Lichen planus is an inflammatory skin disease. It manifests itself in rashes on the mucous membranes and dermis. Another name for the disease is Wilson's disease. It was named after the English scientist E. Wilson, who described the disease, determined its differences from other dermatoses and identified the main forms. The disease has existed for more than a hundred years, but the exact causes leading to its occurrence have not yet been established. In this article we will try to find out why the disease occurs, what are the signs of lichen planus and how to treat it.
Common symptoms of Wilson's disease
Manifestations of pathology are varied, but all rashes consist of the same small flat papules (pimples that look like balls or dense nodules), the diameter of which can be up to five millimeters. Main characteristics:
- The color of the rash is crimson red or red with a purple tint. Papules have a shiny surface withretracted center.
- The peeling of the skin is slightly expressed, the scales are difficult to separate.
- Rashes are formed in groups, can be combined into circles, stripes and garlands, merging, form plaques. After healing, a red pigment spot remains on the affected area.
- The rashes cause severe itching, causing problems with sleep. Sometimes, the appearance of symptoms of lichen planus on the fingers is perceived by the patient as scabies.
- In most cases, the rash appears on the elbows and knees, in the groin, on the inner surface of the thigh, the mucous membrane of the mouth.
- The soles of the feet, palms, face and head are less susceptible to disease, but sometimes dark red lumps appear on them, causing severe itching.
- Lichen in women, located in the genital area, interferes with urination and intimacy, causing pain. In addition, there is constant irritation.
- When red lichen appears in the oral cavity, at the entrance to the vagina, on the glans penis, the dermis remains clean. The resulting nodules are gray in color, grouping, form circles, mesh or rings. Flat plaques with jagged edges usually appear on the tongue, and the lips are affected by purple papules with slight peeling.
- Large papules are covered with a special pattern called the Wickham grid.
- When the disease worsens, the formation of new vesicles occurs on damaged areas of the skin after injuries. This sign is called Koebner's syndrome.
Forms of developmentpathology
A feature of Wilson's disease is its different manifestation and localization. Based on this, clinical forms of lichen planus are distinguished, which have some differences in the development of the disease:
- Warty. The disease begins with the appearance of a rash, which subsequently turns into growths that look like warts. Their structure is denser than that of standard bubbles. Rashes are accompanied by severe itching, which is poorly removed. This disease mainly affects only the shins.
- Atrophic. At the onset of the disease, standard papules appear. After the disappearance of the rash, areas of keratinized skin remain on the damaged areas. Elbow and knee joints and the scalp are affected, where dotted areas of baldness are formed.
- Pigmented. Along with the rash, brown spots form on the dermis. The limbs, face, and trunk are often affected.
- Bubble. On the skin of a person, lichen planus is manifested by characteristic vesicles - vesicles that contain a serous substance, in some cases with an admixture of blood. Blisters form on their own or on top of papules and plaques. The disease affects the feet and lower legs.
- Moniliform. These are rounded waxy rashes that are grouped in the form of a necklace. The rash affects the forehead, auricles, back of the hands, abdomen, and elbows. The skin of the cheeks, nose, soles and interscapular region is never affected.
- Pointed. Papules mostly appear on the head. Rash covershair follicles with the formation of a growth in the form of a spike. After healing, scars form on the damaged area.
- Erosive and ulcerative. Manifested by ulcers and erosions, which are surrounded by swollen red areas of the mucosa. This form of lichen planus occurs in the oral cavity. The affected mucosa is covered with a fibrinous coating, which, when removed, causes bleeding. Erosions can form into numerous groupings that have soreness. Healing is slow and difficult, and then relapses again.
- Ring-shaped. This type of disease develops very quickly. A characteristic feature is the tightening of the center of the plaque, giving it the shape of a ring. The male reproductive organs are affected. Sometimes the ring shape of lichen erythematosus is mistaken for signs of syphilis.
Factors causing disease
Establishing the causes of lichen planus continue to engage scientists to date. It was found that the disease develops with a combination of several adverse factors, the most likely are the following:
- Neurogenic. The occurrence of a pathology or relapse in a patient coincides with the psychological trauma that he suffered the day before. In addition to a skin disease, he also has mental disorders.
- Viral. Penetrating into the upper layer of the dermis, microorganisms are in a balanced state until a certain point, until the immune system is weakened. When activated, they cause an acute stage of the disease.
- Genetic. The existing theory states that the hereditary factor in the transmission of the disease from generation to generation cannot be denied.
- Intoxication. Certain drugs can provoke lichen planus in humans: quinine, arsenic, iodine, gold preparations, antimony, as well as antibacterial and anti-tuberculosis drugs.
- Autointoxication. Associated with the accumulation of a large number of toxins in the body. This can occur with diabetes mellitus, liver cirrhosis, gastritis, stomach ulcers.
- Immunoallergic. This factor is considered the main one. Failure of the immune system leads to all sorts of diseases, including lichen planus.
- Mechanical. A new focus of inflammation easily occurs with mechanical damage to the dermis or mucous membranes: rubbing with clothes, jewelry, damage to dentures, biting the cheeks.
Diagnosis of Wilson's disease
Diagnosis of lichen planus is based on:
- talking with the patient;
- visual inspection. In most cases, the doctor can easily make a diagnosis based on the clinical picture and the patient's complaints.
In doubtful cases appointed:
- general analysis of blood and urine - with red lichen, there should be no abnormalities in urine and blood, with the exception of ESR and an increase in leukocytes;
- blood biochemistry;
- consultation of a gynecologist, therapist, dentist;
- analysis for a biopsy - the dermis is taken from the affected area and carried outhistological study.
After the studies and the exclusion of syphilis, psoriasis and lupus erythematosus, the final diagnosis is made, on the basis of which the treatment of lichen planus will be carried out.
Treatment of Wilson's disease
A patient in a satisfactory condition does not require hospitalization, treatment is carried out on an outpatient basis. The course of therapy is prescribed taking into account the form of lichen, but must include:
- Sedatives, antidepressants, tranquilizers. With their help, normalize the activity of the nervous system.
- Vitamin complexes - the body needs vitamins of groups B, PP, C, E, A, calcium and nicotinic acid. Vitamin therapy is carried out for sixty days.
- Corticosteroid drugs - they usually play a key role in the treatment of lichen planus. To avoid side effects, the attending physician should select the treatment regimen and dosage. Hormonal drugs are prescribed in conjunction with drugs containing potassium, calcium and multivitamins. In addition, a low-s alt diet is indicated.
- "Histaglobulin" - used in injections instead of corticosteroids, taking into account the individual characteristics of a particular individual.
- Hormonal ointments - used for external use: Sinaflan, Fluorocort, Flucinar. They relieve irritation and itching, and are used for rashes that occupy limited areas of the skin.
The intake of hormonal drugs must be under the supervision of a doctor. Possibleside effects, so the courses of treatment are made short and monitor changes in blood pressure and blood components. Lichen planus in the oral cavity of the erosive-ulcerative form is treated by chipping with a hydrocortisone suspension.
To eliminate the symptoms of recurrent chronic lichen, drugs are used that increase the supply of oxygen to the tissues.
Physiotherapy treatment
The impact of physical factors on the manifestations of lichen erythematosus increases the effectiveness of drug treatment.
- PUVA therapy is a combined effect on the dermis of medicinal substances of plant origin: psoralens (P) and ultraviolet rays (UVA).
- Inductothermy - based on the use of a high frequency magnetic field. The procedure is carried out on the lumbar region. As a result, the adrenal cortex produces glucocorticoid hormones.
- Reflexology - in the treatment of lichen planus eliminates symptoms such as burning and itching.
- Diadynamic therapy - pulse therapy, with the help of currents of different frequencies, swelling, redness and itching are reduced.
- Magnetotherapy - exposure to a traveling magnetic field helps to normalize the nervous system, reduce itching.
- Electro sleep therapy - reduces excitability, has an analgesic effect.
- Electrophoresis - performed on the affected area using the drug "Hydrocortisone".
- Phonophoresis - has a medical and ultrasonic effect.
- Ozokerite applications –help to relax, have anti-inflammatory effect.
Treatment of lichen planus with folk remedies
For the treatment of many diseases, they resort to the use of folk remedies, the recipes of which are time-tested. The following folk remedies are suitable to help with medical and physiotherapeutic treatment:
- Hops, fir cones, calendula. This raw material is used for the preparation of ointment. To do this, make a strong decoction and mix it with petroleum jelly. Papules are smeared with the resulting drug once a day.
- Sea buckthorn oil. It is applied to the affected surface in the form of applications. The oil has found wide application in the treatment of mucous membranes. May be used orally, on an empty stomach, a teaspoon daily.
- Calendula. To prepare the infusion, take a tablespoon of raw materials and pour a glass of boiling water. Used for lotions.
- String and chamomile. Each herb is taken in equal amounts of 100 g, poured into a bucket of water, brought to a boil and after three minutes removed from heat. Infuse for half an hour, filter and add to the bath for bathing.
Before you start using folk remedies, you should consult your doctor.
Diet for sickness
In the treatment of lichen planus, a set of measures is necessarily carried out, in which the diet is not the last. Meals should be rationed and regular.
Recommended products:
- lean meat;
- vegetables;
- greens(parsley, dill, lettuce);
- porridge (rice, buckwheat, oatmeal, corn);
- fermented milk products;
- mineral water without gas.
The following foods are not recommended for this disease:
- alcohol;
- smoked meats;
- fatty fish and meat;
- concentrated juices;
- spicy seasonings;
- sweets;
- canned food;
- coffee;
- pickles;
- carbonated drinks.
The main purpose of the diet is to provide proper nutrition that helps the body fight disease.
Can you get Wilson's disease?
Is lichen planus contagious or not? There is no single answer. Some argue that this disease is not infectious, therefore it cannot be transmitted from a sick person to a he althy person. Others say that with long and close contact there is a small chance of getting infected. This happens when there is a genetic predisposition and a weakened immune system. The conclusion is that everyone decides for himself how to behave with a sick individual with this disease.
Commonly used ointments for the treatment of pathology
For topical treatment, lichen planus ointments are often used. They are used as independent agents and combined with solutions and various mixtures that contain citric acid, menthol, anestezin. With severe itching, drugs with antihistamine properties are prescribed. To exfoliate the skin, salicylic ointment is prescribed. It helps reduce inflammationand strengthening the walls of small vessels. Papules soften, puffiness decreases, and he althy cells form in place of the keratinized surface.
The ointment is applied to the damaged area and a bandage is applied, after a day it is changed. The course of treatment is continued up to twenty days. For papules that are in a combed state, Solcoseryl ointment is used. It supplies tissues with glucose and oxygen, protects against the appearance of erosions and ulcers. Apply up to two weeks. Ointment or gel "Fenistil" has an analgesic and antipruritic effect. It has a strengthening effect on capillaries, relieves pain. The agent is applied up to four times a day. The effect appears after 20 minutes. Each of the ointments fulfills its role and provides relief by healing the damaged surface of the dermis.
The most effective treatment for lichen planus of the oral mucosa
This disease is chronic and often recurrent, therefore it is a complex and urgent problem for dentists. Scientists and dental practitioners consider the use of complex treatment to be the most appropriate. It simultaneously affects the symptoms of the disease, physiological processes in the body and includes the following activities:
- Full oral hygiene and advice on its care, a complete diet, the exclusion of irritating food, alcohol.
- For local drug treatment, drugs are prescribed depending on the form of the disease. For therapy use: antimicrobial, analgesic, antiviral, antimicrobial agents. Atin a severe clinic, corticosteroid suspensions are used to chip off damaged areas.
- For general treatment, vitamin complexes, neurotropic, antiviral and sedative drugs, corticosteroids, antibiotics, immunomodulators and cytostatics are recommended.
- Use of physical methods - galvanization, phonophoresis, laser acupuncture.
When using all these measures and by connecting traditional medicine, the patient receives the most effective treatment for lichen planus, after which relief comes.
Prevention
To implement preventive measures, follow simple rules:
- lead a he althy lifestyle;
- have daily physical activity;
- carry out regular hardening of the body;
- avoid stressful situations at work and at home if possible;
- wear comfortable clothes;
- carefully observe oral hygiene;
- have proper nutrition;
- give up bad habits;
- to undergo a preventive medical examination.
Lichen planus is a rather serious disease, it causes a lot of inconvenience, but with timely access to a doctor and proper treatment, it has a favorable prognosis.
Conclusion
Wilson's disease, often chronic, presents with a nodular rash and severe itching. People of all ages are subject to it, but female representatives from40 to 60 years old. With properly selected therapy and timely treatment, the rashes disappear after two months, and pigment spots form on the skin, they disappear after a while. Some forms are difficult to treat, and a prolonged ulcerative process on the mucous membranes can degenerate into a malignant tumor. According to the International Classifier of Diseases, the general code for lichen planus ICD-10 / L43 has been assigned, the frequency of formation is about one percent of all skin diseases. To prevent the consequences, at the first symptoms of the disease, you should immediately contact the local doctor, who will refer you to the appropriate specialist.
