The different localizations
One of the most common manifestations of Lichen ruber is the mouth or the oral mucosa. This is also called “OLP”, the “oral lichen ruber“. It is affected in 20-30% of cases, which is why it will be discussed separately below: It manifests itself by burning spots in the oral mucosa, which are reddish in color and streaked with white stripes.
These stripes are named after their discoverer Louis F. Wickham also “Wickham-Striae” (for latin: stripes = Striae) called. They result from a widening of the mucosal epithelium. In general, women are more often (about twice as often) affected by lichen ruber of the oral mucosa than men, the age of manifestation is in the range between 40 and 60 years.In addition to the impressive striation of the oral mucosa, five to six different forms of Lichen Ruber in the mouth are classified according to definition: the bullous form (with blistering), the erosive form (with skin erosions), the reticular form: In the reticular form, the lichen forms a network-like structure on the oral mucosa.
Furthermore the atrophic form (with tissue loss), the nodular (papular form), and the plaque-like form. Depending on the form, different differential diagnoses can be considered, but the therapy after a clear diagnosis is not different. The above mentioned forms can also occur on all other mucous membranes of the body.
A further subform of Lichen ruber is the manifestation on the scalp or its hair follicles. This form is particularly disturbing for the patient, since it is accompanied by rapidly progressing alopecia (i.e. hair loss). This alopecia is also not reversible naturally after infestation of the hair follicles on the scalp.
In addition to hair loss, itching and reddening of the skin occurs as with the other lichen ruber forms. The reddening is limited in area and blurred, so it extends without edge over the entire scalp. The skin becomes scaly to scabby and itchy, the follicular epithelium of the hair cells – i.e. the cell layer that surrounds the newly growing hair at the root in a sack-like manner – dies and the hair falls out.
Therapeutically, a tincture with a strong glucocorticoid can be applied. Injecting the affected areas is also possible, but does not bring too much success. Overall, however, the therapy is difficult and usually not very successful.
Progression over several years is absolutely normal even in this form. After healing of the disease, large, hairless scar fields remain, whose follicular epithelial cells are destroyed. The only solution for cosmetic correction in this case is hair transplantation.
It is important to diagnose the disease at an early stage in order to stop alopecia in its early stages. However, this is not always easy due to the large number of differential diagnostic diseases. There are various skin diseases, some of which are harmless, but can also be the expression of a malignant disease.
Among other things, color and shape can provide important clues to the cause. Here you will get to the topic: Skin diseasesSkin changes such as wrinkling are a natural phenomenon of aging. Other changes in the skin, in turn, can be an expression of a disease of the skin or other organs. Here you will get to the topic: Skin changes
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