Red lichen planus: symptoms and treatment
Red flat lichen is a disease characterized by the appearance of red papules( nodules) on the skin and mucous membranes.The disease is more common in the age group 30-50 years.It is characteristic that among the sick, a greater percentage of women than men.Table of contents: Causes of red flat lichen Species of red flattening Symptoms of typical form Symptoms of atypical form Treatment of red flat lichen
Causes of red flat lichen
The pathological process is caused by disturbances in the regulation of immuno-metabolic processes provoking an abnormal tissue reactionUnder the influence of all sorts of factors. These factors include:
- Endocrine diseases( diabetes mellitus);
- Diseases of the digestive tract( gastritis, colitis, pancreatitis, liver disease);
- Injuries of the oral mucosa with sharp edges of the teeth, dentures;
- Taking certain medications( ACE inhibitors, NSAIDs, penicillamine, beta-blockers, gold preparations).
Species of red lichen
Approximately 50% of cases have isolated skin lesions.In 40% of all cases, the skin and mucous membranes are affected.In 20-25% of cases only mucous membranes are affected.
The last five forms are attributed to atypical forms of the disease.
Symptoms of the typical form
For the typical form of red flat lichen, the appearance of flat reddish-violet papules is polygonal in size, up to 2-5 mm.In the center of the papule is an umbilical occlusion.When viewed( especially in the lateral placement) on the surface of the papules, it is possible to detect waxy luster.
On the surface of large papules after lubricating them with vegetable oil, it is possible to identify a networked pattern caused by uneven thickening of the epidermis.This symptom is called the Wickham mesh symptom.During the exacerbation of the disease, the phenomenon of Kebner is observed, when new papules appear on the site of the tramatisation of the skin.
Eruptions are located on the flexural surfaces of the hands and feet, the inner thighs, sacrum, in the groin, axillary region, on the mucous membrane of the mouth.Very rarely papules appear on the face, feet and palms.Papules are often grouped in the form of garlands, rings, lines.Much less often the rashes merge, forming a continuous large plaque.Rashes are accompanied by severe itching, which disturbs the peace and sleep of a person.In the place of rashes, there is still hyperpigmentation.
When lesions of the mucous membrane in the mouth, on the eve of the vagina, the glans penis develop grayish papules, grouped in the form of rings, garlands, lace.In the tongue, whitish plaques form.And with the defeat of the red border on the lips there are violet slightly scaly plaques with a characteristic grayish-white mesh on the surface.
Some patients experience changes in the nail plates.On the surface of the nails appears pronounced longitudinal striation.
The disease lasts for a long time, often many months.Under the influence of adverse factors, relapses are possible.
Symptoms of atypical forms
Not always red lichen planus runs as classically as described in textbooks.Some people have atypical forms of the disease.Thus, in the case of a hypertrophic form, reddish-violet rounded large plaques appear on the skin, reaching in diameter 4-7 cm. The surface of the plaque is uneven, bumpy.Small typical papules can develop around the plaque.
At an atrophic form of the disease, a few typical papules appear on the skin of the trunk, head, and genitals.There can be a fusion of nodules into plaques, up to two centimeters.The peculiarity of this form of the disease is that the papules are transformed into atrophic spots with a pink or yellowish-brown color.
For the pigmentary form of the disease is characterized by the appearance of multiple spots of brown color, merging into large foci.Rashes cover a significant surface of the skin.
The peculiarity of the erosive and ulcerative form is the appearance on the skin and mucous membranes of typical papules, as well as erosions, ulcers.The latter have scalloped edges and can reach five or more centimeters.Ulcerous defects appear on the legs, which causes pain when walking.The edges of the ulcers are dense reddish-blue, towering above the surface of the skin.At the bottom of the ulcer granular granulation.This is the most severe and difficult to treat form of the disease.
With a bullous form of red flat lichen on the papules, plaques and even unmodified skin, bubbles appear.Rashes can reach various sizes, their cover is initially strained, and then becomes flabby, wrinkled.The contents of the blisters are transparent, sometimes with blood.
Treatment of red flat lichen
In the presence of limited forms of the disease, treatment begins with the appointment of local glucocorticosteroid agents( betamethasone dipropionate 0.1%, etc.).
But in the presence of extensive eruptions or erosive and ulcerative defects, it is necessary to proceed with systemic drug therapy. Assign the following drugs:
- Glucocorticosteroids( prednisolone, betamethasone dipropionate);
- Preparations of quinoline series( chloroquine, hydroxychloroquine);
- Dermatotropin funds( acitretin);
- Immunosuppressive agents( cyclosporine);
- Cytotoxic drugs( cyclophosphamide, methotrexate);
- Antihistamines( clemastine, chloropyramine);
- Hyposensitizers( sodium thiosulfate, calcium gluconate);
- Neurotropic drugs( tranquilizers, sedatives, hypnotics);
- Vitamins( A, E, Group B).
Large and verrux sprouting is removed by destructive methods of treatment: cryodestruction, electrocoagulation, laser therapy.
No less significant role in the development of the disease is played by the person's lifestyle.The connection between nervous shocks and the appearance of papules on the body is proved.Therefore, a person should limit psychoemotional as well as physical activities.
The diet should limit salt, spicy, smoked food, do not eat allergenic foods.And with lesions of the oral mucosa, it is necessary to exclude rough and hot food.
Grigorova Valeria, medical reviewer