Lichen is a group of polyethological skin diseases characterized by the appearance of rash, itchy elements. There are several varieties of the disease, differing in the type of pathogen, type of rash, localization, contagiousness (eczema – wet lichen; microsporia, phagus, trichophytia – ringworm; psoriasis – scaly lichen; pink lichen – pityriasis; shingles). The course of the diseases is long, with exacerbations, with the danger of secondary infection of skin rashes, bringing physical and psychological inconvenience to the patient, cosmetic defects.
General information
Lichen is a group of polyethological skin diseases characterized by the appearance of rash, itchy elements. There are several varieties of the disease, differing in the type of pathogen, type of rash, localization, contagiousness (eczema – wet lichen; microsporia, phagus, trichophytia – ringworm; psoriasis – scaly lichen; pink lichen – pityriasis; shingles). The course of the diseases is long, with exacerbations, with the danger of secondary infection of skin rashes, bringing physical and psychological inconvenience to the patient, cosmetic defects.
Lichens are a group of skin diseases characterized by the appearance of colored and flaky spots. The etiology, pathways of infection and features of the course may be different, since these diseases are grouped by clinical manifestations – discoloration, the presence of peeling of the skin or peeling of pustules.
Causes
The main causes of lichen are viral and fungal microflora. The mechanism of infection is not known, since not all people, even those who fall into the risk group, get sick with lichen. Presumably, a combination of factors such as decreased immunity, stressful situations, genetic predisposition, infectious diseases, physical and emotional overstrain increases the likelihood of lichen.
Depending on the age group and gender, the incidence of different types of lichen may vary, but the generalized data on the incidence are approximately the same. The duration and nature of the course of lichen is also different: from acute to chronic.
Pink lichen
The disease has an infectious and allergic nature, occurs everywhere among all age groups, is characterized by the appearance of rounded flaky pink spots on the skin of the trunk, more often on the skin of the back.
Pink lichen is not a highly contagious disease and intrafamilial outbreaks are extremely rare. Infection occurs through the general use of bath accessories; provoking factors are a decrease in immunity and viral respiratory infections. Pink lichen is characterized by seasonality, spikes in morbidity are recorded in spring and autumn. The absence of relapses of pink lichen gives reason to believe that a persistent immunity to the disease is developing.
The onset of the disease is characterized by the appearance of a single maternal spot of rounded outlines with a diameter of no more than 3 cm, the central part of which acquires a yellowish hue on the 2-3 day, begins to wrinkle and peel off. After 7-10 days, many similar rashes appear on the skin of the back and chest, but much smaller, rashes of pink lichen are localized mainly along the Langer lines (lines of maximum skin extensibility). Over time, peeling occurs in the center of the lichen, and a red border along the periphery; the elements are not prone to fusion. Itching and other unpleasant sensations are absent.
Inadequate therapy, frequent contact with water, increased sweating increase the duration of the disease, although pink lichen is completely cured in 1.5-2 months. Pink lichen often passes on its own, without any therapy. Patients are not recommended to stay in the sun, wearing synthetic clothing, and should limit contact with water. The use of ointments with antibacterial and antifungal substances, such as Sanguiritrin, quickly relieve the symptoms of pink lichen. Bactericidal solutions, including herbal ones, have a positive effect, often these measures are enough to cure pink lichen.
Diagnosis of pink lichen is carried out on the basis of examination, differentiation with roseola characteristic of syphilis is necessary.
Shingles
Shingles has a herpetic nature and occurs during secondary contact with a virus from the Herpes zoster group, or when a latent herpetic infection is activated. With shingles, the nerve ganglia become inflamed and characteristic rashes appear along the course of the nerve trunks. Mostly people of adult and elderly age get sick, stressful situations, infections and decreased immunity are the provoking moments.
The course of shingles is variable, from mild forms to severe with damage to the central nervous system. Before the onset of rashes, there is pain along the nerves and after 3-4 days, skin manifestations appear. With shingles, the surface of the rash first consists of small vesicles, which then shrink into crusts, sometimes peeling is noted. Depending on the severity of the course of shingles, there may be only minor symptoms of general intoxication or meningoeciphal symptoms. With complicated forms of shingles, the prognosis is extremely unfavorable.
Characteristic clinical manifestations make it possible to accurately make a diagnosis based on a visual examination and interview of the patient. The treatment regimen for shingles depends on the intensity of clinical manifestations and the patient’s condition, hospitalization is necessary in almost all cases. The treatment is carried out jointly by a dermatologist and a neurologist. With a pronounced pain syndrome, analgesics and sedatives are indicated, if there are cerebral disorders, then drugs that correct the work of the central nervous system are prescribed. The use of antiviral drugs and immunomodulators is indicated for all patients with shingles. Local treatment is reduced to the use of antiviral ointments and to the prevention of bacterial complications. The prognosis depends on the severity of the course of shingles and on the adequacy of the prescribed therapy.
Pityriasis
Bran-like or colored lichen is a fungal skin disease that affects the stratum corneum of the epidermis. Sweating, hot climate, seborrheic skin conditions are predisposing factors for the occurrence of pityriasis. The incidence of pityriasis is higher in women and in young people. Outbreaks of infection and relapses of pityriasis are recorded in the hot season. Infection occurs in a contact-household way through the use of common combs, household items, as well as through direct contact of a sick person with a healthy one.
Pityriasis begins with the appearance of a single rounded pink spot, then the same spots, but of a smaller diameter, appear on the smooth skin and scalp. With pityriasis, skin changes are non-inflammatory, the spots are usually yellowish-brown in color, with their scraping there is a slight bran-like peeling. Spots of pityriasis tend to peripheral growth and fusion, itching and other subjective sensations are absent. Under the influence of ultraviolet radiation, secondary leukoderma is observed on the affected areas of the skin.
Pityriasis is diagnosed with a careful visual examination, since sometimes due to the insignificance of manifestations and the absence of unpleasant sensations, pityriasis can not be noticed. Microscopy of the scraping reveals mycelium and a characteristic accumulation of filaments of the fungus. Treatment is carried out with the help of antifungal ointments and tablet preparations, treatment of the affected areas with salicylic alcohol before applying the ointment, allows the active substance to penetrate deeper into the layers of the dermis. Compliance with the rules of personal hygiene is the only prevention of pityriasis. It is impossible to completely get rid of mycotic cells, and therefore in the spring you should use cosmetics with an antifungal effect and avoid insolation to prevent relapse.
Ringworm
Ringworm or trichophytia is a fungal skin disease in which smooth skin, scalp, and nails are affected. The source of infection is sick people and animals, infection occurs by contact and household means. Intrafamilial foci of ringworm and outbreaks of the disease in kindergarten are more common.
After the germination of the mycelium, the structure of the hair is broken, and they fall out, leaving behind “stumps”, the hair looks like shorn, hence the name – ringworm. On the affected skin, there is a slight peeling and a light plaque from the spores of the fungus. There is no itching and unpleasant sensations. Ringworm can occur almost asymptomatically, but with careful examination, you can notice “stumps” of hair. Suppurative forms of ringworm are characterized by the presence of a dense purulent infiltrate, from which pus is released when pressed, infiltrates come in different sizes, but usually occur on the scalp, in the beard and mustache. The infiltrate either resolves itself safely after 7-10 days due to the destructive effect of pus on mycotic cells, or is complicated by abscesses. Without treatment, mycotic cells persist along the periphery and maintain a chronic sluggish course of ringworm.
The diagnosis is made on the basis of clinical manifestations, the microscopy of the scraping confirms the mycotic nature of the disease, and the seeding of the separated allows to identify the type and type of pathogen and determine its sensitivity to antifungal drugs.
The treatment of ringworm is reduced to the local use of antifungal ointments and the internal use of tablet forms. Complicated forms of ringworm require symptomatic therapy. The prevention of ringworm consists in observing personal hygiene, timely identification of patients and regular examination of children in children’s institutions.