Red flat deprive

Description:

Red flat deprive (lichen ruber planus) is the chronic disease which is characterized by monomorphic rashes of papules on skin and visible mucous membranes, it is especially frequent on a mucous membrane of a mouth and a red border of lips. The disease meets in all age groups, the mucous membrane is surprised at women from 40 to 60 years more often.

Red flat depriving symptoms:

The clinic is characterized by formation of the monomorphic rash consisting from flat, polygonal with a brilliant surface, and with the central retraction of papules pinkish-violet or crimson and reddish, with a diameter of 2-3 mm. A peculiar gloss of a surface of papules with a wax-like shade is swept especially well up at side lighting. Papules can merge, forming small plaques on which surface there are small scales. When greasing a surface of papules and in particular plaques vegetable oil notes the small whitish points and strips intertwining in the form of a web translucent through a corneous layer (a symptom of Uikhem) that is caused by an uneven thickening of a granular layer of epidermis. At permission of the centers often there is a persistent hyperpegmentation. The dermatosis is followed by an itch, quite often very intensive, depriving of patients of rest and a dream.

Favourite localization red flat depriving - the flexion surfaces of forearms, area of radiocarpal joints, the internal surface of hips and extensive - shins, inguinal and axillary areas, a mucous membrane of a mouth. Face skin, a pilar part of the head, palms, soles usually are not involved in process. Sometimes rash has a linear, "zoniformny" arrangement; such arrangement meets in extremities more often.

At 25% of patients of damage of mucous membranes (a mouth, a balanus, an entrance of the vagina) are not followed by manifestations on skin. On a mucous membrane of cheeks the grayish-opal dot papules which are grouped in the form of rings, network, laces, on a language surface - the flat, reminding leukoplakia centers, whitish opal plaques with accurate rough edges, on a red border of lips (a thicket lower) - the small plaques of violet color which are slightly shelled, having a grayish-white grid on a surface are formed.

At some patients change of nails with the expressed longitudinal striation, sometimes in the form of combs, a hyperemia of a nail bed with focal opacification of nail plates of brushes and feet is noted.

For red flat depriving isomorphic reaction to irritation is characteristic. Quite often typical elements of a dermatosis are linearly at places of excoriations (Kebner's phenomenon). The disease proceeds is long, quite often many months. Cases of generalization of a dermatosis with development of the phenomena of a secondary erythrosis (lichen ruber planus generalisata) are noted.

Distinguish several atypical forms red flat depriving.

The hypertrophic, warty form (lichen planus hypertro-phicus, seu verrucosus) is a consequence of a warty hyperplasia. It is shown in the form of the plaques of violet or brownish-red color covered with warty giperkeratotichesky stratifications. Around them separate typical papules can be located. Localization - the front surface of shins, is more rare on other sites of an integument.

Atrophic and sclerous forms (lichen planus atrophicus, lichen planus sclerosus). At permission of papules and plaques there can be atrophic or sclerous changes. The melkoochagovy atrophic baldness of a pilar part of the head like pseudopelada which is followed by symptoms of a White's disease on extensor surfaces of extremities (Littlya-Lassuyer's symptom complex) can develop.

Pemfigoidny, or bubbly, a form (lichen ruber pemphi goides, seu bullosus) - a rare exudative form of which vesiculation with serous or serous and bloody contents is characteristic. The size of bubbles about a pea or cherry. They are formed on probably not affected skin or on a surface of papules and plaques, a thicket on shins, feet.

At the same time sometimes there are typical small knots red flat depriving.

Moniliformpy red deprive (lichen ruber moniliformis) it is characterized large, of the size of a cherry stone, by the rashes strung in the form of a necklace (monile - a necklace). Small knots are dome-shaped, roundish, wax-like, keloidopodobny, are located chetkoobrazno that makes an impression of narrow keloid strips. Sometimes elements are located in the form of a beads without keloidopodobny by tyazhy. Rashes can have widespread character, especially affecting forehead skin, the back surface of auricles, a neck, elbow bends, the back of brushes, a stomach, buttocks and leaving free skin of cheeks, a nose, subclavial, interscapular areas, palms, soles, a balanus. Some authors treat this form red depriving as an independent disease.

Sharp-pointed, perifollikulyarny form (lichen planus accuminatus, sen planopilaris). Along with typical polygonal papules conic follicular papules with a horn spinule in the center of such small knots appear. At localization on a pilar part of the head atrophic scars can be formed. The ring-shaped form (lichen planus annularis) develops as a result of distribution of the centers on the periphery and regress from the center where pigmentation appears. It leads to formation of ringlets, arches, garlands, half rings which can result also from merge of separate small small knots. The ring-shaped form is more often observed at men in the field of generative organs, the internal surface of upper extremities where it can remind syphilitic papules.

Distinguish also linear red deprive (lichen ruber linearis, seu striatus) and zosteriformny option (lichen ruber zosteriformis) when small knots are located on the course of nerves and remind shingles.

The erosive and ulcer shape (mucous membrane) is the heaviest and difficult giving in to treatment. At this form on a mucous membrane of a mouth or lips there are erosion, ulcers around which on the hyperemic and edematous basis are located in the form of a certain drawing typical for red flat are more rare depriving of a papule. Erosion have the wrong outlines, are covered with a fibrinous plaque after which removal easily there is bleeding. They can be single, small, low-painful. Erosion can keep a long time, sometimes for years. Under the influence of the carried-out treatment of an erosion are partially or completely epithelized, but recur on the same or other site of a mucous membrane, sometimes at once after the treatment termination.

Red flat depriving of the reason:

Red flat depriving of development disturbances of regulation of the immuno-metabolic processes causing inadequate fabric reaction under the influence of provocative factors endo-and exogenous character are the cornerstone. Family predisposition red flat is established depriving with an autosomal and dominant mode of inheritance.

There are various theories of developing of this disease: nervous, virus and toksiko-allergic. Cases of development red flat are well-known depriving after a stress, effective hypnosis and reflex and segmented therapy, testimonial of a role of a nervous system in a disease pathogeny. In development isolated red flat depriving great importance on a mucous membrane of a mouth the toksiko-allergic option is.

Red flat depriving emergence on a mucous membrane of a mouth to some extent depends on existence at sick diseases of digestive tract (gastritises, colitis other), a liver, a pancreas. At a number of patients undoubted communication of a disease with vascular (hypertension) and endocrine (diabetes mellitus) pathology is noted. In development of a disease on a mucous membrane of a mouth the injury of the last including caused by dental pathology has a certain value: keen edges of teeth, badly pripasovanny removable lamellar prostheses from plastic, lack of teeth, etc.

Recently even more often messages on development red flat appear depriving of skin and a mucous membrane of a mouth in response to action on an organism of some chemicals, including medicines. So-called lichenoid reactions at persons whose work is connected with manifestation of a color film, having contact with a parafinancial ylenediamine, accepting tetracycline (tetracycline lichenins), by PASK, gold drugs, etc. are described. Thus, the disease in some cases can represent allergic reaction to some medicinal and chemical irritants.

Red flat depriving treatment:

At treatment red flat depriving it is important to consider the conditions promoting emergence of a disease. At the same time it is necessary to eliminate risk factors – household and professional harm, associated diseases, the infection centers. Carry out sanitation of an oral cavity, prosthetics. Foodstuff should not cause irritation of mucous membranes of a mouth. The attention to the previous treatment and portability of medicinal substances is paid.

As the main therapy appoint hormones in combination with derivatives 4 aminoquinolines (hydroxychloroquine, chloroquine).

In the presence of the expressed itch the calmatives and antidepressants contributing to normalization of a dream and reduction of an itch and also antiallergenic drugs are shown (tavegil, кларитин, телфаст, etc.).

Vitamin therapy has favorable effect on exchange processes. Vitamin A influences cell fissions of skin (a daily dose for adults – 100 000 ME). Vitamin A derivatives (тигазон, неотигазон, этретионат) reduce expressiveness of an inflammation and normalize cell fission processes. Vitamin A derivatives at damage of a mucous membrane of a mouth and a red border of lips are more effective. The daily dose makes from 25 to 50 mg, treatment continues 2–3 weeks. Also vitamin A analogs – carotinoids are applied (for example, феноро).

Vitamin E (alpha-tocopherol acetate) allows to lower at complex treatment by hormones a daily dose and to reduce terms of hormonal therapy.

At a chronic recurrent current red flat depriving the means improving oxygen providing fabrics are shown (for example, Cyto-IAC, Actovegin).

Red flat depriving outside treatment applications of hormonal ointments, solutions and mixes with menthol, anaesthesin, citric acid, antihistamines apply at an intensive itch.

Large plaques destroy by a cryolysis (freezing) or electrothermic coagulation (cauterization). The ulcer centers treat the healing means (solkoserit, sea-buckthorn oil, dogrose oil).

From methods of not medicinal therapy red flat depriving the phototherapy (ultra-violet radiation) deserves attention. There are messages on treatment of patients with red flat is deprived by the laser.

Therapy red flat is used depriving using the means influencing immune system (реаферон, an interlok, not OVIR, ридостин). Not OVIR of 12,5% is appointed intramusculary on 2 ml of 1 times in 2–3 days, to a course of 5 injections, ридостин – on 2 ml in 2 days on the 3rd, only 4 injections.