Introduction
Lichen ruber (nodular lichen) is a chronic disease of the skin (dermatosis), in which the symptoms of itching and skin changes are the main focus. There are different forms of lichen ruber, which differ greatly in their appearance. The most common form is lichen ruber planus, less common are lichen ruber mucosae, lichen ruber verrucosus and lichen ruber acuminatus.
The Epidemiology
Lichen ruber is a relatively common skin disease. About every 100th person is affected, with the peak of the disease being between the ages of 30 and 60. Infants suffer only very rarely from lichen ruber, if then mostly following a flu-like infection. Men are slightly more frequently affected than women.
The causes
Why a lichen ruber forms is not yet fully understood. However, it is assumed that this clinical picture is an autoimmune disease. This means that the body’s own defense cells, in this case cells from the lowest cell layer of the epidermis, are wrongly classified as dangerous and therefore attack them.
This triggers an inflammatory reaction in the affected skin layer. In addition, it is assumed that there are certain risk factors that can promote the development of lichen ruber. These include, among others: In addition, there is a familial predisposition to lichen.
- Viral diseases (viral hepatitis)
- Other skin diseases (psoriasis)
- Certain medicinal products and
- Some chemicals
The symptoms
Symptoms vary according to the form of the existing nodular lichen. In the classic lichen ruber planus, blue-reddish, flat papules with sharp edges are found, which often appear in groups and can also merge into regular plaques. Typically, the papules have a fine white reticular pattern on their surface which can be stripped off.
This pattern is also known as “Wickham’s stripes”. Some areas of the skin are particularly frequently affected by these skin changes. These inflammatory changes are often accompanied by more or less pronounced itching.
Occasionally, the nails are also affected, which can then become thinner or even fall out. Typically, lichen ruber planus has a relapsing course, which means that the skin changes can persist for several months or even years, then disappear and eventually return. The lichen ruber mucosae affects the mucous membranes of the papules, which are similar to those of the lichen ruber planus, but are less often accompanied by itching.
In the case of lichen ruber verrucosus, large red wart-like foci form, which often lead to scarring in the course of the disease. The lichen ruber acuminatus is characterized by an infestation of hair follicles, which can lead to hair loss.
- The flexion sides of the wrist and knee
- The lower back
- Lower leg and
- Soles
- Mouth/Lips/Tongue
- The outer section of the anal canal and
- The genital area (vagina or penile mucosa)
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