Skin lichen, caused by pathogenic fungi, primarily affects the skin and mucous membranes in humans. If the immune system is intact, the prognosis is usually positive.
What are skin lichens?
Skin lichen is an infectious disease. In medicine, skin lichen belongs to the so-called mycoses. Skin lichen is caused by various parasitic fungi. Both the skin and the mucous membranes of a person can be affected by dermatophyma. If the parasitic fungi grow or multiply in a person’s body, this is often associated with typical symptoms of skin lichen. These symptoms of skin lichen include growth rings that are visible on the skin of an affected person. Such growth rings as a symptom of skin lichen are often surrounded by reddish papules. However, dermatophyma can also progress without external symptoms; in medicine, such symptom-free dermatophyma is also referred to as inapparent dermatophyma. Depending on the patient and the causative agent of a skin rash, the infectious disease may take a chronic course in some cases.
Cause
Superficial skin lichen is usually caused by an infection with dermatophytes (filamentous fungi). Such an infection can occur from person to person; the fungal spores that can lead to skin rash are transmitted through skin flakes. A skin rash of the mucous membranes, on the other hand, is usually caused by fungi belonging to the genus of the so-called Candida. Often the occurrence of mucous membrane dermatitis is favored by a weakened immune system of the affected person. Such a weakened immune system can be caused, for example, by immunodeficiency diseases, recent transplantations or medical measures such as chemotherapy. If a skin lichen occurs as a result of an immunodeficiency, this is also called an opportunistic infection – the weakening of the immune system virtually enables the fungus to grow.
Symptoms, complaints, and signs
A typical symptom of skin lichen is growth rings that appear on the skin after the onset of the disease and are surrounded by nodules or vesicles. The affected areas are sensitive to touch and slightly red. The papules are often itchy or painful and cause the patient to feel very uncomfortable. Some skin lichen scales or detaches completely during the course of the disease. In certain forms, wet patches or even bleeding may occur. If treated incorrectly or not at all, these areas can become inflamed and lead to the development of ulcers. The skin lichens themselves are normally unproblematic. They appear within a few hours and usually persist for a few days to weeks before subsiding on their own. Allergic skin lichens in particular cause only mild discomfort and are generally harmless. If the skin lichen is based on an initial disease, further complications may occur under certain circumstances. Particularly aggressive pathogens can lead to chronic skin lichen. Those affected then often suffer from the typical complaints for months or even several years. In the long term, the disease is also a great burden on the psyche. Many sufferers develop social anxiety, inferiority complexes or depression.
Diagnosis and course
A typical papule formation on the skin or mucous membranes of an affected person may already lead to a suspected diagnosis of cutaneous dermatitis by a dermatologist (specialist in skin diseases). Confirmation of the suspected diagnosis of dermatitis can be obtained, for example, by taking a skin flake and examining it under the microscope. In order to determine in a further step the exact type of a fungus that has led to a skin lichen, a so-called laboratory culture (a cultivation) of the pathogen can be created. If the culture has developed completely, it can, among other things, also give indications for an effective medicinal treatment of the skin lichen. As a rule, a skin lichen takes a positive course with early medical treatment. In some cases, however, it is also possible for cutaneous lichen to take a chronic course.
Complications
Skin lichen, depending on its severity and localization, can greatly affect the daily life of the affected person. This is the case, for example, if the lichen spreads to the hands and fingers or if the skin scales particularly strongly, is reddened and no longer regenerates.It is above all the psychological burden that is underestimated but can be very high. Constant itching and the shame of the scaly skin make life difficult for those affected and can lead to psychological complications. This is particularly the case when the disease takes a chronic course and recurs or does not subside. Then, in most cases, the only thing that can be done is to try to alleviate the symptoms. #
A cure is not completely possible for chronic dermatitis. In five to twenty percent of cases of skin lichen, diseases of the joints occur with severe pain. Since it is often triggered by a weakened immune system, complications can also occur here. Further infections and secondary diseases can occur and negatively influence the healing process of the skin lichen. The lichen can also spread to the whole body and even cause blood poisoning and heart problems. In that case, hospital treatment becomes unavoidable.
When should you go to the doctor?
If dandruff is suspected, various anti-dandruff products can be applied first. If these do not show any effect or if other complaints develop, a visit to the doctor is advisable. Skin redness, itching or papules require medical clarification, especially if accompanied by inflammation or bleeding. If pustules are noticed, a visit to the family doctor should be made on the same day. In case of serious complications such as infections or circulatory problems, immediate examination and treatment is indicated. If left untreated, skin lichen can spread to the entire body and even lead to heart problems and chronic diseases of the internal organs. Chronic skin lichen requires close monitoring by a specialist. In addition to a general practitioner, a dermatologist or a specialist in internal diseases may be consulted. Patients suffering from a disease of the internal organs, the immune system or the thyroid glands should talk to the responsible physician. If the dandruff occurs in the course of chemotherapy, it is best to also inform the responsible medical professional.
Treatment and therapy
As a rule, medical doctors first recommend local therapy of a skin rash. Local therapy of skin lichen is carried out by applying locally effective agents to the part of the body that is affected by skin lichen. In contrast to a so-called systemic therapy, in which absorbed active ingredients (for example in the form of injections) also enter the bloodstream, a local therapy of skin lichen is usually associated with comparatively fewer side effects. Suitable medicinal forms for applying local active substances to the skin include ointments or creams. If mucous membranes are affected by dermatophyma, local therapy (depending on the localization of the affected mucous membrane) can also be carried out with the aid of juices or suppositories, for example. Which medications are suitable for the local treatment of a skin dermatitis in individual cases depends above all on the type of fungus underlying a skin dermatitis. Systemic treatment of skin eczema with antifungal drugs (antimycotics) is usually only carried out after unsuccessful local therapy. In addition, in severe cases of skin lichen, therapy combining locally and systemically applied agents may be necessary.
Outlook and prognosis
The prognosis of cutaneous lichen is favorable in most people. With a stable and healthy immune system, patients usually experience a rapid recovery. Often, medical care is not needed in an otherwise healthy person because the body’s immune system independently kills and clears pathogens from the body. In people who have other diseases or the immune system is not fully capable due to natural defaults, treatment should be given. The healing process is improved if those affected consult a doctor at the first changes in the appearance of the skin or mucous membranes. This enables a quick diagnosis and start of treatment. The risk groups of a weakened immune system include, in addition to sick people, especially infants, children and elderly people. The sooner treatment is initiated in these groups, the faster recovery will occur.The causative fungus as well as other pathogens that promote the spread of skin lichen must be prevented from further multiplication. This is the only way to stop the progress of the lichen. For recovery, the wound healing process must also be monitored. In the case of inflammation or open wounds, complications can occur that should be prevented. In severe cases, the patient is at risk of sepsis. Blood poisoning can lead to premature death.
Prevention
Skin lichen can be prevented primarily by strengthening the body’s immune system. With an intact immune system, the human body is usually able to successfully fight the fungi that trigger a skin lichen. In order to avoid symptom aggravation when skin lichen has already appeared, an early visit to the doctor and an accompanying early treatment of skin lichen can be useful.
Follow-up care
In the vast majority of cases, skin lichen can be treated successfully. In most cases, even the body’s own defense system is sufficient. According to experience, it therefore does not even come to the presentation to a doctor. In many cases, follow-up examinations are not taken up at all. The situation is different for patients with a weakened immune system. Under certain circumstances, therapy can be protracted. This is particularly the case if the disease develops chronically. Microscopically, the skin lichen is first determined by a dermatologist. This is followed by treatment with medication. The physician accompanies the patient in the course of aftercare. This is to avoid complications and to support the patient in his daily life. After a successfully treated skin lichen, the body does not build up immunity. A new infection is possible. However, patients can take their own steps to prevent infection. These are not directly accompanied by a doctor, because they affect the individual’s everyday life. However, those affected receive information on how they can protect themselves. The best preventive measure is considered to be a strengthened immune system. Sufficient exercise and a healthy diet strengthen the body. Those who opt for early treatment also benefit. This is because skin lichen can be combated most effectively in the early stages.
What you can do yourself
Skin lichen requires medical treatment in any case. Depending on the cause, medical therapy can be supported by self-help measures and various home and natural remedies. In many cases, daily washing of the affected skin areas with lemon balm or chamomile tea helps. Lukewarm compresses with tar bran or healing clay soothe the skin and relieve itching, as do cooling compresses and moist compresses. A paste of honey and chopped garlic, which is applied to the affected area, has also proven effective. For classic psoriasis, buttermilk compresses help. In addition, compresses with medicinal plants and herbs such as hay flowers, sage, thyme and juniper can be used. Skin psoriasis resulting from an acute or chronic disease of the skin can also be counteracted with a medicinal plant: the wild pansy. Applied in the form of an infusion, the flavonoids and saponins it contains promote metabolism and relieve itching. For the causal treatment of skin dermatitis, a change in lifestyle is recommended. A healthy diet rich in vitamins and minerals as well as regular exercise can effectively reduce the pathological skin changes. Stress as one of the main triggers can be combated by various methods such as progressive muscle relaxation or autogenic training. In the long term and in the case of recurring complaints, psychotherapy may also be useful.
