Neurodermatitis limited lichen simple chronic. How to treat lichen at an early stage? Other treatments in extreme cases

The diagnosis is established during the examination. Treatment consists of patient education and the use of behavioral techniques to prevent scratching, as well as glucocorticosteroids and antihistamines.

Causes

Lichen simplex chronicus is a thickening of the skin with the formation of various scales, which occurs secondary to repeated scratching or rubbing of the skin. Simple chronic lichen is not a primary disease. The sensation of itching in a certain area of ​​the skin (as a result of pathological changes in the skin or not) provokes friction and mechanical trauma to the skin, which leads to the formation of secondary lichenification and further stimulation of itching. Lichen simplex chronicus often develops in people with anxiety disorders and non-specific emotional stress, as well as in patients with any type of underlying chronic dermatitis.

Pathophysiology

The pathophysiological processes underlying the disorder are unknown, but may involve a disturbance in the perception and processing of the sensation of itching by the nervous system. Skin prone to developing eczematous disorders is more prone to lichenification.

Symptoms and signs

Lichen simplex chronicus is characterized by the formation of itchy, dry, scaly, hyperpigmented, lichenified plaques with irregular, round, or angular outlines.

Diagnostics

• Clinical examination.

The diagnosis is established during the examination. A fully formed plaque has an outer zone of discrete brownish papules and a central zone of confluent, scaly papules. Clinically similar conditions include mycosis of smooth skin; lichen simplex chronicus can be distinguished from these conditions by microscopic examination of scrapings in a wet preparation with potassium hydroxide and biopsy.

Treatment

• Patient education and behavioral techniques.
• Glucocorticosteroids (most often externally but sometimes in the form of intralesional injections).
• Antihistamines.

The patient's primary therapy is to educate and explain the effects of scratching and rubbing. Secondary treatment consists in the use of glucocorticosteroid drugs; flurandrenolide-impregnated surgical sheeting (applied in the morning and changed to a new sheeting in the evening, may be preferred as occlusion prevents scratching). Small lesions can be pricked (intralesional injections) with a long-acting glucocorticosteroid drug, such as triamcenolone acetonide at a dose of 0.3 ml/cm 2 of the area of ​​the lesion; treatment can be repeated every 3-4 weeks. Oral administration of antihistamines that block H 2 receptors may have a positive effect. The use of emollients can also help.

Lichen is an infectious disease of the human skin. There are many varieties of lichen, such as: ringworm, red flat, multi-colored, weeping, etc. And also the list of lichen diseases includes simple white lichen.

White lichen has distinctive symptoms. At the time of the manifestation of the disease, light, slightly flaky spots appear on the human skin. Such spots are not accompanied by itching or soreness. The face of a person has become a favorite habitat for white lichen, a little less often it appears on the neck and chest.

Causes of white lichen

Before today doctors could not identify the exact cause of white lichen. The main version is considered: the presence of the virus in the human body and its constant relapses in a favorable environment. This virus provokes the malassezia fungus, which is present on the skin of absolutely any person. Its large accumulations prevent the entry sun rays in separate areas of the skin, which creates symptoms of lichen simplex - white spots on the skin.

Despite ignorance of the exact cause, doctors, when diagnosing white lichen, brought out a certain number of features and diseases that accompany the appearance of white lichen on the skin of a person.

• age period from 3 to 16 years;
• genetic predisposition to bronchial asthma;
• people with eczema or hay fever;
• allergic dermatitis.

All these diseases are closely associated with the development of lichen simplex.

White lichen in children and adults

Most often, simple lichen covers people in childhood and adolescence. It is practically invisible in winter time when the skin does not tan. And also hard to see white lichen in a child with fair skin.

If you do not treat white lichen in childhood, it takes the form of chronic lichen and is in the human body until adulthood. Already in this period, a healthy body is able to independently fight the disease.

Only ten percent of patients seek help in the treatment of lichen simplex. Since it does not cause much harm to the body and does not cause much discomfort. The main disadvantage of symptomatic manifestations is the habitat of lichen simplex: face, neck, shoulders and chest. This causes some misunderstanding on the part of the interlocutors. This information allows us to safely assert that white lichen is a cosmetic problem.

Therefore, many patients with white deprive themselves struggle with its white spots. To do this, it is enough to lubricate the affected areas with a moisturizer. This procedure will relieve dryness and peeling. But such self-treatment will not be able to remove white age spots. To do this, you need to consult a dermatologist.

Treatment of white lichen

When applying for medical care the doctor will prescribe topical drugs: ointments, creams and various solutions or talkers. The main goal of treating white lichen is to combat acquired skin pigmentation. Doctors use the only possible method - the safe removal of pigment (white) spots from the skin. The main drug in the fight against disease and depigmentation of the skin is a one-percent ointment with hydrocortisone. It is very effective in the winter season. Since at this time the skin is prone to frost and dries out much faster.

For the summer period, the treatment method is much simpler. The course of recovery includes sunbathing or treatment of affected areas with ultraviolet rays. It also adds constant skin hydration with natural creams.

Folk methods in the fight against simple lichen

Many people ask the same question: how to treat white lichen in humans. And in addition to medicinal ointments and creams, there are a number of safe traditional medicine.

• Aloe juice has been considered since ancient times medicinal plant. To this day, its possibilities for treatment have not faded away and are used in many areas. And the treatment of white lichen also applies to them. In this case, it is necessary to cut the aloe leaf lengthwise and wipe the affected white spots with crumb.

• Birch also appears in many traditional medicine recipes. Birch buds, sap, tar, coal and birch mushroom- chaga. For the treatment of white lichen, birch buds will be needed. It is important that they should be collected from January to March, before they begin to bloom. A glass of birch buds must be poured with boiling water in a ratio of 1: 1 and the contents kept for another 10 minutes on low heat. After that, the infusion is filtered and cooled. When applying, it is necessary to moisten a piece of gauze with a ready-made birch solution and apply it to the affected areas of the skin.

• In the case of a white lichen problem, you will need a mixture of plants such as: celandine, tansy and wormwood. To prepare herbal infusion, you will need one teaspoon of each of the plants. They are poured with a glass of boiling water and infused for ten hours. Before use, the infusion must be filtered and applied to problem areas three times a day with a soft cloth.

There is still a very large number medicinal herbs that help the human body cope with the disease. ethnoscience always helped and suggested how to treat any disease.

Prevention of lichen simplex

There are no separate measures and rules in order to avoid white lichen. Therefore, for the prevention of the disease should refer to generally accepted precautions.

• Hygiene rules. Any virus or infection accumulates in public places such as transport, hospital, gym and others. Therefore, be sure to wash your hands after coming from the street and before eating food. And also in this precautionary measure, domestic animals play an important role, which are the main carriers of many types of lichen.
• Medical examination. Equally important is a regular full medical examination, which will help to identify the presence of the disease while still in its infancy. An early diagnosis will simplify the severity of symptoms and treatment of the disease.

• Disease vaccinations. From the very birth of a child, a course of vaccinations against various diseases. Do not neglect them, as they prevent the independent appearance of the disease and develop immunity to them in case of possible contact with the patient.
• It is known that most varieties of lichen manifest themselves in moments of immune exhaustion, so it is rational to engage in constant healing of the body. This preventive measure includes: visits to sanatoriums, health resorts, the use of vitamins, hardening of the body and other methods of recovery.

Similarity of white lichen with other species

Different medicines and ointments react absolutely differently to the patient's condition. For example, the most common remedy in the treatment of lichen is sulfuric ointment. It is based on natural ingredients sulfuric acid) and is suitable for both adults and children. But the use of sulfuric ointment for white lichen can complicate the situation by causing burning, redness and itching in the affected areas.

Any self-medication is not recommended by any physician. The main reason for this phenomenon is the inability to independently make a correct diagnosis. If ordinary cosmetical tools could not help in solving the problem of white spots, then there is a possibility of the presence of another type of fungus. The definition, which can be obtained by passing tests and scrapers.

Simple white lichen is very similar in its symptoms to vitiligo disease, ringworm, atopic dermatitis, skin mycosis and others. They are much more dangerous than simple white lichen, and can cause complications in the work of individual organs and body systems. When the first signs of lichen appear, it is imperative to consult a dermatologist and make the correct diagnosis. White lichen in most cases goes away on its own, and while the expectation of this recovery passes, in case of an error in the diagnosis, another disease can gain growth and move into more severe stages of development.

The skin is the largest and most important human organ. It is necessary to treat with great responsibility any manifestations of symptomatic diseases and contact a professional physician. Any self-medication can cause complications.

Simple chronic lichen is a disease that develops as a result of scratching the skin. Scratching provokes increased itching, which leads to the progression of the disease. Often the disease develops in people with frequent neuroses. The main treatment is to get rid of itching and restore the skin.

Etiology

Simple chronic lichen is manifested by thickening of the skin, accompanied by the formation of scales. There is no single version of what exactly is the reason for its development. The most likely assumption is that the disease is caused by the penetration of a specific fungus into the body, the presence of which leads to the production of a substance that prevents ultraviolet rays from penetrating the skin. Also, the pathogen affects the process of transporting melanin to keratocytes, due to which pigmentation is disturbed.

There are also a number of factors that can provoke the development of the disease:

• nervous excitability;
• diseases digestive system in a chronic form;
• improper functioning of the endocrine system;
• hormonal disorders;
• skin injuries;
• allergic reactions;
• genetic predisposition.

The disease occurs in both men and women.

Symptoms

The first sign of the disease is itching of the skin. Usually, the manifestations of this form of lichen are located on the neck, under the knees and in the place of the elbow bends, on the inner surface of the thigh, in the intergluteal folds. However, lesions can also occur in other places, including on the scalp.

Important! At the onset of the disease, no visual changes are noted. However, as itching and scratching of the affected areas appear, compacted papules with scales appear.

Gradually, the papules increase in size, connect with each other, taking an oval or round shape. They can range in color from pink to deep red. The skin cover changes - the skin thickens, a more pronounced skin pattern appears.

The peak of the disease is accompanied by the allocation of individual sections of the lesion. The outer border is blurred; it encircles the hearth. The middle area is a cluster of light pink nodules, resembling the size of a pin head.

Papular formations have an irregular shape, they practically do not rise above the skin. Due to constant scratching, they are usually covered with a bloody crust. The area located inside is a zone of increased infiltration of the skin.

Treatment

Important! The diagnosis is made by the doctor after the examination. Treatment should be comprehensive and take into account the reason for the development of simple chronic lichen. The patient needs not only to take medications, but also to make adjustments to his lifestyle, to adhere to a certain diet.

Since the cause of scratching foci of lichen is itching, it is necessary to take antihistamines for treatment. It could be Suprastin or Claritin. To increase the effect, you can supplement the treatment with external agents - Fenistil-gel and other drugs to reduce the sensitivity of the skin.

Since the trigger for simple chronic lichen is often a failure nervous system, then the treatment requires taking drugs, the action of which is aimed at its restoration. It can be ordinary valerian or complexes like Sedavit. Such drugs reduce anxiety, remove anxiety, help to cope with insomnia.

Simple chronic lichen must be treated, in addition to antiallergic drugs, with agents that dry and restore the skin. For this purpose, applications with boric acid or resorcinol are made. You can also use products that include salicylic acid and tar.

Depending on the severity of the disease, drugs with glucocorticosteroids may be prescribed. Means such as Advantan have a complex effect: they reduce itching, relieve inflammation, and help reduce lesions.

With caution, drugs with steroids should be used when treating the neck, face, scalp. For these purposes, only weak means are suitable. Such creams are applied in an exceptionally thin layer, twice a day for a short period of time. Precautions must be observed, as under the influence of steroids, the skin becomes thinner, and its protective functions are reduced.

Often, due to scratching, a bacterial infection penetrates into the lesions. Antibacterial drugs are used to combat it. They can also be used in two forms: for external use and ingestion.

A dermatologist may prescribe light therapy. This procedure is relevant in cases where the inflammatory process has not developed. Due to the action of UV rays, the process of regeneration of the skin is accelerated, microbes die.

Areas of the skin on which manifestations of chronic lichen simplex have arisen require special care - additional hydration and nutrition. Experts recommend after water procedures to lubricate the affected areas with Mustela or Physiogel gels. These drugs form a protective film on the skin, which helps to retain moisture.

Diet

As for the diet, it is necessary to exclude products that are related to allergens. These are chocolate, honey, citrus fruits, coffee and seafood. For the entire period of treatment, you should stop using alcoholic beverages. In the diet, it is necessary to focus on gluten-free cereals, vegetables and fruits of white and green color (red ones are excluded).

You should provide additional support to the body by taking vitamins. The most important for a speedy recovery are vitamins B, C, E, A.

Lichen is treated for a long time, so the patient will have to be patient.

At the stage of recovery, the affected areas are covered with a crust, which soon falls off. The skin in this place becomes white or pink, and for some time differs from healthy areas.

Preventive actions

To reduce the risk of developing lichen, you must adhere to the following recommendations:

• Carefully monitor the integrity of the skin, excluding the appearance of microtrauma. If the skin is damaged, it is necessary to treat the affected area with an antiseptic solution and seal it with a plaster.
• You should not use the things of a person who has lichen.

Limited neurodermatitis (simple chronic lichen) is characterized by thickening of skin areas due to frequent scratching. Symptoms of the disease often appear in people prone to neuroses. The main treatment is aimed at eliminating itching and restoring the epidermis.

Symptoms and Causes

Lesions appear in the bends of the elbows, under the knees, on the torso, back, side of the neck, near the genitals. The disease is diagnosed more often in adult men. You may notice the following symptoms:

The plaques are oval in shape, with clear edges, arranged symmetrically. In the center of the lesion, compaction and coarsening are most pronounced. The second zone consists of small pink papules, Brown, with a shiny surface. The third zone is pigmented, gradually turning into a healthy epidermis.

There is no weeping of plaques; upon recovery, the rash becomes covered with crusts, which soon fall off. The skin after falling off remains pinkish or white, different from healthy skin over some period of time.

Simple chronic lichen is diagnosed by a dermatologist based on an external examination, the results of skin scraping tests, and a biopsy of the affected areas.

Simple lichen occurs in humans due to disruption of the internal systems of the body. It is also believed that this disease can cause allergies. The main factors contributing to the onset of the disease:

Patients often complain of insomnia, irritability, anxiety, instability of the nervous system. Treatment of limited neurodermatitis will be effective if internal problems are eliminated and nervous stress is limited.

Treatment

After confirming the diagnosis, the doctor prescribes a comprehensive treatment, taking into account the individual characteristics of the patient and the development of the disease. Therapy consists not only in taking medications, but also in observing healthy lifestyle life, diet.

For the prevention of exacerbations of lichen simplex, patients are shown sanatorium treatment in countries with a dry climate.

Lichen simplex chronicus (L28) is a skin change in the form of lichenification caused by repeated scratching due to chronic pruritus.

Adults are ill, more often men.

Localization: posterior and lateral surfaces of the neck, popliteal and elbow folds, anogenital region, inner thighs, intergluteal folds, less often - the scalp.

Factors leading to the development of the disease:

• chronic stress.
• Diseases of the nervous system.
• Allergies.
• Diseases of the gastrointestinal tract.
• Endocrine diseases.
• Long-term skin damage.
• Familial predisposition (cases of similar diseases in close relatives).

Gradually, itching appears, leading to scratching of the skin (up to 100%). Under the influence of scratching, areas of compaction appear on the skin, in some places the skin peels off (80%). Then plaques, areas of hyperpigmentation (70%) gradually form. There is a thickening of the skin, it becomes rough (80%). During the course of the disease, periods of exacerbation and subsidence of the process are noted. 75% of patients are anxious and irritable.

Physical examination of the skin reveals excoriations, polygonal papules of a dense consistency, and floury peeling. In the center of the plaque there are merged papules, covered with scales, the outer zone consists of individual brownish papules. Characterized by lichenification of the affected areas.

Diagnostics

The diagnosis is made on the basis of a dermatological picture. For the purpose of differentiation, a KOH test is carried out. A skin biopsy of the affected areas with histological examination is required.

Differential Diagnosis:

• Skin dermatomycosis.
• Lichen planus.

Treatment of simple chronic lichen

Treatment is prescribed only after confirmation of the diagnosis by a specialist doctor. Local glucocorticoids, an occlusive patch to prevent scratching, itching ointments (menthol, diphenhydramine, anesthesin), systemic non-blocking antihistamines, weak antipsychotics are used. A hypoallergenic diet is required.

Essential drugs

There are contraindications. Specialist consultation is required.

• (antiallergic drug). Dosage regimen: inside adults and children over 12 years of age are prescribed 1 tab. (1 mg) morning and evening. In cases that are difficult to treat, the daily dose can be up to 6 tablets. (6 mg). Children aged 6-12 years are prescribed 1/2-1 tab. before breakfast and at night. Tablets should be taken before meals with water.
• Mometasone furoate () - GCS for external use. Dosage regimen: cream or ointment is applied in a thin layer to the affected areas of the skin 1 time / day. The duration of the course of treatment is determined by its effectiveness, as well as patient tolerance, the presence and severity of side effects.
• Menovazan ointment (combined preparation with antipruritic and local anesthetic action). Dosage regimen: externally 2-3 times a day for rubbing painful areas of the skin. The course of treatment depends on the form and course of the disease, as well as on the nature of concomitant therapy. The maximum daily dose is 9 g.