Lichen planus - one of the most common diseases of the skin, different from many other dermatoses frequent combination with a variety of diseases of internal organs (chronic gastritis, peptic ulcer, cirrhosis liver, diabetes diabetes and etc.).
Causes
At the heart of the emergence planus are impaired immunity. Under the influence of provoking factors (psycho-emotional stress, trauma in a broader sense - mehanicheckaya, chemical, drug; hormonal and metabolic disorders) increases the sensitivity and susceptibility of skin cells to pathogenic attack.
It is known that immune disorders are controlled by genetic mechanisms. Currently, the accumulated data on family history of lichen planus. There are cases of family illness this dermatosis, get sick more often relatives in the second and third generation.
Of the many causes of lichen planus can be divided into three main groups:
- infection
- chemicals, drugs for household and professional character;
- own biologically active substances that occur in stressful situations, diseases of internal organs.
shape
- A typical form of lichen planus - polygonal plaques characteristic pink color with a purple hue;
- Hypertrophic form - large nodules and plaques with warty surface;
- Atrophic form - with or without hyperpigmentation it;
- Bullous form of lichen planus is presented in the form of subcutaneous bubbles;
- Erythematous form - a common form of skin redness.
Downstream planus may be acute (continues up to 1 month) or subacute (continued to 6 months), and long-flowing (greater than 6 months).
Symptoms of lichen planus
Mucous membranes (mostly oral) is found in most patients with rashes on the skin, or exist in isolation; outward manifestation may be plaque, redness, blisters and sores.
Nail changes have been reported in 12-20% of patients, they come in all forms of lichen planus, but the most severe damage to arise in the common forms (bullous and erosive and ulcerative). Wherein the nail plate are deformed in the form of longitudinal ridges, grooves, striae, surface Nail becomes uneven, there is a median crack, the plate becomes thinner, until the complete disappearance.
Often, skin rash accompanied by intense itching.
Photo: site of the Department of dermatology Tomsk Military Medical Institute
Diagnostics
The diagnosis of lichen planus is carried dermatologist and presents no great difficulty, as is almost always not detect plaques typical polygonal shape with a distinctive color, a smooth surface, pupkoobraznym impression transverse striation.
Multiple lesions are prone to group and are located in the "favorite" places: mainly on the flexor surfaces forearms, in the elbow folds, armpits, lower abdomen, lower back, inner thigh, genitals and shins.
To clarify the diagnosis produces a skin biopsy.
Treatment of lichen planus
In the treatment of lichen planus is important to take into account the conditions conducive to the emergence of the disease. It is necessary to eliminate the risk factors - household and occupational hazards, comorbidities, foci of infection.
Carry sanitation oral prosthetics. Food should not cause irritation of the mucous membranes of the mouth. It draws attention to the pre-treatment and tolerability of drugs.
As the basic therapy depriving hormones administered in combination with 4-aminoquinoline derivatives (hydroxychloroquine, chloroquine).
When the presence of pronounced itching shown sedatives and antidepressants promoting normalization of sleep and reduce itching, as well as anti-allergic agents (tavegil, Claritin, and telfast et al.).
Metabolic processes has a beneficial effect vitamin. Vitamin A affects the dividing skin cells (daily dose for adults - 100 000 IU). Derivatives of vitamin A (tigazon, neotigazon, etretionat) reduces the severity of inflammation and normalize the processes of cell division. More effective vitamin A derivatives with lesions of the oral mucosa and the vermilion border. The daily dose is from 25 to 50 mg, treatment is continued for 2-3 weeks. When planus apply also analogues of vitamin A - carotenoids (e.g., fenoro).
Vitamin E (alfa-tocopherol acetate) allows for complex treatment hormones reduce the daily dose and timing of hormone therapy to reduce.
With chronic relapsing course shown agents that improve oxygen supply of the tissues (such as the cyto-Mac aktovegin).
External treatment planus applications hormonal ointments, solutions and mixtures with menthol, anestezin, citric acid, antihistamines are used with intensive itching.
Large plaque by destroying cryoablation (freezing) or electrocautery (cautery). Ulcerative lesions treated healing agents (Solcoseryl, sea buckthorn oil, rosehip oil).
Among the methods of non-drug therapy deserves attention phototherapy (ultraviolet irradiation). There are reports of patients with laser treatment.
Used therapy with agents that affect the immune system (IFN, interlock, neovir, ridostin). 12.5% Neovir administered intramuscularly to 2 ml of 1 every 2-3 days, a course of 5 injections ridostin - 2 ml 2 days 3 minutes, a total of 4 injections.
Forecast
Rational choice of drugs, consistent landmark (course) the application taking into account the individual characteristics of the patient and the nature of the disease makes it possible to achieve positive results.
This article is based on information of breast cancer - Independent publications practitioners
