Is there an Ayurvedic remedy for dermatography
Lichen planus, nodular lichen
What is lichen planus?
Lichen planus is a relatively common disease of the skin and mucous membranes. It is estimated that around 0.5% of Germans (around every two hundredth) suffer from it, most often between the ages of 30 and 60. The German expression for lichen ruber is "Knötchenflechte". Lichen planus occurs in men and women and at all ages; Women over 40 are slightly more likely to be affected. Familial accumulation is possible, but rarely with lichen.
Lichen planus complaints
Lichen planus can take many forms. In the most common case, numerous small, reddish or brownish nodules appear on characteristic parts of the body: wrist bends, forearms, buttocks, sides of the neck, genital area. The millimeter-sized nodules are covered by a whitish network ("Wickham phenomenon"). Reticulated stripes are often found on the inner lining of the cheek, on the vaginal lining or the penis. Changes to the nails are also possible and sometimes the only symptom. The nail plate can tear, longitudinal stripes appear, the nail plate may become thinner (koilonychia), the nail plate and cuticle can grow together.
There are some special, rare forms of the disease:
- Lichen planus follicularis: nodules only on the hair follicles, pitted hair loss
- Graham little syndrome: simultaneous scarring on the head
- Lichen planus verruccosus: larger, itchy, firm knots on the shins
- Lichen planus in older people: little itchy nodules over the tailbone
- Lichen planus-like drug allergy: looks similar, but has completely different causes
- Eruptive lichen planus: extensive infestation, symmetrical on the arms, legs and body, rarely on the head / hands / feet
- Lichen planus atrophicus: rare, white-bluish spots, especially on the trunk and legs
- Lichen planus pigmentosus: dark nodules and spots, especially on dark skin and in South Americans
- Lichen planus pemphigoides, lichen planus vesicobullosus: rare, with vesicles and blisters, especially on the legs
- Lichen planus erosive: rare, accompanied by ulcers and open wounds, especially feet, trunk, penis
- Lichen planus of the nails: with chronic inflammation of the nail bed, nail damage, adhesions of the cuticle
In 75% the symptoms heal within 1 year, in 90% within 2 years. In severe cases, almost the entire skin of the body can be affected (erythroderma) - Lichen planus linearis: rarely, ribbon-like arrangement of the nodules, e.g. on the arms - Lichen planus atrophicans: scar-like skin thinning - Lichen planus pemphigoides: rarely, with blisters - Lichen planus actinicus: especially in people from the Middle East, tropics, subtropics. Sun as a trigger - genital lichen planus, analis: around 20% of affected men also have nodules on the penis, somewhat less often in the vagina of women. Affection of the anus skin is usually very itchy. - Lichen planus follicularis: formation of nodules around the hair roots
Formation of the nodular lichen
The exact cause of the disease is unknown. Under the microscope you can see very typical skin thickening and inflammation. Science suspects a connection with so-called autoimmune diseases: here the immune system attacks its own skin cells (keratinocytes) for unknown reasons. Sometimes the disease starts in association with excessive stress or liver problems, rheumatism, jaundice, death of loved one, antimalarial drugs, gold treatment, organ transplants. Lichen planus occurs quite frequently in connection with liver diseases (viral hepatitis, etc.). Contact allergies to metal, amalgam, plastic, spices, etc. have been described. (Scientific background: apoptosis of basal keratinocytes and unspecific deposits of C3, IgM and IgG is described. Apoptosis is mediated by CD8-positive cytotoxic cells and takes place via the perforin-granzyme pathway or the Fas / Fas-L pathway Hepatitis C-associated cases seem to be infected by HCV keratinocytes. Cytokines also play a role)
Is it cancer?
Lichen planus is not cancer; nor is the disease contagious in any way. Only in rare cases does lichen planus occur more than once in a family.
Can lichen planus be curable?
Fortunately, the disease usually heals by itself over time (usually after many months), on average the disease lasts for 1-2 years. Unfortunately, there are also years of gradients. Because of the severe itching, the affected person is treated beforehand. Oral mucous membrane infestation can persist for many years. Relapses are also possible years after healing. In the case of severe itching, extensive infestation and disfiguring appearance, early and intensive treatment is indicated. Those affected should not be fobbed off with reference to the allegedly "harmless" character of the disease. Therapy is possible and useful.
Treatment of the lichen planus
Treatment of the lichen planus is often difficult and lengthy. Nevertheless, resignation is not necessary. We try to find the possible causes and triggers before each treatment. Many different therapy methods are available to us. Unfortunately, there is no such thing as an "optimal" healing method that is 100% effective. There is also no evidence that conventional or naturopathic treatment would be more or less effective. Therefore, in our opinion, a combination of the procedures is often useful. You can treat with, for example
- external cortisone therapy, also possible under foil
- Externally tacrolimus, pimecrolimus, calcipotriol or tretinoin can be tried
- Tar and ichthyol therapy externally
- UV radiation, possibly so-called PUVA therapy, balneophototherapy, tomesa
- Internal medication applications are possible: steroids, neo-tigasone / acitretin, resorchin, interferon, thalidomide, antihistamines, cyclosporine, penicillin, metronidazole and many more.An experienced doctor works with the patient to find the right therapy.
- Internal antihistamines often relieve itching
- Low molecular weight heparins and heparinoids, especially when the oral mucosa is affected
- Cortisone can be injected directly into tough, itchy lumps
- Dental restoration or amalgam removal can be useful
- Dark spots can be treated with bleaching creams or the Ruby laser
- Spicy food, nicotine and alcohol should be avoided
- We have had good experiences with high-dose vitamin infusions, mild naturopathic immune stimulation and orthomolecular medicine
- External irradiation with UVB 311 nm or PUVA is often used
- a very effective method is the so-called eximer laser (see under the heading "eximer laser"). Since its introduction, it has become a standard method for us - as long as the whole body is not affected
Home remedies for lichen planus
There are no effective home remedies for lichen planus. Anything that balances your immune system is good for lichen planus. Be patient. Try to stick to the chosen therapy method - as discussed with the dermatologist - as consistently as possible. If for any reason (e.g. fear of side effects) you want to change or discontinue treatment, we should talk about it. Each therapy has its advantages and disadvantages, and in the end, of course, you must be satisfied with the treatment. Resist the temptation to keep scratching. Often new nodules appear at the scratched areas (this is called the "Koebner phenomenon"). The skin symptoms can often be healed through accompanying naturopathic treatment.
Lichenoid dermatoses: related diseases
There are many other skin conditions that can cause itchy lumps to appear. One speaks of "lichenoid dermatoses" because they have a similar effect to lichen planus. However, the typical Wickham mucosal changes are almost never found. So-called lichenoid drug eruptions are common. They often only develop months after taking medication. Typical triggers are, for example: gold salts, D-penicillamine, antibiotics, anti-diabetes agents, antimalarial agents, dapsone, ACE inhibitors, neuroleptics, diuretic drugs, quinine, beta blockers, tuberculosis drugs ... Also color developers (p-phenylenediamine) and methacrylates (car industry, Tooth materials) are possible causes. An allergy test is always useful here to find the cause. The treatment is mainly carried out by discontinuing the drug or avoiding the causative chemical. We hope that you now understand your skin disease better.
You can find much more information in our patient guides, which are available in bookshops.
Your practice team Dr. H. Bresser Peschelanger 11 81735 Munich 089-677977 www.drbresser.de
These pages serve exclusively to inform our patients. Duplication, including excerpts, is only permitted for personal use. Copyright Dr H Bresser, Peschelanger 11, 81735 Munich, 089-677977, www.drbresser.de
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