How to treat lichen on the head. Lichen planus

Quite often, patients turn to a dermatologist with such skin diseases like lichen. At the same time, many patients do not even suspect that they have lichen on their skin, and not a rash of a different nature.

Among adults, the stereotype is erroneously widespread that lichen is exclusively childhood disease, which occurs when in contact with street animals.

But this is not at all the case, lichen can have a very large list causative factors. And with almost a 50/50 chance, lichen can appear in both children and adult patients.

Most often, adults are faced with lichen planus. He is chronic illness, which can affect not only the skin, but even the mucous membranes. In rare cases, red lichen can even affect the nails.

Why does red lichen appear?

Research to determine the causes of lichen planus (LP) is ongoing. This is due to the fact that the exact factors that contribute to this disease have not yet been identified.

Scientists name only hypothetical causes that unite most patients with red lichen. But at the same time, these reasons do not have scientific confirmation.

We list the main factors that, according to scientists, can contribute to the appearance of CPL:

• disturbed the immune system. Among patients who have been diagnosed with LP, the following immune diseases are quite often detected: vitiligo, alopecia areata, ulcerative colitis.
• The impact of stress. Strong experiences, emotional overwork and shocks, according to research, can not only provoke the appearance of red lichen, but also increase the exacerbation of the disease.
• Mechanical damage to the skin. Places of the skin where a person has scratches, abrasions, chafing and other damage can become the area of ​​localization of new foci of red lichen. The mucous membranes of the mouth can be injured by the sharp edges of the teeth, dentures, and lichen red can also appear in places that are constantly prone to injury.
• Reception medicines. In rare cases, patients claim that the appearance of red lichen on the mucous membranes of the mouth was associated with the start of taking the following drug groups: angiotensin-converting enzyme inhibitors; sulfonylurea derivatives; medicines for malaria; beta blockers; painkillers anti-inflammatory drugs (Ibuprofen, Diclofenac, Aspirin). In these cases, the patient must consult a dermatologist.
• Allergic reactions. The mucous membranes of the mouth may be susceptible to lichen erythematosus when allergic reactions in a patient for components and flavors that are part of toothpastes, mixtures for filling teeth and dentures. With this reason, red lichen for its disappearance may be sufficient to replace the toothpaste or prosthesis.

Is LP contagious?

Many patients are concerned about whether LP is contagious.

The answer to this question is negative, this species lichen is not transmitted between people and is not contagious.

The danger lies in the fact that in some patients LP can be provoked by viral hepatitis C. And this disease is transmitted sexually.

Therefore, if you find out that loved ones have identified LP in themselves, then be sure to consult a doctor on how to protect yourself from hepatitis infection. The doctor will definitely prescribe an analysis for hepatitis C.

These measures are not redundant, since hepatitis C can long time develop in the body without showing any external symptoms.

What are the symptoms of LP?

Let us describe the specific symptoms by which LP can be detected on various fields body.

Face, chest, torso, legs, arms, groin

• Lichen begins to form with the appearance of nodules (seals) on the skin from dark red to purple.
• The nodules cause intense itching. The initial foci are localized in the area of ​​​​the joints on the arms and legs.
• After 2 to 3 weeks, nodules begin to appear on other parts of the body.
• The most severe itching is caused by groups of nodules on the fingers.

Lichen red in the listed areas has the following forms:

1. Ring-shaped. Nodules on the skin appear in whole groups. With the development within the group, they disappear, and new ones are added along the edges. Therefore, outwardly, lichen resembles a ring.
2. Vesicular. Over time, liquid-filled blisters appear on the foci of lichen. This form is often found on the back, legs, buttocks and mouth.
3. Warty. From the initial nodules, hard and compacted plaques form. Frequent places localization: knuckles, shins, ankles.

Tongue and oral mucosa

Ringworm looks like a small red lump. This form can be described as total absence no symptoms, and manifest as painful ulcers.

Sex organs

Ringworm in the genital area is more commonly diagnosed in men than in women.

Red lichen on the genitals causes the following symptoms:

• Strong itching in the area of ​​localization.
• Pain during intercourse.

Areas of localization of lichen on the genitals:

1. For men, the area foreskin; skin of the scrotum; penis head. The shape of the lichen is ring-shaped.
2. In women - the labia, the inner walls of the vagina. The growth of lichen leads to a narrowing of the vagina and urethra, as well as difficulty urinating.

Nails and scalp

Red lichen on the scalp is a brown seal with scales at the top. This type of lichen causes severe itching and even hair loss.

With the localization of red lichen on the nails, the following symptoms appear:

• The nail plate is deformed and covered with grooves.
• The color of the nails becomes brown, they become cloudy and thicken.

How is the treatment carried out

The choice of treatment for red lichen depends on the area in which the disease arose and how seriously it progressed.

Methods of treatment for localization of lichen on the skin

In this case, the disease should go away on its own. But this may take a long time. To speed it up, the doctor may give the following recommendations:

• Ointments based on corticosteroid hormones. They must be applied to the affected areas of the skin 2 times a day.
• Corticosteroid injections (Triamcinolone acetonide).
• course of acitretin.
• Corticosteroid tablets (Prednisolone). Reception within 21 - 42 days.
• Phototherapy sessions 2-3 times a week.

Treatment of diseases in the mouth

Doctors note that if lichen neoplasms in the mouth do not cause pain and do not cause discomfort, then there is no need to treat them.

Otherwise, the doctor will advise the following methods of treatment:

• Laser cauterization of foci.
• Preparations with corticosteroid hormones.
• Medicines based on pimecrolimus (the effectiveness of this method of treatment has not been scientifically proven).

As noted in the causes, red lichen in the mouth can occur due to permanent injuries of the mucous membrane with tartar, sharp edges of the teeth. In addition, the composition of mixtures for dental treatment can influence. Therefore, before starting treatment for lichen on the mucous membranes of the mouth, it is necessary to consult a dentist.

Treatment for lichen on the genitals

• Topical application of corticosteroid ointments (Clobetasol, Triamcinolone).
• Ointments containing Tacrolimus (Protopic).
• Lubricators with water-based lidocaine. Necessary if the patient experiences pain during intercourse.

Treatment of LP with localization on the nails and scalp

In cases where a patient has red lichen on the head, then it is necessary to immediately begin its treatment, since the lichen causes hair loss that cannot be reversed.

Treatment is as follows:

• Ointments with corticosteroid hormones.
• corticosteroid hormones.

Treatment of red lichen on the nails occurs in a similar way.

Sometimes men develop lichen on the penis. Unfortunately, this problem is not immediately noticeable. That is why, when a man discovers trouble, it is already at a serious stage.

It is advisable to contact a dermato-venereologist as soon as possible so that the treatment is faster and more effective.

Is it contagious

This disease is not transmitted. So it is possible not to worry about sex or domestic contacts. However, it is worth considering that if a man suffers from such deprivation, then not everything is in order with the immune system. Therefore, other infections and viruses may be present in the body.

And do not forget that the non-contagiousness of this infection is evidenced by studies and statistics. However, humanity is changing, becoming resistant to what hurt before, and vice versa.

That is why, if such a nuisance 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.

Is it dangerous for health

This problem does not pose a threat. At least, if the lichen is localized only on the penis. However, this does not mean that the problem should not be fought, because these are fungal formations, and they tend to grow in the absence of deterrents.

It also slightly weakens the immune system and, in principle, indicates the weakness of such. That is why it is desirable to get rid of such trouble. Otherwise, over time, other problems are sometimes added to this seemingly insignificant disease. And the latter, perhaps, will be more serious.

What does it look like

The disease manifests itself in different forms, depending on the stage. At first, nothing is imperceptible, but even at this stage, slight discomfort is possible. However, this is not manifested in everyone, because the degree of sensitivity in men is different.

It then occurs in the following order:

1. White rash. That is why the problem is called lichen planus on the penis.
2. Plaques of the same color.
3. The plaques are covered with a crust, and the color changes to red or pink.

The rash is already visible to the eye, but it is easy to confuse it with goose bumps if a man likes a cool shower. However, then the rash already merges into plaques. These are hard to miss. Then the plaques begin to peel off, and a crust appears on top of them.

Such formations differ in hypertrophic, vesicular, annular and pigmented. However, it is not so easy to distinguish those from the photo. This is another reason why you should see a doctor.

The rash and plaques look like nodules. More often these are ring-shaped formations. Sometimes the spot in the middle of the ring is dark. Other forms are much less common. All varieties need treatment or they will progress.

Why does

The reasons for the appearance of such trouble are different. Sometimes it's about stress. This is not about one or a couple of such conditions, but about regular nervous strains.

That is why it is so important to develop a calm and positive attitude in any situation. This is difficult to combine with an adequate perception of reality, but it is worth trying and making it a habit.

Also, red lichen on the penis occurs as a result of various diseases that weaken the immune system. After all, the main reason lies precisely in the weakening of the body's defense system, otherwise the fungus would simply not be allowed to multiply. Therefore, any factor that weakens the immune system can indirectly cause and deprive.

Finally, there is the lack of proper personal hygiene. However, one should not think that the matter is only in the insufficiency of procedures. Of course, in such a situation, dirt accumulates, the immune system ceases to cope, and the fungus creates additional favorable conditions for reproduction.

However, even with excessive hygiene, such a problem sometimes arises. The fact is that in this case, the body's protective layer disappears and pathogens develop more easily.

It is important to consider that even with a calm and measured life, good genetics and a competent lifestyle in general, weak immunity is enough for this trouble to occur. And if this happens, it is important to check the body for autoimmune diseases.

Such diseases are dangerous because a person has little or no protection against infections. And such people often become infected at the first insignificant contact with sick people, for example, while standing in line.

The disease that occurs after is often severe, and therefore it is important to immediately begin the fight not only with all infections, but also with an autoimmune problem.

This problem usually occurs between the ages of 15 and 45. Very rarely, such a nuisance is due to genetics. Often these are men with weak immunity, prone to stress. Often this problem goes side by side with some chronic diseases.

How to deal with lichen

To defeat the problem, you should first go through the diagnosis. For these purposes, apply:

• histology;
• sowing scales;
• inspection of fragments under a microscope.

The doctor will also examine the rash. It is important to understand that the symptoms of this trouble are similar to the manifestations of other diseases, including syphilis. That is why differential diagnosis is so important, that is, one that will help distinguish one problem from another.

If lichen is found on the head of the penis or on another part of this organ, a course of treatment is prescribed. It is advisable to follow this to the end in order to achieve a result.

Calcium gluconate injections, as well as other drugs of similar action, help. Still in use antihistamines. Perhaps the appointment of sedatives. If the disease has spread further, antibiotics are prescribed. And they also use immune agents, for example, Cycloferon. For topical treatment, corticosteroid ointments are used.

Also, the doctor will advise you to remove any factors that create favorable conditions for the development or.

It is difficult to say how long it will take to fight, because it largely depends on the individual, his immunity, allergies. However, if you consult a doctor at the initial stage, you will definitely be able to overcome the problem in a month.

Conclusion

Ringworm on the penis is important to treat. This is not some harmless formation on the skin. The sooner treatment is started, the sooner the problem can be dealt with. In addition, the timeliness of the fight against the disease will relieve complications.

Ringworm on the penis refers to noncommunicable diseases skin, often fungal etiology. In most cases, it is diagnosed in men aged 16-35 years.

In patients of an older age category, lichen appears less frequently, due to a change in metabolism. Most often in men, a urologist can detect lichen ruber planus or lichen planus on the penis. However, there are other forms of damage to the epidermis with localization on the genitals.

• pink lichen
• Shingles
• Lichen sclerosus (lichen)
• Treatment various forms lichen
  • Treatment pityriasis versicolor
  • Shingles treatment
  • Treatment of brilliant lichen

Pityriasis versicolor on the penis

Tinea versicolor(pityriasis versicolor) or pityriasis(varicolored) lichen is a common dermatosis. It is characterized by multiple, small, oval, scaly patches 1-3 cm in diameter. This is a benign superficial infection of the skin.

Most commonly seen in young people during hot, humid weather, it is caused by the fungi Malassezia globosa and Malassezia furfur. Lesions may be light brown, reddish, or white color, hence the name that versicolor (rainbow).

Pityriasis (colorful) lichen on the penis is quite rare. The main localization of rashes is the back and abdomen. The rash on the genitals is usually asymptomatic, although some patients complain of mild itching. The differential diagnosis includes inflammatory pigmentation and vitiligo.

Although the pathogenesis of the discoloration is not fully understood, the fungus is known to produce azelaic acid. This is a substance that prevents the activity of tyrosinase and the subsequent synthesis of melanin.

The rash will clear up completely over time, but recurrences of this type of lichen are common. Sometimes spontaneous disappearance of the rash under the influence of ultraviolet radiation is possible.

Wilson's lichen (lichen lichen)

Lichen ruber planus or red lichen planus. Able to show up in any area skin men and the groin are no exception.

red lichen on the penis- chronic inflammatory, dermatosis disease of unknown origin. Characterized various types skin lesions (papules, nodules) more often in middle-aged people. The etiology of this type of lichen is still unknown.

Experts say that genetic, immunological and hormonal factors play a role in the formation of dermatosis. The most common lesions are purple papules with well-demarcated borders. Usually found on the wrists, lower limbs and the male genital area.

The disease is diagnosed by visual examination of the patient, and can be additionally confirmed using dermatoscopy. In some cases, a biopsy is recommended to help identify squamous cell carcinoma. it possible complication genital lichen.

Lichen ruber planus with localization on the genitals is rarely accompanied by extensive symptoms. Patients may complain of severe itching and the formation of bright papules on the head of the penis.
Treatment includes prescription hormonal drugs, steroid, antihistamines, sedatives. The rash may persist for several months and reappear intermittently for many years.

pink lichen

Ringworm Zhibera or pink lichen refers to infectious-allergic dermatosis 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 (contagious), but this judgment is erroneous. Pink lichen is able to pass on its own, even without medical treatment. In some patients, scaly redness on the penis may persist for several months. Until they completely regress over time.

In almost 90% of cases, the disease is asymptomatic, sometimes accompanied by itching. Promote development pink lichen may decrease immunity against a background of viral pathology or infectious. Most often, the disease is diagnosed in men aged 10 to 40 years.

Shingles

Shingles(shingles, Herpes zoster) is based on reactivation of chickenpox infection.

Because the virus persists after primary infection in childhood throughout life. Reactivation can 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 that, burning, itching and soreness occur in the skin area.

Approximately 4 days after the onset of the disease, erythema with homogeneous vesicles and papules is observed. After 7-12 days, the rashes dry up 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 start a course of antiviral therapy as soon as possible.

Shiny lichen (Lichen nitidus)

Shiny lichen is a rare and benign inflammatory skin condition first described in 1907 by Pincus. It is estimated that the prevalence is about 0.34% of all dermatological conditions. Lichen nitidus usually occurs in children and young adults.

It is characterized by the presence of many asymptomatic, skin-colored or white, small, flat-topped papules that have a shiny surface. The most common sites of involvement are the arms at the elbows, the dorsal sides of the arms, and the genitals.

Shiny lichen on the penis is manifested by small, dense nodules, not prone to merging and spreading. The main localization of the rash falls on the head of the penis. The disease is not accompanied by special symptoms, does not cause genital itching or burning.

Shiny lichen does not require special diagnosis and treatment. It is possible to prescribe symptomatic therapy, which will include taking steroid drugs, antihistamines and immunostimulants. Patients with Lichen nitidus may be recommended a course of physiotherapy and taking vitamin supplements.

Lichen sclerosus (lichen)

Lichen sclerosus(Lichen sclerosus) is an inflammatory dermatological disease that occurs in chronic form. It is accompanied by a change in the histomorphology of the skin of the genital organs and the formation of scar tissue.

The main localization of the pathology falls on the anogenital region; in men, such lichen occurs on the glans penis. On other areas of the body, such as the back, arms, or abdomen, lichen sclerosus is rare, occurring in about 6-15% of cases. The exact causes of the pathological process are unknown.

There are suggestions about the hereditary transmission of the disease. It was found that 15% of patients with this diagnosis have relatives with the same disease.

Some researchers believe that lichen sclerosus may be an autoimmune disorder where the immune system attacks its own cells and healthy tissues. Lichen sclerosus has also been found to be more common in women with other autoimmune diseases. such as problems with thyroid gland(thyroiditis) or diabetes mellitus, psoriasis.

Lichen sclerosus is a serious enough dermatological disease that can lead to phimosis without appropriate treatment. Ringworm can lead to more serious complications: violation of urination, narrowing of the urethral canal, cystitis and other diseases of the urogenital area.

Prolonged lack of treatment leads to the development of severe forms of the disease. This, in turn, can serve as a trigger in the formation of penis cancer.

The main symptoms are whitish patches and nodules (hyperkeratosis) that may coalesce into larger areas (plaques). Severe itching is also possible.

Antibacterial drugs and mycotic agents are usually ineffective. In this case, it is necessary to consult a urologist and determine an individual therapy regimen.

Methods for diagnosing forms of lichen

For an accurate diagnosis, differential diagnosis of various forms of lichen, including those with genital infections, plays an important role. The first stage of the examination is a face-to-face examination of the patient by a dermatologist.

The doctor evaluates the characteristics of the rashes, their structure and shape. Histopathological analysis is performed to confirm the diagnosis.

The histology of the affected area of ​​the epidermis is based on a microscopic examination of the tissue, which reveals atypical changes. Dermoscopy can also be performed by a doctor, its picture will give a more detailed answer regarding skin lesions with lichen on the penis. In addition, the study is aimed at identifying atypical changes in skin tissue that cannot be detected with the naked eye.

Dermatoscopy is a simple, safe, non-invasive and generally available method of examination. Provides valuable information for the evaluation of epidermal lesions of vague origin.
In a more simplified version of the diagnosis of skin diseases, a Wood's lamp is used.

Additionally, scrapings from the surface of the rash can be taken for analysis according to Giemsa or Tzank. With the localization of lichen on the genitals, an analysis for STIs is prescribed, it is important to exclude the presence of sexually transmitted diseases. Blood tests for STDs can detect a specific type of pathogen or antibodies to it.

Treatment of various forms of lichen

The tactics of therapy depends on the form and type of skin lesions.

The therapeutic effect is selected by the doctor strictly on an individual basis. The specialist will provide a list where he will indicate necessary drugs for treatment, schemes of their use and dosage.

Treatment of pityriasis versicolor

Treatment of pityriasis versicolor on the penis is carried out using drugs of the mycotic group.

The doctor may recommend topical antifungal drugs. Such as Ketoconazole for oral and topical use.
Oral antifungals can cause side effects such as nausea and damage to liver tissue. Therefore, medicines should be taken strictly according to the prescription of the attending doctor.

For patients with extensive epidermal lesions and frequent relapses Fluconazole is prescribed at 150 mg/time every seven days for 2 to 4 weeks.

Treatment of lichen planus (lichen ruber planus)

In the treatment of red lichen, the following groups of medications are used:

• Creams or ointments based on corticosteroids. Reduce the severity of the inflammatory process, accelerate recovery
• Vitamin RR. Improves skin condition, participates in cellular reactions
• Antihistamines. Reduce the severity of itching
• Antispasmodics or painkillers. Appointed if necessary, when itching is accompanied by painful sensations

Therapy for Pityriasis rosea (Pityriasis rosea)

Pityriasis rosea usually does not require any specific drug treatment. The rash may resolve on its own within 6-8 weeks.

If the patient has unbearable itching, a dermatologist may prescribe antihistamines in the form of tablets or ointments. During the period of rashes, it is not recommended to stay in the sun for a long time and wear tight, synthetic underwear.

Shingles treatment

herpes zoster- pathology of a viral nature, in the treatment of the disease, antiviral agents are prescribed. More often they resort to the appointment: Acyclovir, Cyclovir, Valaciclovir, Groprinosin.

Valaciclovir is reported to have greater overall efficacy than aciclovir.
Because it causes higher levels of antiviral activity in the blood. Thus, Valaciclovir may be the best alternative drug for patients at increased risk of complications.

Patients should avoid scratching the lesions to reduce the risk of scarring and keep the lesions dry and clean. At the time of therapy, it is necessary to exclude sexual intercourse in order to avoid transmission of infection.

Treatment of brilliant lichen

Shiny lichen characterized by a benign course. As a rule, rashes go away on their own and often require only symptomatic therapy.

Vitamin preparations and immunostimulating drugs are prescribed, aimed at strengthening the immune system. As a local treatment, doctors recommend taking baths with a decoction of pine needles. Salicylic acid-based ointments are also externally prescribed.

If all of the above methods do not give the desired result, the doctor prescribes the use of a hormonal ointment, previously diluted in a baby cream.

Lichen sclerosus treatment

Unfortunately, there is no cure or way to completely get rid of this form of genital lichen.

However, there are ways to reduce or eliminate Clinical signs diseases for a more comfortable life:

The patient will also need regular check-ups and a visit to the attending physician. This will help control the disease, as well as prevent complications.

For any, even minor changes in the skin or color, the structure of the rashes on the penis, you should consult a doctor as soon as possible.

If you suspect lichen on the penis, contact the author of this article, a dermatovenereologist in Moscow with many years of experience.

Lichen planus is chronic illness human skin. The reason is unknown. Main symptom: a papular (nodular) itchy rash appears on the skin and mucous membranes. Treatment is carried out by a dermatologist. Women get sick 2 times more often than men. Age of patients: 30-60 years. In children, it is extremely rare. The duration of the disease is from 1 month to 1 year.

ICD 10 code: L43. Abbreviated medical name: KPL. Latin name: LICHEN RUBER PLANUS. According to the classification, it refers to papulosquamous skin diseases.

The reasons

The etiology (cause) of lichen planus is unknown!!!
The pathogenesis (mechanism of development) of the disease is autoimmune. That is immune cells organisms begin to perceive their own skin cells as foreign, and begin to attack them. Why this happens - no one knows with 100% certainty, that is, no one knows the main reason for the development of this process. Therefore, there are several theories.

Theories of development of lichen planus

1. hereditary causes. The hereditary predisposition to the disease is higher in families where one or both parents suffer from lichen planus. Statistically, the incidence in such families is higher.
2. neurogenic theory. The disease often occurs after nervous stress and mental shocks in humans.
3. infection hypothesis. In some patients, manifestations of red lichen occurred after viral or bacterial infections. For example, after viral hepatitis, after herpetic infection, after the flu.
4. Toxic-allergic causes. Lichen planus sometimes occurs with prolonged contact with chemicals, with materials for filling carious cavities in dentistry. Rarely, manifestations of the disease appear after taking medications, for example, after a massive course of antibiotic therapy.
5. diseases of the gastrointestinal tract, endocrine system: gastritis, enterocolitis, pancreatitis, diabetes mellitus, etc.

Is lichen planus contagious?

No, it's not contagious. At histological studies no infectious agents were found. That is, it is not transmitted from person to person.

Symptoms and clinic

1. papules. The main symptom of lichen planus is the appearance of reddish-cyanotic or purple papules (nodules) 2-4 mm in size on the human skin. The shape of the papules is polygonal, non-circular. In the center there is a slight depression, so the papule looks flat. Over time, the papules become covered with small scales, but the peeling is unexpressed, not the same as with psoriasis. The scales are separated from the base with difficulty.
2. Skin itching. This is a sign of an exacerbation of the disease. In the remission stage - there is no itching and papules, but foci of increased pigmentation (hyperpigmentation) may remain.
3. Symptom of waxy sheen: in transmitted light, papules and plaques have a waxy sheen.
4. Wickham's mesh symptom: when smeared with vegetable oil, a mesh pattern (gray dots and stripes) is clearly visible on the surface of large papules.
5. Koebner's symptom: the appearance of new rashes in the course of scratching the skin is a sign of the presence of severe pruritus.

The main locations of the papular rash in lichen erythematosus

• skin folds on the flexion surfaces of the joints of the arms and legs,
• on the trunk, especially in the sacrum,
• genital organs - labia, glans penis,
• on the arms and legs - the front surface of the legs and forearms,
• in 20% of cases - oral mucosa (whitish rashes on the tongue, on the lips, in the mouth),
• rarely - nails (thinning, turbidity, furrows and depressions on the nail plate),
• rarely papules are located along the passage of nerve endings,
• very rarely - hairy part heads.

Clinical forms of lichen planus

1. The typical form is in 75% of patients. Papules appear on the skin, they can merge into groups.
2. Hypertrophic, or warty atypical form. Papules merge into large formations, grow like hyperkeratosis or warts, outwardly resemble senile keratosis. They are most often located on the anterior surface of the legs.
3. Ring-shaped atypical form. Papules merge into a ring.
4. Bullous or blistering atypical form. In addition to papules, blisters appear with clear or bloody contents. Requires prompt initiation of treatment.
5. Erosive and ulcerative atypical form. Localized in the oral cavity. Along with papules, erosions and sores appear on the mucosa.
6. Atrophic atypical form. There are few papules, in their place spots of a bluish-pink color appear over time. Skin itching is minor.

Diagnostics

The diagnosis of lichen planus is made by a dermatologist based on clinical picture: complaints, presence of rashes, characteristic symptoms. If the patient has an atypical form, especially in the oral cavity, which is difficult to distinguish from other diseases, a biopsy and histological examination are performed.

The patient needs to apply for an appointment with a dermatologist at the KVD (dermal and venereal dispensary) with compulsory medical insurance policy. Or go to a private clinic.

The differential diagnosis is made with

• bullous pemphigoid,
• eczema,
• neurodermatitis,
• seborrheic dermatitis,
• atopic dermatitis,
• lupus erythematosus,
• oral leukoplakia,
• nodular pruritus,
• lichenoid and warty tuberculosis of the skin,
• papular syphilis.

Complications

The hypertrophic and erosive-ulcerative form of lichen planus in 3% of cases is malignant, that is, it degenerates into squamous cell carcinoma.

Treatment

How to treat lichen planus if the cause is unknown? According to current guidelines, effective treatment disease should always include multiple directions.

In 99% of cases, hospitalization is not required. Treatment is carried out under the supervision of a dermatologist at home and in the ATC clinic.

Treatment or elimination of the underlying disease or precipitating factor

This may be the treatment of viral hepatitis, diabetes, elimination of the action of a toxic substance, stress management, etc.

Local therapy

1. Corticosteroid creams and ointments are prescribed. These drugs reduce the immune response in the skin, reduce the activity of inflammation.
   Ointments:, Akriderm (), Sinaflan, and others.
   Lubricate the affected area of ​​the skin 2 times a day - 4 weeks. Repeated course - only after agreement with a dermatologist.
   Treatment with corticosteroids is effective. According to reviews, the signs of exacerbation of the disease disappear within a week. But there's a danger side effects and the “rebound” effect, when after the abolition of glucocorticoids, a relapse of the disease occurs.
2. Preparations based on naphthalan.
   Ointment and cream.
   Lubricate the affected area of ​​the skin 2-3 times a day - 4 weeks. If necessary, the course is repeated after a week break.

General therapy

1. Antihistamines - prescribed to relieve itching and reduce inflammation.
   Claritin, loratadine, suprastin, erius, telfast, tavegil, diphenhydramine.
2. Retinoids: Tigazon and isotretinoin. The action of the drugs - inhibits the excessive growth of skin cells, normalizes the processes of keratinization. Membrane structures of cells are stabilized. Take neotigazon 20-30 mg once a day with meals. The course of treatment is 1.5-2 months.
3. Immunosuppressants are drugs that suppress the immune system. They are prescribed only by a doctor, and are prescribed by prescription. Used for severe forms lichen planus, not treatable by other means:
   - Corticosteroid hormones in droppers and tablets: prednisolone, dexamethasone and others.
   - Cytostatics: Chloroquine, Hydroxychloroquine, Cyclosporine A.
   The effect of the use of immunosuppressants is fast and persistent, but there are many side effects.
4. Antibiotics - are prescribed in the presence of infectious and purulent complications on the skin in patients with lichen erythematosus.
5. Sedative therapy (valerian, motherwort), hypnosis, electrosleep. Decreased excitability nervous system favorably affects the healing process - it always goes faster and more efficiently.
6. Diet. Exclusion of allergenic foods (chips, soda, citrus fruits, honey, etc.), spicy foods, hot food, alcohol. It is especially important to follow a diet in case of damage to the oral mucosa.

Physiotherapy