Red deprive. Red lichen in adults and children - what does it look like, how to treat it? Lichen planus: the most effective treatment Lichen planus treatment drugs

Red lichen is a disease that is rare in children, but is characterized by a long course. The cause of the pathology has not been identified, so etiological treatment is not carried out.

To eliminate the nosology, symptomatic therapy is sufficient, since the body copes with the pathology on its own.

Reasons for the appearance

There are several theories explaining the causes of red lichen in humans:

Genetic. In practice, infectiologists meet with cases of the appearance of nosology in relatives of 2-3 degrees of kinship;
Neuroendocrine. In patients with diseases of the autonomic nervous system, hormonal disorders after the onset of hypertension, diabetes mellitus, hypoestrogenism, early menopause, red spots often appear on the skin. The frequency of a combination of secondary nosology with lichen according to statistics is over 65%;
Viral. Some scientists suggest that the disease is associated with damage to the epidermis by a filtering virus that lives on human skin. The theory is not supported by research. Experiments to find the pathogen ended in failure;
Toxic-allergic. In metabolic diseases, hypersensitivity to food elements, metabolic products, antibacterial agents, modified vitamins occurs. An irritating effect on the skin of arsenic, bismuth, sulfur compounds, gold, mercury, and other trace elements is expected;
Metabolic. Metabolic disorders can lead to red rashes, so the disease often appears on the background of diabetes. In practice, experts observe an atypical course of dermatosis in violation of glucose metabolism.

Upon careful analysis of the theories described, it becomes clear that the reasons given do not stand up to scrutiny. Discussions continue, but modern treatment of lichen red, including in the oral cavity, is based on the elimination of provoking factors:

Infections - hepatitis, pancreatitis, renal failure. An additional negative factor is the long-term use of pharmaceuticals for the treatment of these nosological forms;
Metabolic disorders - metabolic syndrome, gout, diabetes mellitus, excessive accumulation of fats in the walls of blood vessels;
Disorder of the functioning of the digestive system;
chronic diseases;
xanthomatosis;
Renal failure.

Symptoms

Downstream, lichen in the oral cavity is divided into atypical and typical. Forms are easy to differentiate on the basis of external manifestations. In the classic course, rashes appear on the skin, which are accompanied by itching. Malaise, apathy, weakness are intoxication symptoms. Their presence suggests an infection, but experts failed to identify the pathogen. The patient's neuropsychic instability is a symptom that indicates damage to nerve fibers or brain cells.

Lichen planus is a disease that affects the skin, mucous membranes (lichen planus of the mouth), in 20% of cases nails are also affected. Mostly adults are ill, cases of this type of lichen among children are very rare. Lichen planus in humans is characterized by a chronic relapsing course.

The reasons

The causes of red lichen have not been definitively determined. There are several theories for the onset of the disease. Here is some of them:
1. Infectious-allergic theory: there are foci of chronic infection in the body, which, under certain external factors, exacerbate the disease in the form of rashes of red lichen
2. Hereditary predisposition
3. Weakened immunity
4. Diseases of the gastrointestinal tract
5. Hormonal disorders
6. Stress
7. Sometimes lichen planus develops as an allergic reaction to certain medications.

Lichen planus of the mouth - causes
Red lichen of the oral cavity develops as a continuation of the disease by this type of lichen of the whole organism and is based on the same causes of occurrence. The impetus for the development of the disease in the oral cavity can be an injury to the mucous membranes of the mouth with sharp edges of teeth, fillings, abrasions from low-quality prostheses. Often lichen of the oral cavity develops if the prostheses are made of different types of metal.

Symptoms of lichen planus
With lichen planus, the skin of the chest, abdomen, arms, legs is primarily affected. Often it is localized in the elbows, armpits. Itchy reddish-purple seals (papules) appear on the skin with a flat, shiny surface and a depressed center. Papules may coalesce to form small plaques (like "cobblestone"). On the surface of the papules, you can see a whitish mesh pattern - Wickem's mesh. After resorption of papules, brown skin pigmentation remains.

Lichen planus of the mouth - symptoms
Papules are located on the inner surface of the cheeks, lateral surfaces and back of the tongue, on the red border of the lips. The gums and palate are less commonly affected. They are whitish in color, shiny, form a "fern pattern" or resemble a grayish-white lace net. There is a burning sensation in the mouth, a feeling of tightness of the mucous membrane, pain when taking spicy food. In a more severe (erosive-ulcerative) form, severe pain occurs when eating any food, the oral mucosa can often bleed. This form is characterized by erosion, ulcers in the center of lesions.

Lichen planus - alternative treatment

Before treating lichen planus with folk methods and remedies, it is necessary to eliminate the factors that contribute to the development of the disease. Often this type of lichen accompanies diseases such as chronic gastritis, gastric and duodenal ulcers, cirrhosis of the liver, diabetes mellitus, etc. It is necessary to treat these diseases. Often, lichen planus manifests itself as an allergic reaction to medications - so you need to find an adequate replacement for these drugs.
Before treating red lichen of the oral cavity caused by traumatic factors, these factors must be removed - polish the sharp edges of the teeth, change dentures, cure caries and periodontal disease, stop smoking and spicy foods

Treatment of lichen planus of the oral cavity with sea buckthorn oil
Soak a piece of cotton wool or a folded piece of gauze with sea buckthorn oil and apply an application to the affected area of the mucosa for 30-60 minutes. Inside, it is also desirable to use sea buckthorn oil - 1/2 tsp. per day on an empty stomach.

Vinegar treatment.
It is recommended to treat lichen planus with apple cider vinegar: 4-6 times a day, apply undiluted apple cider vinegar to the affected area for 10 minutes. Instead of vinegar, you can use viburnum or cranberry juice.

Ointment from hops, burdock and calendula.
Take 1 tbsp. l. calendula flowers, and 2 tbsp. l. hop cones and burdock roots, pour 200 g of boiling water and boil, strain. Mix 1 tbsp. l. decoction and 2 tbsp. l. vaseline. Apply this ointment to the affected areas in a thin layer several times a day.

Herbal compress.
Take 3 tbsp. l. mullein flowers, 1 tbsp. l. celandine and 1 tbsp. l. willow bark. Pour 1 liter of boiling water, leave for 1 hour. Make compresses from this decoction on the affected areas or simply wipe them several times a day.

How to treat lichen planus with beets.
Grate the red beets and tie to the lichen. When the beets dry out, you need to replace them with fresh ones. Carry out treatment until the lichen passes.

Folk water treatment
Pour lichen planus with hot water for three minutes. 2 times a day; after 3 days improvement is noticed, and after two weeks the lichen disappears.

Lichen treatment with herbs.
External treatment of lichen planus is desirable to combine with the intake of herbal infusions. Here are some traditional medicine recipes for red lichen:
1. Mix in equal parts St. John's wort, centaury, nettle, juniper, plantain, wormwood, yarrow, horsetail, sage.
2. Mix in equal parts kopek root, clover flowers, birch buds, dandelion root, wormwood grass, string.
3. Mix in equal parts yarrow, tansy flowers, immortelle flowers, burdock root, goldenrod herb, bearberry
4. Mix in equal parts cornflower flowers, cudweed grass, rose hips, rowan fruits, cinquefoil root, erect cinquefoil root
5. Mix in equal parts black elderberry flowers, nettle, dandelion root, birch buds, juniper berries, St. John's wort
2 tbsp. l. collection, pour 1 liter of boiling water, insist overnight in a thermos. Take the entire infusion during the day, 100-150 ml. The course is 3-4 months. Then they take a break for 10-14 days, change the collection and continue treatment. Continue to treat lichen with these remedies for at least 12 months.

Tar
Mix 150 g of birch tar with 2 egg yolks and 100 g of fresh cream. Rub into affected areas twice a day.

How to treat lichen planus with calendula
When treating lichen planus with folk remedies, calendula flowers for compresses and rubdowns can be used in the form of an alcohol tincture, infusion (2 tablespoons per 1 cup of boiling water) or ointment. Ointment from calendula inflorescences gives the best result in the treatment of lichen planus. To prepare it, you need to grind 10 g of powdered inflorescences with 50 g of petroleum jelly.
On the affected surface of the skin, apply gauze moistened with tincture or infusion, or lubricate the affected skin with calendula ointment.

Lichen red flat - treatment with folk remedies - recipes from the newspaper Bulletin of healthy lifestyle

Cold water in the treatment of lichen planus.
This type of skin lesion was cured after several days of dousing with cold water. (HLS 2004, No. 21, p. 9)

Ointment for the treatment of lichen.
Church incense (only not imported), aloe, garlic - all 50 grams, 1 egg white. Chop and beat everything. Shake before use. Keep in refrigerator. Lubricate the affected areas. This folk remedy also helps with psoriasis and purulent wounds. (2002, No. 22, p. 18)

Alternative treatment of lichen planus
In three days, it was possible to cure lichen with the moisture of a misted window - wipe the misted window with a cotton swab and lubricate the affected areas. (2005, No. 22, p. 29)

A mixture of herbs for the treatment of red lichen.
A woman for many years could not get rid of lichen planus, was treated with antibiotics, expensive ointments - on one lower leg the lichen disappears, on the other it appears. I decided to treat lichen according to the folk recipe "Six Herbs". It is necessary to take in equal parts dandelion roots, calamus roots, yarrow grass, wormwood and horsetail, cloves. Grind everything into powder. Take 1/4 tsp with water 2 times a day 2 hours before meals. The course of treatment for lichen is 2-3 months. The woman carried out the treatment for 2 months, but did not notice the results, she quit the treatment. After a while I noticed that it got better, and soon red lichen disappeared completely. (Healthy lifestyle 2012, No. 2, p. 38,)

Herbal baths for the treatment of red lichen.
With severe itching, baths or washings with infusion of St. John's wort, chamomile, sage, oak bark will help. To prepare the infusion 3-5 tbsp. l. pour one of these plants with 1 liter of boiling water, insist and pour into a bath of water. Lie down for 15-20 minutes. Course - 10 procedures. (HLS 2012, No. 20, p. 12)

Calming teas.
To cure red lichen faster, it is recommended to use soothing and restorative teas from mint, oregano, St. John's wort, motherwort, valerian. It is necessary to brew 1 tbsp. l. any herb with one glass of boiling water. Drink 1/3 cup 3 times a day. The course of treatment is 1 month. (HLS 2011, No. 20, p. 12)

Propolis ointment
A woman was helped to cure lichen planus by such a folk remedy: 100 g of petroleum jelly (you can take 100 g of lanolin or 100 g of fish oil) put in an iron mug, add 15 g of grated frozen propolis, heat in a water bath for about 15 minutes until the propolis dissolves. Then strain. To smear deprive in the morning and in the evening. (HLS 2010, No. 20, p. 10)

If a person has characteristic rashes on the mucous membranes and skin, then most likely he has developed contagious lichen erythematosus (dermatitis red, lichen pink). This chronic inflammatory disease is the most common pathology of the oral cavity. In an adult, lichen planus occurs much more often than in a child, but it is equally difficult to cure it, because the symptoms are similar. The disease looks like a normal dermatosis, but differs from its other varieties in that it appears against the background of already existing problems with internal organs.

What is lichen planus

This is a chronically flowing dermatosis, the characteristic element of which is the papule. Pathology affects the skin, nails, mucous membranes. The variety of papules, their localization, appearance and the presence of groups causes a huge number of forms of lichen planus. More often the disease is detected in women 40-60 years old. The disease proceeds slowly, relapses alternate with periods of subsidence of clinical symptoms. Elderly people and children rarely get lichen planus.

Is it contagious

Doctors have not yet been able to find a definite answer to this question. It is believed that lichen planus is not contagious. However, in medical practice, there are facts of the occurrence of pathology in all family members. An episode was also documented when a doctor who took tissue from a patient found a pointed papule on his skin a week later. A month later, the doctor developed numerous rashes similar to those that were present in his patient. It can be assumed that infection with red dermatitis is possible through close contact.

Symptoms

The most characteristic sign of red lichen is Wickham's mesh. It is a pattern on the surface of large papules, which is perfectly visible when vegetable oil is applied to the rash. Lichen planus looks like a collection of small nodules alternating with compacted plaques. Skin with red dermatitis looks like a glossy sheet of paper, which has a purple-bluish tint. Symptoms of lichen planus are difficult to confuse with another skin problem, because with its development it is easy to notice whitish dots and stripes, which are a thickening of the stratum corneum of the epidermis.

In children

In appearance, lichen planus is not much different in adults and children. The first rashes are localized on the legs and arms in the area of the joints of the child. Then the red dermatitis spreads to other parts of the body, and small shiny papules are grouped on the skin, resembling a ring. On the joints, seals are harder than on other parts of the skin. The vesicular form of lichen is expressed by fluid-filled vesicles, which are localized at the site of foci of chronic inflammation. They can affect the mucous membrane of the child's mouth and be accompanied by itching, which provokes sleep disturbance.

Causes

There are many theories about the etiology of the disease:

Hereditary. Based on some cases of disease of relatives in the 2nd and 3rd generation.
Neuroendocrine. The main reason is emotional stress, long-term mental disorders, dysfunction of the nervous system due to certain diseases (early menopause, hypertension, hypoestrogenism, and others).
Allergic. It is based on the toxic-allergic reaction of the body to chemicals, vitamins and drugs, food products.
Viral. Red lichen is explained by the presence of a filtering virus in the body, which is activated when immunity is reduced.
Metabolic. It is based on the common development of lichen planus and diabetes mellitus, which often occur together.

Classification

According to clinical manifestations, red dermatitis is classified according to the type of disease:

Form of the disease	Main clinical signs
Typical (reticular)	On the mucosa, whitish papules are observed, which are not removed when scraping. Typical rashes look like a mesh pattern.
Hyperkeratotic (warty)	Lichen is manifested by significantly raised large papules, which are covered with brown-gray dry horny layers. They are localized more often on the sacrum, on the anterior surface of the lower leg.
Ulcerative - erosive	On the mucous membrane of the cheeks, white papules merge into a pattern, against which erosion is visible. Ulcers are observed on the hyperemic mucosa of the tongue in combination with papules.
annular	Typical papules are connected into rings of different sizes. The rash is localized on the head of the penis, around the joints, in the region of the shoulder blades.
Hyperkeratotic	Differs in hypertrophic keratinization foci protruding above the red border of the lips. At the same time, the rashes are accompanied by papular elements, which merge into stripes in transitional folds.
Exudative-hyperemic	It is characterized by rashes on the inflamed mucous membrane of the mouth.

Diagnostics

At the first symptoms of a skin disease, you need to contact a dermatologist. The diagnosis of "lichen planus" is carried out on the basis of a visual examination and is not difficult. Plaques of a polygonal shape of a smooth surface with a characteristic color of rashes indicate red dermatitis. To clarify the diagnosis, the following laboratory tests are carried out:

skin biopsy;
histological examination of the biopsy.

Treatment of lichen planus

The lack of clear knowledge about the causes of the disease causes the use of different schemes and methods of its treatment. Drug therapy is carried out with the use of sedative drugs and drugs that relieve itching. Selective phototherapy and PUVA therapy effectively fight the disease. Another treatment for red dermatitis is the combined use of antimalarial and corticosteroid drugs.

In most cases, local therapy for lichen planus is not prescribed. The exception is the hypertrophic form of the disease, in which dressings, intralesional injections, destruction of lesions by radio wave or laser are used. If the nodules are located on the mucous membranes, then phytoextracts, corticosteroid ointments, and vegetable oils are recommended for treatment.

Medications

For the treatment of red lichen, a wide range of medications is used:

In the acute and subacute course of the disease, the sedative drug Medazepam is prescribed, which calms the nervous system and relieves stress. The disadvantage of taking the medication is the possibility of developing multiple side effects.
With very common rashes, the doctor prescribes the antiviral drug Zovirax. The medicine has contraindications: renal failure, neurological symptoms.
Additionally, vitamin E is prescribed, which reduces the duration of treatment. With its overdose, apathy, loss of vision, and digestive problems can be observed.
To eliminate the painful itching, the doctor will recommend the antihistamine Cetrin, which reduces inflammation. The drug is not prescribed during pregnancy and lactation.
If complications arise that are associated with erosive and ulcerative skin lesions or the addition of a secondary infection, then treatment with the antibiotic Tetracycline is performed. Among the disadvantages of its use are multiple adverse reactions.
With long-term treatment, the corticosteroid Dexamethasone is additionally prescribed. There are risks of getting allergic and dermatological reactions after using the medicine.

Ointment

Doctors in dermatovenereology, in addition to drug treatment, recommend the use of external agents. The best ointment for lichen planus on the mucous membranes is Flucinar. This is a glucocorticosteroid drug that has anti-allergic, antipruritic, anti-inflammatory effects. It is applied within 1-2 weeks on the damaged mucosa with applications. Do not prescribe ointment to children under 2 years of age.

To quickly cure a disease of external origin, Advantan ointment is recommended. It relieves itching, swelling, removes inflammation, pain. The ointment is applied to the affected surface 1 time / day until the lichen disappears completely. Among the disadvantages of using Advantan is that it cannot be used for skin tuberculosis, rosacea, skin manifestations of syphilis.

Physiotherapy

It will be easier to get rid of red lichen if, in addition to tablets and ointments, you undergo a course of physiotherapy. Main methods:

PUVA therapy - the combined effect of photosensitizers and ultraviolet radiation, which gives an anti-inflammatory effect;
magnetotherapy, which improves tissue regeneration;
applications of ozocerite, which have a resolving effect.

Treatment of lichen planus at home

So that red lichen does not cause atrophic baldness of the scalp, along with the main treatment, alcohol tincture of calendula, which is easy to find in a pharmacy, should be used. Rub the product into the affected areas of the scalp, preferably several times a day. Judging by the reviews of patients, sea buckthorn oil helps to cope with lichen planus, which must be applied to gauze daily, leaving the lotion on the site of inflammation for at least 1 hour.

Lichen planus is a chronic skin disease that is difficult to treat due to the unclear cause of its development. With lichen planus, the most effective treatment is the one that helps a particular 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 a skin lesion appears is still not known. Presumably, the causes of the disease can be the following factors:

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

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

How to recognize lichen

The disease is manifested by 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 is a dense nodules of small size. 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, the formation of nodules on the genitals is possible.

Lichen can also affect the nail plates, causing the nails to flake, thin, and may atrophy.

Principle of treatment

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

Often, the following types of drugs are used to treat the disease:

sedatives;
antibiotics in tablets and ointments;
drugs against malaria;
special diet;
ointments with corticosteroids;
antihistamine tablets;
general strengthening drugs to increase immunity

Often, a number of physiotherapeutic methods are used for treatment.

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

Sedative drugs

One of the possible causes of such a skin disease as red lichen is a violation of the nervous system. This disease is often faced by people prone to frequent stress. In this case, you can solve the problem with the help of sedatives.

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

For sleep disorders, the patient is indicated for herbal sedatives, while for the treatment of anxiety, stronger medications, such as tranquilizers or antidepressants, may be needed.

The safest sedatives are:

peony tincture;
tincture of valerian root;
glycine.

Tincture is easy to purchase at any pharmacy, it is quite inexpensive. The dosage of the drug is selected by the doctor individually for each patient.

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

Often, patients are prescribed B vitamins to strengthen the nervous system. With a mild degree of lichen, such treatment, together with ointments for treating the skin, quickly brings results.

Ointments for skin treatment

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

salicylic ointment;
ointment with corticosteroids;
dibunol ointment.

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

Salicylic ointment promotes exfoliation of dead skin cells of the affected skin and improves regeneration. It is used for moderate rashes, and to soften plaques and nodules on the skin.

If the rash is localized on the mucous membranes, dibunol ointment is prescribed for their treatment. This cream is applied pointwise to the affected areas.

Other drugs

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

Antihistamines can relieve itching, swelling and discomfort in the affected area. Allergy pills are selected by a doctor. Unpleasant sensations from lichen planus recede the next day after the start of taking antihistamines.

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

With extensive skin lesions, the patient is shown physiotherapy. Most often, patients are prescribed a special ultraviolet irradiation of the affected areas of the skin, which helps to 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.

Power principle

The basis of treatment is a diet for lichen planus. Nutrition is based on the rejection of the following products:

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 sugary soda.

How much to stick to the diet depends on the degree of skin damage. Often, the duration of the diet is from one to three months, in especially severe cases, such a diet will have to be followed up to six months.

Folk remedies

Traditional medicine helps to reduce unpleasant symptoms, but does not eliminate the problem forever. They can be used only after consulting a doctor, however, such treatment should complement, but not replace, diet and drug therapy.

Mix one large spoonful of dried and chopped chamomile, calendula and sage, pour boiling water and let it brew until cool. Then a gauze compress is moistened in the resulting decoction and applied to the affected area of the skin.
Grind a few leaves of aloe, pour boiling water and insist for a day. Then the tool is applied to compresses.
Mix a large spoonful of frankincense with the same amount of juice from aloe leaves, add three cloves of garlic crushed into gruel to the resulting mixture. In the resulting product, a compress is moistened and applied for 20 minutes to the area of skin lesions.
In folk medicine, birch tar is also used. This remedy 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.
It is also recommended to lubricate nodules and plaques with slightly warm sea buckthorn oil. This allows you to accelerate the regeneration of the skin and eliminate discomfort.

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

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

Lichen planus- a chronic inflammatory disease, which is characterized by the appearance of itchy rashes on the mucous membranes and skin. Sometimes the disease affects the nails.

It proceeds for a long time: exacerbations of the disease alternate with periods of subsidence of the symptoms of the disease.

According to statistics, lichen planus among all dermatological diseases in adults ranges from 0.78% to 2.5%. And among the diseases of the oral mucosa - about 35%. And, unfortunately, the number of patients is growing year by year.

It is noteworthy that simultaneous damage to the skin and mucous membranes occurs in 30-40% of cases, and in 12-20%, nails are also involved in the process along with the skin. However, in 25% of patients, only the mucous membrane is affected.

The disease occurs in all races, both among men and among women. Moreover, men get sick more often at a young age, while women - over 50 years old. In addition, in women aged 40 to 60 years, the mucous membranes are somewhat more often affected.

There is evidence that in 10-12% of cases, lichen planus degenerates into a tumor disease.

Children and the elderly rarely suffer from this dermatosis, and a disease that occurs in early childhood is an exceptional case. In 1860, F. Gebra coined the term "lichen planus". And in 1869, the English dermatologist E. Wilson first described this disease in detail, identifying the distinguishing features from other dermatoses and highlighting its main forms.

In the domestic medical literature, this disease was first mentioned in 1881 by V. M. Bekhterev and A. G. Polotebnov.

Despite the fact that dermatosis has been known for over 100 years, the exact causes that lead to its development have not yet been established. There are only theories on this subject, which are speculative.

However, this dermatosis is often combined with some autoimmune diseases: systemic lupus erythematosus, rheumatoid arthritis, scleroderma. This is evidence that these diseases probably have the same causes and mechanism of development.

Causes of lichen planus

The most common theories of origin

neurogenic
It is based on the fact that dermatosis suddenly develops or relapses (a period of deterioration) after a mental trauma. In addition, most patients with this dermatosis suffer from one or another disorder of the nervous system (neurasthenia, vegetative neurosis, and others).
In addition, rashes are often located along the nerve branches in the presence of neuritis.
Some patients have violations of the innervation of the skin and its nutrition, which are caused by damage to the spinal cord node for a completely different reason. For example, trauma, the presence of a herniated disc or sciatica.
Viral or infectious
According to her, the virus or pathogen is in an inactive state in the lower rows of cells of the epidermis (the outer layer of the skin).
However, under the influence of certain factors, it activates and stimulates cell division of the upper layer of the skin. In response, the immune system begins to produce antibodies that simply "eat" their own cells. In this case, these are epidermal cells.
hereditary
It is believed that there is a gene - the carrier of the disease, which is inherited. However, up to a certain point, he “sleeps” (is in an inactive state), but under the influence of some provoking factors, he “wakes up”.
This theory is supported by the fact that in the family of 0.8 -1.2% of patients with lichen planus suffered from this disease for several generations.
In these cases, there is an earlier onset of the disease (sometimes even in childhood), a long duration of exacerbations, as well as frequent relapses (deterioration of the general condition and return of symptoms of the disease).

Intoxication
It is based on the toxic effects of a number of substances on the body:
- Medications(according to the type of allergic reaction)
  About 27 drugs are known that can cause the development of dermatosis:
  - preparations of gold (treatment of rheumatoid arthritis), antimony, iodine, aluminum, arsenic.
  - antibiotics: tetracyclines, streptomycin.
  - anti-tuberculosis drugs: Ftivazid, para-aminosalicylic acid.
  - quinine and its derivatives.
  - and others.
  However, the paradox is that some of these drugs are used to treat lichen planus. For example, arsenic preparations externally (arsenous acid), antibiotics. Apparently, in some cases, these drugs can really cause dermatosis. Or they lead to toxic skin lesions like lichen planus.
- Autointoxication
  They arise due to the accumulation of toxins in the body in case of impaired liver function (cirrhosis, hepatitis), diseases of the stomach and intestines (gastritis, peptic ulcer), diabetes mellitus, arterial hypertension. Presumably, the cells of the liver, gastrointestinal tract, pancreas, heart and blood vessels are damaged by the same factors as skin cells.
  According to studies, some patients with lichen planus have changes in liver function tests (blood chemistry).
  The rest have impaired carbohydrate metabolism, so often dermatosis is combined with diabetes. And in this case, the disease is especially difficult.
immunoallergic
considered to be the leader. In fact, it unites all theories, since each of them is based on disorders in the immune system.
According to studies in patients in the blood and at the site of rashes, the ratio of T-suppressors (cells that lower the immune response) and T-helpers (cells responsible for an active immune response) is disturbed due to an increase in the latter.
At the same time, circulating immune complexes are found in the blood, consisting of antibodies (proteins produced by the immune system) and part of the "stranger" wall (in this case, skin cells).
That is, the immune system "does not recognize" its own tissues. Therefore, it develops and sends its “soldiers” (antibodies, lymphocytes, leukocytes, immunoglobulins, and so on) against them, which damage the cells of the skin and mucous membranes.
Therefore, in the affected area of \u200b\u200bthe skin, substances that cause inflammation begin to be produced: prostaglandins, interleukins.
As a result, immune inflammation (delayed-type allergic reaction) develops. It leads to the death of the cells of the upper layer of the skin and mucous membranes or their inability to perform their functions in the affected area.

Classification

Downstream, lichen planus happens:

acute - up to one month
subacute - up to six months
chronic - from six months to several years

Symptoms of red lichen

The onset of the disease is different:

Often there are several signs that the patient does not pay attention to: slight malaise, weakness, nervous overexcitation. And after 8-10 days, the first rashes appear.

Rash sometimes occurs without previous symptoms.

Elements of the rash often capture large areas of the skin at once. Or they appear crowded in one place, and only after some time they spread to other areas of the skin.

If the disease is accompanied by severe itching, then irritability, insomnia may appear.

What does lichen planus look like?

The main symptom of this dermatosis is itchy rash that appears on the skin and/or mucous membranes.

The location of the rash on the skin

It can hit any area, but it has its favorite places:

the inner surface of the thighs, wrist joints (the place where the hand passes into the forearm), forearms
elbow bends
ankle joints
popliteal fossae
axillary folds
lumbar region
lateral surfaces of the body
underbelly
palms and soles

This dermatosis "loves" the mucous membranes:

oral cavity (mainly buccal mucosa, hard palate, occlusion area, tongue)
glans penis
vestibule (entrance) of the vagina

This arrangement is due to the fact that in these places the skin is thinner and subject to friction.

Whereas the genital mucosa is injured during intercourse, and the oral mucosa is injured by poorly installed prostheses, sharp teeth, burning or spicy food.

The reason is a decrease in the body's ability to adequately respond to environmental influences due to a disruption in the functioning of the immune system.

Features of a skin rash in typical (usual) cases
In place of the papule, after its reverse development (the elements of the rash heal), pigment spots often remain, which disappear with time.

Atypical forms of lichen planus

warty or hypertrophic

It is a consequence of warty hyperplasia (growth). It is characterized by the appearance of shiny, strongly itchy papules or plaques of pinkish, purple, brown color, which tend to merge with each other.

The rashes look like warts with a honeycombed surface (as if pricked with pins), which are covered with a small number of scales.

The most common location is the anterior surface of the legs. However, sometimes this form affects other areas of the skin.

The most difficult to treat.

Atrophic (sclerotic)

It is formed due to atrophic (malnutrition leading to a decrease in cell volume) and sclerotic (replacement of normal cells with connective tissue) changes at the site of ordinary papules.

It can be primary (develops independently) and secondary (formed as a result of the reverse development of typical papules).

This form is characterized by the appearance of rounded grayish or ivory spots the size of lentils, not rising above the level of the skin or somewhat sinking.

Sometimes around the elements of the rash there is a rim of lilac or deep pink.

When the foci are located on the scalp, pubis, armpits, baldness may develop. If - on the flexion surfaces of the limbs, then - follicular keratosis (blockage of the expanded hair follicles with horny masses). This symptom is called Little-Lassouer.

Bubble (bullous)

It develops infrequently: with a rapid course of dermatosis, often accompanied by a severe general condition of the patient.

Women over 50 are most susceptible to this form.

It is characterized by the appearance, as well as the rapid spread of small and large bubbles (sometimes the size of a pea) on unchanged or reddened skin, papules or plaques.

The blisters are filled with serous (transparent whitish) or bloody-serous fluid. Their capsule is quite dense, so they do not open for a long time. And after opening, ulcers or erosions form at the site of the blisters, which heal faster than with the true erosive form of this dermatosis. Moreover, in the oral cavity, the blisters open quite quickly.

Around the blisters there are rashes typical of the usual form of lichen planus.

Erosive and ulcerative

The most severe and difficult to treat form. It mainly affects the mucous membranes: more often - the oral cavity, less often - the glans penis or the vestibule (entrance) of the vagina.

Defects appear on the mucous membranes, from which sharply painful ulcers and erosions of an irregular or rounded shape quickly form.

Usually around these formations or distant areas of the skin there are rashes typical of lichen planus.

Ulcers and erosions have a pinkish-velvety bottom, and sometimes they are covered with films or plaques, and after their removal bleeding easily occurs.

Often this form is one of the components of the Potekaev-Grinszpan syndrome, which includes diabetes mellitus, arterial hypertension and erosive and ulcerative form of lichen planus.

During treatment, as a rule, these formations disappear, but then reappear. Therefore, the process can take years.

Erythematous

On a significant part of the skin, widespread reddening of the skin, swelling and peeling suddenly appear. Then there are soft nodules.

annular

It is formed as a result of the spread of the focus in breadth, while in the middle the elements of the rash fade. Thus, rings are formed.

Most often this form occurs in men in the genital area, on the mucous membranes or on the skin of the inner surface of the legs.

Nail lesions

It is rare and comes in two varieties:

Onychorrhexis. Increased fragility and longitudinal splitting of the nail plates appear (furrows, depressions, opacities form on the nail).
Onycholysis. The growth of the nail stops or it is completely destroyed. As a result, a skin roller in the form of a wing grows on a bed devoid of a nail.

Mucosal lesions

As a rule, small papules of a grayish-white color appear first, which stand out well on the mucous membrane. Further, plaques form, but they do not have a waxy hue, due to constant maceration (softening). Moreover, combining with each other, papules can form bizarre shapes: rings, nets, and so on.
With a typical form of rash, as a rule, they are painless and asymptomatic, which distinguishes it from erosive-ulcerative.

Lichen planus in children

It proceeds somewhat more aggressively due to the peculiarities of the structure of the skin: an increased ability of tissues to retain water and a large number of blood vessels in the skin.

Therefore, the skin quickly swells, the rash acquires a rich red color with a bright purple or purple hue, and blisters form on the surface of the papules.

How to treat lichen planus?

The basis of this dermatosis is immune inflammation (the reaction of tissues to damage by the immune system), which destroys the cells of the skin and mucous membranes.

Therefore, in the treatment are used:

drugs that lower the activity of the immune system - drugs of choice (prescribed in the first place) for severe disease
agents that improve tissue nutrition and accelerate their recovery
drugs that reduce itching, improve sleep, normalize the functioning of the nervous system
topical ointment

In addition, provoking factors are eliminated:

prosthetics and treatment of diseases of the oral cavity, as well as foci of chronic infection
drugs and occupational hazards are excluded
food that does not irritate the oral mucosa is recommended
and others

Drugs for the treatment of lichen planusappointed in the event that the condition of patients is disturbed.

Group of medicines	A drug	Mechanism of action	Methods of application and dosage form	Expected effect
Immunosuppressants- drugs that lower the activity of the immune system	Basic preparations (act on the basis of the disease) Cyclosporine A (most commonly prescribed) 4-aminoquinoline derivatives (Hydroxychloroquine, Chloroquine)	They suppress the activity of substances that cause immune inflammation, inhibit the movement of cells of the immune system (“soldiers”) to rashes. Flaws: do not work immediately they need to be taken for a long time to get better.	Cyclosporine A. It is prescribed in injections and tablets. The initial dose is 5 mg / kg / day. Then, as the condition improves, it is reduced to maintenance - 2 mg / kg / day. Derivatives of 4-aminoquinoline are taken in tablets with meals at a dose of 200-400 mg per day.	The drugs begin to act not earlier than a month later. As a result, the papules gradually turn pale, and the ulcers heal. Reduces swelling of the skin in the affected areas. The effect is quite persistent: after discontinuation of the drug, a long-term remission occurs.
Systemic corticosteroids(hormones) Suppress the immune system. They are prescribed alone or together with basic drugs (especially at the beginning of treatment in order to quickly suppress immune inflammation).	Prednisolone, Metipred	They reduce the activity of lymphocytes and their movement to the focus of inflammation, and also reduce the formation of substances that cause it. Suppresses the release of histamine (a substance that causes allergies) by mast cells (cells of the immune system found in connective tissue).	It is prescribed in tablets up to 1 mg / kg / day	They quickly lead to improvement: usually, after a few days of use, the reverse development of papules begins, redness, swelling and itching decrease. Flaws: cause many side effects (formation of ulcers in the gastrointestinal tract, sleep disturbance, and others) after discontinuation of the drug, all symptoms may return again, even with greater severity ("rebound" effect)
Synthetic interferons and interphenogens(stimulate the production of interferon in the body) are prescribed for severe disease.	Neovir, Ridostin, Interferon-alpha 2b	They normalize the number of lymphocytes, reduce the level of circulating immune complexes, and suppress the reproduction of viruses.	Assigned intramuscularly: Neovir - 2 ml 1 time in two or three days. Course - 5 days. Ridostin - 2 ml every three days. Course - 4 injections. Interferon-alpha 2b. Duration and dosage is determined individually.	At the end of the course, redness, swelling, soreness quickly decrease and then disappear, and ulcers and erosion heal.
Systemic retinoids - vitamin A derivatives.	Tigazon, Neotigazon, Etretinat, Isotretinoin Acitretin	Reduce local inflammation and the rate of cell division of the upper layer of the skin. Accelerate the maturation, death and exfoliation of skin cells, as well as healing.	Available in capsules. It is prescribed depending on the severity of the disease from 35 to 50 mg per day.	The reverse development of papules, as well as the healing of erosions and ulcers, occurs many times faster.
Antihistamines(antiallergic)	Zyrtec, Parlazin, Clemastine, Cyproheptadine, Tavegil, Suprastin, Promethazine, Phencarol, Hydroxyzine, Loratadine, Diazolin	Blocks receptors in the cell wall, which are affected by free histamine.	Available in tablets and ampoules. Dosage, duration of administration depends on the generation and method of administration of the drug, as well as the severity of the disease.	15-20 minutes after taking the drug (if intramuscularly or intravenously) or a few hours (if in tablets), swelling and itching decrease.
Antibiotics(prescribed for severe disease)	Teracyclines: Metacycline, Doxycycline, Tetracycline macrolides: Azithromycin, Erythromycin, Roxithromycin, Sumamed	They fight pathogens that live and multiply inside the cells of the human body.	Available in tablets. Dosage and frequency of administration depend on the severity of the disease, age and the specific drug.	Reduces swelling and redness. The general condition of the patient improves.

Treatment of red lichen with physiotherapy methods

Physiotherapy method	Mechanism of action	Expected effect
PUVA therapy- taking a photosensitizer (Methoxalen) orally or applying it externally, and after two hours, irradiating the skin with long-wave ultraviolet light.	UV rays penetrate the skin and, in combination with a photosensitizer, quickly inhibit the division of damaged skin cells. The procedure is carried out in a special cabin.	The reverse development of the elements of the rash begins after 4-5 procedures. In almost 80% of patients, the skin is completely cleared fairly quickly. Remission lasts up to several years. Good tolerance and no habituation effect. The course of treatment is 20-30 procedures.
Laser therapy	Improves metabolism in cells, increases their resistance to the damaging effects of the immune system.	Reduces inflammation, itching and swelling, and also accelerates the regression of papules, healing of ulcers and erosions. Improvement occurs after 3-4 procedures. The doctor determines the number of sessions and duration of treatment individually.
Magnetotherapy	Magnetic fields improve metabolic processes in cells, reduce the production of substances that cause inflammation.	Reduces itching, inflammation and swelling of the skin, speeds up recovery, improves mood and the functioning of the nervous system. The number of procedures per course is 10-15, each of them lasts 20 minutes.

Given that this dermatosis disrupts the work of many organs and systems, treatment of comorbidities: diabetes mellitus, arterial hypertension, neuroses, chronic inflammatory diseases (for example, chronic stomatitis) and many others.

With severe itching, which leads to disruption of the nervous system or insomnia, sleeping pills and sedatives are prescribed(Medazepam, Phenazepam).

For normalization of metabolism and tissue nutrition- vitamins (C, group B) and agents that improve the supply of oxygen to tissues (vitamin E).

With the aim of improve blood supply tissues - vascular preparations (Trental, Xanthinol nicotinate).

What ointment can be used to treat red lichen?

Outwardly, ointments are prescribed to relieve itching, reduce immune inflammation, improve nutrition, accelerate the regression of rash elements, as well as the healing of erosions and ulcers.

Name of the ointment	Mechanism of action	Application and expected therapeutic effect
Ointments containing corticosteroids (hormones)
Hydrocortisone (unexpressed action) flumethasone (moderate action) Triamcinolone, Clovate, Betamethasone (pronounced action)	Locally reduce the activity of lymphocytes and leukocytes, as well as their movement to the focus of inflammation. They reduce the production of substances that cause immune inflammation, as well as the release of histamine (a substance that causes allergies) from mast cells. Slow down the division and keratinization of skin cells, as well as mucous membranes. Constrict the blood vessels.	Apply to the elements of the rash with a thin layer from one to three times a day. The course of treatment is 10-14 days. They work pretty fast: itching decreases after 10-15 minutes after 1-3 days of application, swelling and redness decrease, the reverse development of the elements of the rash begins
Antiallergic non-hormonal ointments
Gistan- ideal when there is an allergy to many drugs. Composition - extracts of plants and herbs: birch buds (active substance betulin), succession, Japanese Sophora, lavender oil.	Reduces allergic reaction and immune inflammation. An invisible film is created at the application site, which allows oxygen to pass through, but delays the penetration of moisture and substances that cause allergies. Improves nutrition and blood circulation in tissues.		Itching, redness and swelling are reduced, healing of ulcers and erosions is accelerated, and papules regress faster. As a result, at the site of rashes and ulcers, there are practically no pigment spots or foci of atrophy (decrease in cell size) on the skin. It is applied to problem areas of the skin with a thin layer two to four times a day. The duration of treatment is determined individually.
Fenistil (ointment, gel)	Reduces immune inflammation as well as capillary permeability associated with an allergic reaction. Locally anesthetizes and cools.		Reduces itching and irritation, relieves pain. Apply a thin layer to the affected areas of the skin two to four times a day. Begins to act after 15-20 minutes, reaching a maximum after 1-4 hours.
Non-hormonal anti-inflammatory
Tacrolimus, Pimecrolimus is a new class of drugs	They reduce inflammation in the skin, inhibit the activity of T-lymphocytes, block the production of substances that cause inflammation, as well as their release from immune system cells (leukocytes, mast cells).		Quickly reduce itching, redness and swelling. It is applied in a thin layer on the elements of the rash and rubbed in, after which it is impossible to cover this area with an airtight material. Applied twice a day. The course of treatment is 6 weeks.
Exfoliating ointments
Ointment based on salicylic acid(Salicylic ointment) Sometimes salicylic acid is combined with corticosteroids (Diprosalik, Belosalik), in which case the effect of the treatment comes faster.	Reduces immune inflammation, normalizes the permeability of the wall of small vessels. Promotes exfoliation of dead cells. Thus, allowing the formation of normal skin cells.		Quite quickly softens papules, reduces redness and swelling. Apply a thin layer to the affected areas and cover with a gauze cloth for a day, then it is replaced by another. The course of treatment is from 6 to 20 days.
Wound healing ointments
Socoseryl	It improves the supply of tissues with glucose and oxygen, protects cells from destruction, accelerates tissue repair, as well as the healing of ulcers and erosions. Stimulates the formation of new blood vessels.	Accelerates the healing of wounds and erosions. Improvement usually occurs on the 2-3rd day of application, if the ulcers are shallow. The ointment is applied to the affected areas of the skin with a thin layer once or twice a day. The duration of treatment is about two weeks (but sometimes longer).

Before using this or that ointment, be sure to consult your doctor, as they often need to be combined.

What are the traditional methods of treating red lichen?

The true causes and mechanism of development of this dermatosis have not been established, therefore, traditional medicine often needs to be supplemented. And then the “pantry of nature” comes to the rescue. After all, its bins have been replenished for many decades with various recipes by knowledgeable herbalists.

However, sometimes there are situations when there is an allergic reaction to certain drugs or they provoked the development of this dermatosis. In this case, traditional medicine is the only way to alleviate suffering and speed up recovery.

Alternative treatment of lichen planus

Name	Cooking method	Mode of application	Expected effect
Calendula oil	Pour marigold flowers into a glass dish and pour olive oil over so that they are completely covered. Then shake, close with a tight lid and place in a warm place for 4-6 weeks. At the same time, do not forget to shake the container daily. Next, drain the oil and store in a cool place.	Lubricate the affected areas of the skin two to three times a day.	Locally, redness and swelling are reduced. Papules soften, the reverse development of the rash accelerates, as well as the healing of ulcers and erosions. Fights microbes.
Ointment based on calendula	Place 200 ml of calendula oil and 20 grams of beeswax in a water bath, stirring constantly, wait until they melt. Then remove from heat and pour into glassware. Store in a cool place.	Lubricate the elements of the rash two to three times a day.	The properties of calendula are enhanced with beeswax, so redness, softening of papules and healing occur many times faster.
Birch tar	Produced in finished form	On the affected areas of the skin, gauze bandages are applied once a day. At first, the application time is 10 minutes, but gradually it increases to 30 minutes. Or the affected areas of the body are simply lubricated with tar oil 1-2 times a day.	It softens papules, exfoliates dead cells, accelerates the regression of rash elements, and also contributes to the normal division of cells in the upper layer of the skin. Has a disinfecting effect.
Sea buckthorn oil	Produced in finished form	To treat formations in the oral cavity, make a turunda from cotton wool, soak it with sea buckthorn oil. Then apply in the mouth to rashes, erosions or ulcers. To treat skin lesions, soak a gauze bandage with oil and apply it to the erosion or ulcer. Procedures are repeated two or three times a day. Their duration is 30-40 minutes.	Reduces inflammation and pain and speeds up healing.
Berry-herbal infusion	Mix in equal parts chopped nettle leaves, black elderberry flowers, juniper berries, St. John's wort and dandelion roots. From the resulting mixture, take two tablespoons and pour 0.5 liters of boiling water. Let it brew for an hour, then strain. Store in refrigerator.	Take 100 milliliters 2-3 times a day for one month. After a break of 2-3 weeks, the course can be repeated.	Due to its complex chemical composition, the infusion improves the functioning of the immune system, nutrition and blood supply to tissues, and reduces immune inflammation. Therefore, papules turn pale and undergo reverse development faster, edema decreases, and ulcers and erosions heal.

However, before resorting to these recipes, remember that each body reacts to them differently: in one case, they are a panacea, and in the other, they can cause side effects (increased local edema, nausea, and so on). Therefore, be careful, and even better, consult with your doctor first.

Is red lichen contagious?

There is no definite answer to this question, since all theories about the occurrence of this dermatosis are currently unproven.

However, there are cases occurrence of lichen planus in members of the same family including both spouses.

Besides, the episode of infection of the doctor is described who took tissue from the patient from the focus (biopsy) for further research. A month after the manipulation, he developed the first single focus, and three weeks later, numerous new rashes, identical to those that his patient had.

Therefore, we should not forget that infection is probably still possible, but most likely through close contact.

And if you live with the patient, then take it as a rule: do not use scissors, a razor, a glass for a toothbrush, linen, a towel, clothes and shoes with him.