in the mouth or on the genitals (rare).

There are different forms that differ in appearance rashes. The classification is as follows:

1. Erosive-ulcerative form - affects the mucous membranes, most often the oral cavity. Ulcers usually do not heal for a long time (even with intensive treatment), and the surface of the epithelium itself becomes red and swollen.
2. Ring-shaped - rashes most often appear around the genitals and on the inner thighs. Arranged in whole or half circles.
3. Moniliform - the rash forms a “necklace” with a waxy sheen. Most often it occurs on the buttocks, ears, neck, forehead, elbows or abdomen.
4. Pointed - papules rise more above the surface of the skin than in other forms. At the peak of each nodule, a keratinized area forms. Typically appear on the legs, shoulder blades or neck.
5. Blistering - elements of the rash look different from other types, like vesicles (vesicles with serous contents, sometimes with blood). They can form both on healthy skin and on other types of papules. Usually occur on the legs. In advanced cases, they can acquire large sizes (in this case the form is called bullous).
6. Hypertrophic lichen planus (or verrucous, warty) - is characterized by the development of a bumpy rash that occurs around large spots. It usually pops up on the shins, less often on the arms or face.

Possible complications

KPL is not the best dangerous disease. Lichen ruber is primarily unpleasant for the patient. It can lead to the following consequences:

• scars and welts at the site of large rashes;
• hair loss;
• adhesions and scars, which can cause the vagina to narrow in women and cause phimosis in men;
• blurred vision or narrowing of the tear duct (if the eyes are affected);
• nail deformation;
• darkening of the areas of the skin where the rash occurred (the symptom is usually temporary, and the darkening gradually goes away).

Another consequence that makes lichen ruber dangerous is the possible development malignant tumor. This happens infrequently, and only when the oral mucosa is damaged (in such cases, oral cancer occurred in 2% of patients).

How to determine that it is red dermatitis

Lichen planus can be confused with scabies (due to itching) and psoriasis (papules may peel off). Visually, the rashes have a typical appearance, and the dermatologist at the appointment usually immediately makes a preliminary diagnosis.

To clarify, the following diagnostic methods are used:

1. Clinical analysis blood. Not the main method, but can also be used. Confirmation is leukocytosis, increased ESR and eosinophils.
2. Biopsy. The main way in which it is clarified that this is lichen ruber.

How to get rid of lichen planus

How and with what to treat LP during an exacerbation period must be decided by the doctor. Common list methods:

• taking medications orally;
• use of ointments;
• folk recipes;
• diet;
• normalization of lifestyle.

Traditional methods can be used at will, as an additional treatment. The remaining points must be followed comprehensively.

Pharmacy medicines

The most effective treatment is medication. The drugs can be used for the following purposes:

• Reduce itching, relieve inflammation.
• Normalization of the immune system.
• Enhancing tissue repair.
• Preventing the spread of the rash.

Treatment of lichen planus in humans is carried out with drugs the following groups:

1. Interferons and interphenogens (Neovir, Interferon Alpha, Ridostin). Used to relieve skin inflammation and speed up its recovery.
2. Vitamins A, B, D, E. They are used only as an addition to other drugs, to support the body and accelerate skin recovery.
3. Antiallergens. Such tablets are prescribed if an exacerbation is caused by an allergic reaction.
4. Antibacterial agents. They are used if, in addition to lichen ruber, another infection develops.
5. Sedatives. Used if the patient is easily upset or if he has to work in mentally stressful conditions.
6. Corticosteroids. The use of corticosteroids is indicated to slow the spread of the disease and rapidly reduce the papules. However, such therapy is at the same time harmful to the body due to the suppression of its own immunity. As a result of their use, they may develop side effects, and the likelihood of re-exacerbation increases.

To lubricate the rash with lichen planus, the following types of ointments can be used:

1. Hormonal (Triamcinolone, Hydrocortisone, Cloveit). Purpose - reduction of itching, general improvement of skin condition.
2. Non-hormonal (Fenistil). Used if lichen worsens due to allergies. They stop the spread of papules, reduce swelling and redness, and eliminate itching.
3. Anti-inflammatory. Reduce swelling.
4. Healing. They are used when the peak of the lichen exacerbation has already passed and the skin has begun to recover, to speed up healing.
5. Salicylic ointment or ointments based on it. Used for more fast healing skin.

Folk remedies

Treatment of lichen ruber is acceptable, but only in addition to drug therapy. The essence of such methods is to treat the affected area with a red rash and reduce itching, inflammation and the spread of plaques.

What can be used to treat (all products are applied to the affected areas in the form of lotions):

1. Sea buckthorn oil. Apply for 30-60 minutes.
2. Apple vinegar(without dilution). Apply for 10 minutes.
3. Birch tar ointment gruel (150 g), 2 egg yolks and cream (100 g).
4. Porridge of finely grated beets.
5. Composition: church incense (50 ml), aloe juice, 1 yolk and chopped garlic clove.

Rationalization of nutrition

Since one of the possible causes is an allergic reaction, it is recommended to follow a diet for lichen ruber. Create a menu excluding from your diet:

• sweet;
• products with a lot of dyes;
• fat;
• spicy;
• smoked;
• foods that cause an allergic reaction (red and orange fruits);
• coffee, strong teas, carbonated drinks, packaged juices.

You should not eat this food, even if you are not allergic to such foods, and if the lichen does not clearly worsen after such food.

The menu should include:

• boiled or stewed fish;
• dietary meats;
• vegetables;
• fruits (except citrus fruits).

Other methods

What to do besides the methods listed above:

1. To refuse from bad habits.
2. Minimize exposure to papules: do not scratch them yourself, and do not wear clothes that will rub them.
3. Observe hygiene rules. The doctor will answer whether it is possible to wash with LLP. Yes, you can (both in the shower and take a bath), even in the acute stage. The only limitation: do not use hard washcloths for areas with papules. After a shower, you can lubricate them with moisturizer - this will partially relieve the itching.
4. Prevent stress, hypothermia, overwork.
5. Quickly and timely identify and treat other diseases.

How long does it take to treat ringworm in humans?

The main clarification: it is impossible to get rid of this chronic infection forever. However, it is possible to minimize the frequency and extent of manifestations so that the patient can feel normal around other people and lead a normal life.

The disease is divided into periods of remission (when there are no rashes) and exacerbation (when rashes appear). When a red rash appears on the skin, it can last from 6 to 24 months. With traditional treatment, the rashes subside after this period, but may appear again in the future.