Lichen
The content of the article:
- Types of lichen
-
Causes and risk factors
- Causes of pink lichen
- Causes of pityriasis versicolor
- Ringworm causes
- Causes of weeping lichen
- Causes of lichen planus
- Shingles causes
-
Lichen symptoms
- Symptoms of pink lichen
- Pityriasis lichen symptoms
- Ringworm symptoms
- Symptoms of weeping lichen
- Symptoms of lichen planus
- Shingles symptoms
- Diagnostics
-
Lichen treatment
- Pink lichen treatment
- Pityriasis versicolor treatment
- Ringworm treatment
- Treatment for weeping lichen
- Treatment of lichen planus
- Shingles treatment
- Possible complications and consequences
- Forecast
- Prevention
Lichen is a large group of skin diseases of various origins, which are characterized by the appearance of spots, papules or nodules on the skin, usually accompanied by peeling, as well as pigmentation disorders.
The disease is more susceptible to persons with reduced immunity.
Lichen is a fungal disease
Types of lichen
Depending on the etiology and nature of the pathology, the following main types of lichen are distinguished:
- pink (lichen of Zhiber);
- pityrious (multicolored, colloquially "sunny fungus");
- ringworm (trichophytosis, dermatophytosis, dermatophytosis, dermatomycosis, outdated scab);
- weeping lichen (eczema);
- lichen planus;
- herpes zoster (herpes zoster, Herpes zoster).
Causes and risk factors
The causative agents of lichen are viruses and microscopic fungi, but not all people who come into contact with the pathogen develop the disease - a necessary condition is weakening of the immune system. Risk factors for developing lichen include:
- hereditary predisposition (hereditary weakness of one of the links of the immune system);
- physical and emotional overload;
- hypothermia or overheating;
- infectious diseases;
- endocrine disorders; and etc.
Each type of lichen is due to the action of its own causative factor, in some cases the exact cause of the onset of the disease has not been identified, only the predisposing conditions are known.
Causes of pink lichen
Often develops against the background of diseases of the digestive tract, respiratory infections, may be the result of vaccinations, stressful situations. A surge in the incidence occurs in the autumn-spring period, with reduced immunity, relapses of the disease are possible. Adults are more prone to pathologies. Pink lichen is not transmitted by contact.
Causes of pityriasis versicolor
The causative agents of pityriasis versicolor are microscopic yeast-like fungi of three types (Malassezia furfur, Pityrosporum orbiculare, Pityrosporum ovale), which infect the stratum corneum of the epidermis. Risk factors include increased sweating, dysfunction of the sebaceous glands, high levels of cortisol in the blood, and prolonged treatment with steroid hormones. Not transmitted by contact.
Pityriasis versicolor occurs as a result of damage to the epidermis by yeast-like fungi
Ringworm causes
The infectious agent of this type of lichen is microscopic fungi (Epidermophyton, Trichophyton, Microsporum). Children are more susceptible to the disease. The contact-household transmission path from person to person or from animal to person is characteristic.
Causes of weeping lichen
The causes of this type of lichen can be both exogenous and endogenous. External (exogenous) include allergic reactions, mechanical, thermal or chemical damage. Internal (endogenous) factors are genetic predisposition, infectious diseases, diseases of the digestive tract, urinary, endocrine and nervous systems, long-term use of drugs and other conditions leading to immunodeficiency. All age categories are affected by the disease.
Causes of lichen planus
It occurs against the background of disorders of the immune and metabolic processes in the body, in addition, a hereditary predisposition to the disease has been established. It occurs in all age groups, but women 40–60 years of age are more susceptible to the disease.
Shingles causes
It occurs as a result of the reactivation of the varicella-zoster virus (Varicella zoster). Persons of elderly and senile age are more susceptible to the disease. Risk factors include immunodeficiency, malignant neoplasms, chemotherapy, and long-term use of corticosteroids. Upon contact with a patient with shingles, children who have not previously had chickenpox may develop chickenpox.
Shingles develops as a result of reactivation of the varicella-zoster virus
Lichen symptoms
The clinical picture of lichen depends on its type.
Symptoms of pink lichen
The initial symptom of shingles of this type is the appearance on the skin of a single large pink spot (maternal plaque) up to 3 cm in size. The spot has a rounded shape, after a few days it acquires a yellow tint and begins to peel off. After 1-1.5 weeks, multiple smaller eruptions (daughter plaques) appear on the skin (often on the back, chest and / or extremities). The elements of the rash are surrounded by a pink roller, covered with scales, the central part of the element sinks somewhat, individual elements are not inclined to merge. Itching and other unpleasant sensations may be absent or only slightly manifest. After the rash disappears, spots of hypo- or hyperpigmentation remain on the skin.
Lichen pink begins with a single pink patch on the skin.
Pityriasis lichen symptoms
The disease begins with the appearance of a single rounded spot, after which the same spots, but smaller in size, appear on the skin and scalp. The spots are not inflammatory, they have clear outlines, their color can vary from pale yellow to brown (yellowish brown, brown, brown, etc.), pityriasis peeling is observed. Stains form on the skin of the neck, shoulders, chest, abdomen, back, armpits and groin. On the scalp, rashes can also be, but often remain invisible, the hair with this form of lichen is not affected. The spots are prone to fusion and peripheral growth; sunburn does not appear on the affected skin areas. Light areas of the skin at the site of the former spots can remain for several years after the pityriasis lichen heals. Other signs of shingles can be itchy skin and excessive sweating.
With pityriasis versicolor, no tan appears on the affected skin
Ringworm symptoms
Ringworm affects the skin, hair and, in some cases, nails. The disease begins with the appearance of one or more scaly spots of irregular shape, covered with a light bloom and broken off hair, which falls out on the affected areas (hence the name "shearing"), bald spots are formed. The patient is worried about itching on the affected areas of the skin, sometimes very intense.
With ringworm, the patient is worried about intense itching
Symptoms of weeping lichen
Weeping lichen is manifested by vesicles with serous and hemorrhagic contents, which, after opening, become crusted, the affected areas are hyperemic and edematous. Patients are worried about severe itching, aggravated in the evening or upon contact with water.
Symptoms of lichen planus
Lichen planus debuts with the appearance of pinkish-purple papules with a shiny surface. Elements of the rash are localized on the trunk, limbs, mucous membranes of the oral cavity and external genital organs, their appearance may be accompanied by itching and soreness. In some cases, damage to the mucous membranes occurs in isolation.
Shingles symptoms
With this form of the disease, the appearance of a rash on the skin is preceded by intense pain of a burning character that occurs in the area of the affected nerves. A few days later, vesicular (vesicular) rashes appear along the peripheral (most often intercostal) nerves, which is caused by the migration of the virus along the peripheral nerves into the skin. The rash usually forms on the trunk, but can occur on the face and limbs; usually only one side is affected. After some time, the vesicles shrink, and peeling may occur in the affected areas. Depending on the severity of the disease, the clinical picture can vary from minor symptoms of general intoxication to severe lesions of the central nervous system. Throughout the disease, the patient suffers from intense pain syndrome,after the rash has resolved, postherpetic neuralgia develops, which is persistent in nature - it can bother for several months or even years.
Shingles is accompanied by severe pain at the site of the lesion
Diagnostics
The primary diagnosis of lichen is carried out on the basis of the collection of complaints, anamnesis and examination of the patient. For some types of lichen, specific diagnostic methods have been developed that are used to confirm the primary diagnosis and differential diagnosis with other diseases with similar symptoms:
- lichen rosacea - differential diagnosis is necessary with rashes characteristic of secondary syphilis, as well as with psoriasis, seborrheic eczema, measles and rubella;
- pityriasis versicolor - an iodine test is carried out ((the skin is smeared with tincture of iodine, and then alcohol, after which the pityriasis lichen spots become brown) and microscopic examination of scrapings from the affected areas. Differential diagnosis with alopecia areata is carried out;
- ringworm - microscopic and cultural examination of scrapings from the affected area is used;
- weeping lichen - differential diagnosis with syphilis, systemic lupus erythematosus, leukoplakia, psoriasis is required;
- lichen planus - must be differentiated with syphilis, systemic lupus erythematosus, leukoplakia;
- shingles - to clarify the diagnosis, use serological, immunofluorescent methods, microscopic examination. Differential diagnosis is carried out with chickenpox, acute eczema, herpes simplex.
Lichen treatment
The choice of a lichen treatment regimen also depends on the type of disease.
Pink lichen treatment
In most cases, lichen rosacea does not require special treatment and goes away on its own. Patients are not recommended to wear clothes made of wool and synthetic materials, or use decorative cosmetics. Limit exposure to the sun and contact with water. A diet is shown: highly allergenic, as well as irritating to the mucous membrane of the digestive tract, foods are excluded from the diet. With the spread of the pathological process or the addition of a secondary infection, patients are prescribed antibacterial and antihistamines, immunomodulators.
Pityriasis versicolor treatment
Therapy is carried out with the help of antimycotic drugs in the form of an ointment, sometimes antifungal agents of general action in tablet form are sometimes prescribed in parallel. To prevent relapses, the ointment should be applied not only to the lesions, but also to the surrounding intact skin areas, where there may be unnoticed foci. In order to prevent relapses in the spring, it is recommended to use topical antifungal agents.
Ringworm treatment
Antifungal agents are used in the form of an ointment, gel, as well as aseptic solutions. In some cases, oral tablets of antimycotic drugs may be prescribed. When a secondary infection is attached, antibacterial agents are prescribed. With a long course of ringworm, it is recommended to take vitamin complexes and immunomodulators.
If lichen is caused by a fungal infection of the skin, antimycotic ointments and creams are prescribed
Treatment for weeping lichen
Treatment consists mainly of antihistamines and a hypoallergenic diet. Patients are advised to wear clothing made from natural materials and avoid contact with skin irritants. Locally, ointment (gel, in the form of sprays) anti-inflammatory drugs can be prescribed.
Treatment of lichen planus
Since lichen planus is often a symptom of immunodeficiency that has developed under the influence of a general disease, a prerequisite for the treatment of lichen planus is the therapy of the primary pathology, the sanitation of the oral cavity. Patients are shown antihistamines, vitamin complexes, immunomodulators. Topically applied corticosteroid drugs in the form of an ointment, phototherapy.
Shingles treatment
In some cases, shingles is treated in a hospital setting. Intense pain syndrome is relieved by analgesic drugs, non-steroidal anti-inflammatory drugs, and sometimes narcotic analgesics, sedatives are also used. Antiviral and immunomodulating drugs are shown, in parallel, local antiviral drugs are prescribed.
Possible complications and consequences
Pink lichen can be complicated by the addition of a bacterial infection with the possible development of hydradenitis, folliculitis, impetigo, etc.
The consequence of pityriasis lichen is light spots on the skin at the site of the former lesion, but over time, although slowly, they disappear.
A complication of ringworm with the development of an inflammatory process and / or suppuration can be irreversible hair loss.
Weeping lichen can cause erythroderma, often there is a bacterial or fungal infection with the development of pyoderma.
Complications of lichen planus are severe itching and cosmetic defects, in rare cases, rashes on the oral mucosa can be malignant.
Irreversible alopecia can be a complication of ringworm
Shingles has serious complications: meningitis, heart muscle damage, viral pneumonia, neuralgia, visual impairment, hearing impairment and other neurological disorders.
Forecast
The prognosis with timely diagnosis and adequate treatment is favorable, it worsens with the development of complications. In the case of herpes zoster with serious lesions of the nervous system, the prognosis for recovery is poor.
Prevention
The prevention of lichen is based on strengthening the immune system, giving up bad habits, a rational balanced diet, avoiding physical and emotional stress, and observing the rules of personal hygiene.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
