Pathogenesis (disease development) The etiology (causes) and pathogenesis of lichen ruber planus are not fully understood. Much evidence suggests that it is an autoimmune disease. It is thought to be an autoimmune reaction against keratinocytes (horn-forming cells). Destruction of basal keratinocytes by cytotoxic T cells occurs. Etiology (Causes) Genetic burden – familial lichen ruber planus … Nodular Lichen (Lichen Ruber Planus): Causes
General measures Avoid dehydration and irritation of the skin by balancing skin care. Suitable care products are oily skin care products. Avoiding strong mechanical stress on the skin. Avoid synthetic underwear. This is not very breathable and promotes a moist environment. Instead, wear loose cotton clothing. Nicotine restriction (refrain from tobacco use), including avoidance of … Nodular Lichen (Lichen Ruber Planus): Therapy
Medical history (history of the patient) is an important component in the diagnosis of lichen ruber planus (nodular lichen). Family history Are there frequent skin diseases in your family? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). What skin symptoms have you noticed? Reddish-purple nodules Coarse, yellowish, strongly keratinizing, areal or plate-like substance … Nodular Lichen (Lichen Ruber Planus): Medical History
Skin and subcutaneous (L00-L99). Medicinal exanthema, lichenoides (“lichenoid”). Lichen sclerosus – rarely occurring, chronic inflammatory disease of the connective tissue, which is probably one of the autoimmune diseases. Papular syphilid – itching is low or absent. Pityriasis lichenoides – lues in the early syphilis (secondary stage)/sexual disease stage. Psoriasis punctata (psoriasis) – the Auspitz phenomenon, … Nodular Lichen (Lichen Ruber Planus): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be caused by lichen ruber planus (nodular lichen): Skin and subcutaneous (L00-L99). Alopecia cicatrica (scarring alopecia). Hyperpigmentation of the skin Nail dystrophy with frayed nail plates with longitudinal surface distortions and numerous spots Digestive system (K00-K93) Burning mouth syndrome (BMS) (synonyms: Glossalgia, glossodynia, glossopyrosis; … Nodular Lichen (Lichen Ruber Planus): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) of the skin and mucous membranes. Skin [reddish-purple papules (nodules)?; these show surface reflection when light is incident from the side; whitish reticulation on papules (“Wickham’s pattern”)] Palms and … Nodular Lichen (Lichen Ruber Planus): Examination
There are no landmark laboratory parameters. The diagnosis is made clinically.
Therapeutic target Symptom relief, i.e., treatment of itching. Therapy recommendations External therapy (topical therapy) Glucocorticoids Circumscribed low-symptom findings: 0.25% prednicarbate; 0.1% mometasone furoate (both are potent group substances) Persistent cases: 0.05% clobetasol (among the most potent topical preparations (class 4)). If necessary, also injecting the foci with glucocorticoid crystal suspension triamcinolone acetonide (moderately potent topical … Nodular Lichen (Lichen Ruber Planus): Drug Therapy
The following symptoms and complaints may indicate lichen ruber planus: Flat, mostly polygonal, reddish-purple papules (nodules) that are noticeably itchy Papules can be arranged in larger groups and sometimes confluent (flow together) to form plaques (areal or plate-like substance proliferation of the skin) Papules show a surface reflection when light is incident from the side … Nodular Lichen (Lichen Ruber Planus): Symptoms, Complaints, Signs