Lichen planus: how to eliminate a characteristic of the disease itching and cure it?
Good day! Dear readers, today we continue the topic about lichen planus, a detailed look at its treatment.
About the disease
Lichen planus in humans described more than a hundred years ago.
He refers to chronic skin inflammation in which the body of the patient spots appear monomorphic papular in nature.
In the mucosa of the lips, mouth, and other visible mucous membranes and skin there are primary cells, they are accompanied by itching of varying severity (see photo).
Why lichen planus is an actual problem? First, it is revealed increasingly, and secondly, there are chronic and severe forms of the disease that are difficult therapy.
Among the diseases of the mucous membrane of the mouth this pathology is around 35%, lesions of the skin falls to 2.5%.
The disease has no racial, age and gender, with the exception of inflammation of the mucous membranes, spots on them occur more often in women aged 40 to 60 years, rarely in children.
Possible causes and course of the disease
Modern experts consider several main theories about the origin of lichen planus: neurogenic, immune, viral, hereditary, intoxication, allergic.
All the reasons applicable to the patient in the individual case, for example, the mucous membrane of the mouth is affected more often in patients with concomitant diseases of the gastrointestinal tract. About it in more detail you can read in this article.
Positive Association with disease is seen in those who suffers from diabetes and hypertension.
In recent years more and more cases of the CPL is noted as a response to exposure to chemical agents, drugs, that is, in these cases, the disease occurs as an allergic reaction to internal or external stimuli.
How is the disease?
The disease is characterized by monomorphic rash. This suggests that all elements are the same type of morphological forms, in this case, the papules.
They are flat, the surface is shiny in the centre is seen as a the impression, different color (from crimson-purple to pink-red).
The diameter of the papules reaches only 2-3 mm… Shine them resembles wax, is very well visible in the presence of side lighting.
Elements in lichen planus tend to merge, forming plaque, covered with small scales.
The disease is accompanied by pathognomonic symptoms, that is, those that will help to distinguish it from other, apparently similar, dermatosis:
On the periphery of the formation of new plaques of small papules that tells about the jerky course of the disease.
The emergence of new podsyhanii in unusual places after injury is accompanied by progressive stage of the disease.
Of subjective symptoms in the first place is intense itching. The resolution of the spots takes place with the formation of areas of hyperpigmentation.
Localization of sources of the KPL: skin (flexor surfaces of the wrist and forearms), legs (the front surfaces of the shins), skin in the sacral region, on the penis. The rash of shingles is very common, up to the formation of erythroderma.
Signs of lesions of the mucous membranes
Often affects the mucous membranes of the oral cavity, rarely in the genitals.
Spots can be noticed in the mouth: the cheeks on the inside, on the palate, gums and tonsils. The beginning is characterized by the appearance of the miliary, that is small, white papules, which form plaques.
The constant maceration of the spots in the oral cavity leads to changes in their color, they become shiny, waxy, whitish.
Infiltration are negligible, the elements almost do not rise above the surface.
Change the nail plate with the CPL, they become muddy, grooves and depressions. The nails become thin, collapse and break down.
This video also describes in great detail about the disease:
Approaches to therapy
CPL refers to a benign chronic disease, but even given this, is attentive to its treatment, because there are atypical resistant forms of the disease, complications and resistance to treatment.
First and foremost, you need to eliminate the harmful causal factors associated with illness, professional and domestic factors, acute infection, poor nutrition, allergic factors, it is necessary to pay attention to already used drugs, prescribed diet.
With the defeat of the internal organs and erosions on the mucous membranes used hormonal immunosuppressants, as well as chloroquine and hydroxychloroquine.
They inhibit the immune system, stop inflammation.
What can relieve itching? Intense itching cropped using antihistamines, blockers of catecholamines and antiserotoninova. Normalize sleep will help sedatives and antidepressants.
Successfully used vitamins, namely Vit a derivatives.A and carotenoids. They affect the development of cells of the skin and mucous membranes.
Reduce the time of treatment with the hormones vitamin E.
Methods of external therapy
If the disease is accompanied by intense itching, external use of local corticosteroids (creams or ointments), mixtures and solutions with menthol, anestezin, citric acid and antihistamine components.
Erosive-ulcerative defects treated epitelizirutmi drugs: Solkoseril, sea buckthorn oil and rosehip.
On the immune reaction in the skin is beneficial phototherapy. After a few treatments disappears infiltration in the skin, normalizes the structure of epidermal cells.
The latest research showed a positive result in immunotherapy of red lichen. In particular, she used exogenous interferons (Interlok and IFN), as well as interferonogene (Ridostin and Neovir).
If you suspect the chemical nature of the disease (e.g. medications), conducting research and their cancellation.
Also, patients with the CPL must be analyzed for blood sugar, mental status and the condition of the gastrointestinal tract.
The possibility of physical treatment
Physiotherapy treatments are widely used in this disease. Your doctor may prescribe electric, as a sedative method, inductometer the lumbar region, and paravertebral diathermy currents.
Lesions on the mucous membrane of the oral cavity treated with triamcinolone, which is more than half of the patients leads to an improvement in 2 days.
As prevention of secondary fungal infection (candidiasis) apply fluocinolon-based gel hydrocellulose in combination with chlorhexidine and miconazole.
Lichen planus has a good prognosis, but only with timely treatment. Do not self-medicate using traditional remedies without your doctor’s approval, it may cause complications.
Author: Anna Derbeneva (dermatologist)