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Red lichen planus


Red lichen planus

Red lichen planus

This is a chronic disease of the mucous membranes and skin, characterized by the appearance of small red papules. The causes of development are not fully understood. Women of middle age are ill mainly. The treatment uses antiallergic agents of systemic and local action.


This type of lichen refers to the so-called dermatoses, that is, skin lesions as a result of multifactor exposure. It is characterized by a fairly extensive lesion of the skin. It should be noted that the final reasons for the formation of flat red lichen are not established. Currently, there are a number of scientific theories that substantiate the relationship between the development of symptoms of flat red lichen with various systemic pathologies, nerve loads and impaired immunity.

Various disorders of the immune system cause the long-term nature of the disease, as well as the unusual reaction of the skin to various external and internal damaging factors. Cases of depriving of members of one family are repeatedly described. This proves a certain genetic predisposition, since by itself a person with such a lichen is not contagious and not dangerous to others.

Numerous studies prove the existence of a direct relationship between the initial occurrence or new exacerbation of lichen edema and various stresses (both positive and negative), hypnotic effects, segmental-reflex therapy.

The undoubted relationship of this skin disease and chronic therapeutic pathology, such as:

  • diabetes;
  • chronic inflammatory and dystrophic processes of the gastrointestinal tract;
  • hypertonic disease.

Currently, lichen planus is considered as a kind of pathological toxic and allergic reaction of the body to various chemical compounds. These include:

  • film developer;
  • tetracycline antibiotics;
  • gold compounds;
  • anti-TB drug PASK.

This type of lichen is characterized by a long and persistent course. Complete cure of flat red lichen is almost impossible. With a certain long-term treatment, you can achieve a long period of remission.

Lichen planus: symptoms

This skin disease affects not only the skin itself, but also the mucous membranes (sometimes only the mucous membranes), which greatly complicates the treatment and worsens the condition of the sick person. For the classic form of flat red lichen, a number of features are typical, making it easy to distinguish it from other similar skin diseases. Namely:

  • rash elements are flat polygonal papules that have a central depression;
  • papules are various shades of red, from dark pink to purple-red;
  • elements of the rash have a shiny surface, which is most noticeable in the processing of oil and side lighting;
  • papules tend to merge, forming rather large plaques that are prone to finely lamellar peeling;
  • a rash is associated with severe itching that deprives a sick person of sleep and rest;
  • one of the most important symptoms is the Wickham sign; uneven thickening of the epidermis (granular layer) causes the presence of web-like bands and dots, which is clearly visible upon careful examination;
  • Kebner's symptom is the location of new papules in the scratching zone;
  • red lichen papules can cover the whole body, but are most often localized on the limbs (flexor and extensor surfaces of the joints), inguinal and axillary folds;
  • such areas of the skin as the head, palms and feet are mainly not involved in the process.

In some patients, the presence of papules is noted only on the mucous membranes (oral cavity, genitals) without skin lesions. On the surface of the mucous membrane, the papules of the lichen have a characteristic light gray color, arranged in the form of rings with moderate peeling.

In a small number of patients, there are changes in the nails: longitudinal ischerenia, clouding of the nail plate itself, redness of the nail bed.

For flat red lichen described numerous atypical forms, in which there are no characteristic symptoms. This greatly complicates the process of establishing the correct diagnosis. Among them are: warty, sclerotic, pemphigoid, moniliform, pointed, erosive, annular and linear. These atypical forms are distinguished by the following features:

  • warty form - dark plaques, covered with dense keratinized growth, located only on the front surface of the tibia;
  • atrophic (sclerotic) form - atrophic processes predominate, that is, instead of cutaneous epithelium, connective tissue is formed, possibly focal baldness; typical location of lesions on the extensor surfaces of the limbs (a symptom of Lassuir-Littl);
  • pemphigoid (blister) form - instead of papules, painful blisters with bloody contents are formed;
  • Pointed shape - along with classic papules, pointy elements appear, perhaps combined with atrophic changes;
  • moniliform (necklace-like) version - the elements of the rash are arranged in the form of clear long strips that resemble the necklace; may spread to the scalp and face;
  • ring-shaped - more typical for men with lesions of the mucous; with the reverse development of primary papules, new ones are formed at some distance from them, forming rings or arcs;
  • linear variant - papules are detected only along the nerve trunks (usually in the intercostal spaces);
  • erosive and ulcerative variant - it is noted only on mucous membranes, the formation of a long-term non-healing, but few painful ulcers and erosions is typical.

Treatment of lichen planus

The key to successful treatment of flat red lichen is the identification and treatment of diseases of the nervous and digestive systems. One of the components of therapy are herbal-based sedatives (motherwort, Valerian, hawthorn).

Without fail all patients are prescribed desensitizing agents (loratadine, desloratadine, cetirizine), in severe cases - steroid hormones (prednisone, dexamethasone).

Directly, the elements of the rash are treated with steroid ointments (fluocortolone, betamethasone) and sealed with a plaster, which significantly speeds up the process of their reverse development.

People with red lichen are usually advised to follow a hypoallergenic diet that excludes spicy and spicy foods.

| 12 January 2015 | | 11,893 | Skin diseases