Pityriasis lichen - a skin disease caused by a yeast-like fungus, is not contagious. The disease is not dangerous, does not cause discomfort, but adversely affects the appearance of
. Under the name "lichen", a lot of various skin diseases are hidden, which are characterized by the appearance of spots and flaking. Peregrine lichen refers to those of them, whose causative agent is a yeast-like fungus. This illness is chronic, and, it is cured relatively easily, but is prone to relapse.
Features of the disease
This ailment has been known for a long time and has been well studied. In everyday life, it is often called a multicolored lichen or even a "sun fungus", as most often suffer from it in hot climates. Unlike quite a few such diseases, pityriasis not only does not decrease under the action of the sun, but it also intensifies. It is connected, however, not so much with ultraviolet, as with overheating of the body and heavy sweating.
The causative agent is a yeast-like fungus, known in 3 forms: rounded Pityrosporum orbiculare, oval Pityrosporum ovale and mycelial Malassezia furfur, capable of taking different forms. On human skin, it lives constantly, but is activated only under the influence of certain factors:
- violation of hygiene rules;
- profuse sweating - both with heat, and with certain diseases, tuberculosis, for example;
- for violations in the endocrine system and some diseases of the gastrointestinal tract - the ability to "manifest itself" in the fungus appears due to a change in the acidity of the skin;
- in diabetes mellitus;
- immunodeficiency - both due to illness or general weakening, and due to the intake of certain drugs: cytostatics, glucocorticoid hormones.
Basically, the ailment is active from April to June. According to some sources it is a contact disease, but this statement raises doubts: the fungus does not belong to the pathogenic microflora and is present on the skin in all people without exception. It provokes its development only coincidence of several favorable factors. If these factors act on a group of people, then the risk of the appearance of lichen becomes equal. The incubation period is 0.5-1.5 months.
Odruiferous lichen in man( photo)
Causes of
Yeast-like fungus belongs to the part of normal microflora and in normal condition does not cause any harm. In fact, the disease itself does not cause anything other than discomfort and unattractive appearance. However, it serves as a kind of signal that there are hormonal or endocrine disruptions in the body.
Under favorable conditions - overheating, stress, high skin moisture, the fungus passes into one of 2 pathogenic forms. At the same time, it begins to multiply actively and penetrates into the upper layer of the epidermis - horny. Pathogen affects the work of melanocytes, cells that are responsible for the synthesis of melanin and ensure normal skin color. Yeast-like fungus secretes azelaic acid, which reduces the production of pigment, resulting in the formation of light spots on the skin. The spots are prone to fusion, forming formations up to 15 cm in diameter. Inflammation is not observed, and the appearance of scaling is possible due to the destruction of the stratum corneum by the fungus. In most cases, itching is absent.
In the first phase of development the pathogen penetrates into the sebaceous gland, next to the hair follicle. It is here that the fungus begins to multiply actively, capturing the site of the stratum corneum around the hair. At this stage, the lichen spots look like small yellow-brown dots. As the multiplication and capture of all new areas of the skin, the points turn into spots of irregular shape, and in a variety of colors: from yellow-brown to brown on light skin to cream on the swarthy skin.
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Symptoms of pity lichen
The main sign of the ailment is the appearance of color spots. At the first stage it is a question of not noticeable points appearing around of hairs. Because of this feature of the fungus - multiply in the sebaceous gland near the hair follicle, the ailment primarily affects the areas where thicker hairs are combined with high moisture of the skin - armpits, chest, hollow on the back. Occasionally, the scalp will be affected.
- The points gradually turn into spots. The latter gradually change color - from yellow to brown or from brown to light, becoming brighter. The more a person tans, the lighter the spots become and the more they stand out. This feature and served as the reason for the name of the disease - a multicolored deprive.
- Peeling of lesions is insignificant, increases with prolonged exposure to the sun. The symptom is poorly expressed, since during bathing or ablution in the soul the exfoliating particles are completely removed mechanically.
- In many cases, increased sweating is observed, which in turn provides the fungus the ability to multiply.
- If you ignore the disease, you may have papules and even pustules up to 3 mm in diameter. This stage is accompanied by more pronounced itching. The second stage, as a rule, appears under the most unfavorable circumstances.
People of any age are afflicted with anilments, but in children under 7 years of age, the colored lichen was not registered. In addition, even with prolonged chronic course, lichen disappears to 55-60 years. Associate this with a general decrease in the hormonal background.
Lishay is more common in men: the fact is that their hair is more pronounced, which means that a more favorable soil is formed for fungal development. Yes, and sweating, as a rule, men are higher.
Since lichen does not have any negative effect on the condition and development of the fetus, the appearance of it and during pregnancy does not require any urgent treatment. On the contrary, doctors recommend to refrain from using antifungal drugs until the end of pregnancy. In extreme cases, you can use external means - creams.
Classification of
There are no disease variants per se. You can distinguish 2 stages of the process:
- erythematosquamous form of - the appearance of non-inflammatory color spots of different shapes and sizes. Itching is insignificant, scaling is imperceptible;
- the follicular form - thus there are papules and pustules. The itch in this case is much stronger. This form is manifested against a background of severe disorders of the gastrointestinal tract, endocrine diseases and so on;
- invert form - non-inflammatory spots appear in natural bodily folds - under the breast, in the breech fold, under the arms.
The localization of lichen is the same in any form - the humeral girdle, especially the armpits, chest, back, rarely the abdomen, that is, all areas where sweating is increased and there is a large number of sebaceous glands.
Diagnosis of
Symptoms of varicolored lichen are not so specific that one can only determine the appearance of the disease. Very often, pityriasis is confused with a pink gill or even seborrhea. To accurately identify the ailment, a special examination is necessary:
- anamnesis collection - absence of pronounced ecdysis and inflammation indicates that the nature of lichen is most likely associated with a yeast-like fungus;
- microscopic examination of - are studied under a microscope of the scales of the stratum corneum from affected areas of the skin. The scraping is treated with alkali, and the fungus and mycelium are clearly visible under the microscope;
- inspection under Wood's lamp - the latter is a fluorescent lamp that generates ultraviolet radiation. In this light, the lichen spots give a characteristic greenish or reddish-brown glow, depending on the real color of the spots themselves;
- the Balzer sample is an elementary method to independently determine the nature of the skin ailment. Suspicious stain and skin around the eyes are smeared with usual tincture of iodine and after a couple of seconds they are wiped. A normal yellowish color appears on the healthy skin, but the damaged one absorbs iodine in excess and becomes dark brown.
Differential diagnosis is resorted to when both multi-colored lichen and pink zebra are initially suspected in the initial stage or nevus.
Treatment of
In itself, the ailment does not present any danger, and in mild form it can pass spontaneously, as soon as provoking factors disappear. However, the attractiveness of spotted skin does not add, so that most patients listen to the recommendations of dermatologists.
Causes and symptoms of such a disease - the theme of the video below:
Therapeutic way of
All the recommendations for treating the disease can be attributed to the general:
- the most important thing is thorough hygiene. Sweating and high air temperature - the main cause of activation of the fungus. Avoid this combination is possible only by not allowing increased sweating. To do this, you need to choose clothing for the season, always made of natural fabric, since the synthetic does not have sufficient hygroscopicity;
- is obligatory to comply with the rules of hygiene - the accumulation of sweat, dirt and natural lubrication creates an excellent environment for the reproduction of fungus;
- bathing with pityriasis is not prohibited, but even shown, but it is recommended to use only warm water - hot provokes itching, and do without soap;
- every day to wash up to 95% of clothes, change things every day. Be sure to iron the hot iron before dressing.
Medical method
Since the fungus is localized in the uppermost part of the epidermis, its treatment almost always comes down to the use of external means.
The general scheme looks like this: for the first 2 weeks, the affected areas of the skin are lubricated with external antifungal agents, and then for the next 2-4 weeks - with keratolytic agents until the peeling disappears. The latter is a clear sign of death of the fungus. The spots themselves are retained for some time, since to remove them it is necessary to completely renew the upper layer of the skin.
The most commonly used antifungal agents are:
- ketoconazole or mycosoral - ointment, applied once a day;
- bifonazole - bifosin, mycospores, 1% cream or solution, applied once a day;
- clotrimazole - amylon, imidil, 1% solution;
- terbinafine - atifin, lamil, 1% cream or spray, applied 2 per day;
- Cyclopyrox - 1% cream or solution.
When breastfeeding, use antimycotic drugs undesirable. In any case, it is necessary to take maximum care so that the remnants of the product do not reach the baby when feeding.
Antifungal ointments can cause itching and increased peeling. As a rule, this is due to the individual intolerance of some component. If among the anti-mycotic drugs is not suitable, prescribe alternative drugs:
- sulfur salicylic ointment - 10%, inflicts on the spots 1 time per day;
- solution of benzyl benzoate, also used once a day. Adults are prescribed 20% solution, children - 10%;
- aqueous solution of sodium hyposulphite - applied to the affected area, and then treated with a 6% solution of hydrochloric acid. Thus, changes in the acidity of the skin are achieved, which prevents the reproduction of the fungus.
These methods are not as effective as antimycotic drugs, so treatment is not so successful and lasts longer.
If pityriasis is observed on the scalp for treatment, use a special shampoo, which includes ketoconazole, selenium sulphide, zinc pyrithione and so on. The head is washed daily for 2-4 weeks, until the peeling disappears. The most famous option - shampoo nizoral.
In the most severe cases, if the lichen accompanies more serious disorders, external means is not enough. In this case, the course of therapy includes systemic antimiotics:
- and itraconazole - is used after meals once a day for 100 mg. The course of treatment is 15 days. Another scheme is allowed: 200 mg for 1 week;
- fluconazole - is taken within 1-2 months for 150 mg every day.
Taking antifungal medications can affect the functioning of the digestive tract, suppress appetite, cause fatigue and dizziness. Often, the intake of antimycotic drugs inside is accompanied by the use of antihistamines - suprastin, for example, or fenistila.
Against the background of renal failure and in severe heart diseases, it is advisable to avoid taking drugs and restricting oneself to ointment or solution. It is forbidden to take medications of this kind during pregnancy.
Use of folk remedies in household conditions
Folk remedies have little effect on the condition of the fungus. However, they can be used for symptomatic treatment, that is, in order to reduce the amount and size of the spots.
It is necessary to resort to popular recipes with caution. Numerous methods for controlling lichens offer oil and oil infusions for treatment. The benefits from them are extremely doubtful, since oil complicates heat removal and sweating, which only exacerbates the problem. Peeling with pityriasis is small, so there is no need for such effective measures to suppress it.
It is worth paying attention to recipes that use substances that affect acidity.
- Apple cider vinegar - the solution lubricates the damaged area up to 2 times a day. The treatment lasts at least a week, then they take a break for a week and then repeat it.
- Decoction of the root and seeds of sorrel - a glass of vegetable raw material is poured into a glass of boiling water and boiled for 5 minutes. The broth obtained is wiped up to 5 times a day.
- Tincture of St. John's wort - 2 tablespoons per 1 cup of boiling water, is also quite effective for various skin diseases.
- Juice onions - very "fragrant" and quite irritating, but effective. Juice is smeared with stains up to 3 times a day until the peeling disappears.
- Boric acid and salicylic - also dry the top layer of the skin and do not allow the fungus to multiply intensively.
Prevention of
If the fungus has never been activated, all preventive measures are reduced to adherence to hygiene and common sense requirements:
- bathing and showering as needed;
- is a moderate tan;
- strengthening of the immune system;
- wearing clothes made of natural fabric at least during the hot season. Synthetic fabrics do not absorb sweat properly and do not let in air, and this combination is the best way to "wake up" a yeast-like fungus.
If the pityriasis has already shown itself, then the following rules are added to the listed rules:
- Once a month throughout the year it is necessary to apply ketoconazole - 400 mg or other medicine;
- before the start of the summer season 3 days in a row you need to wash your head with shampoo nizoral;
- should not allow excessive sweating - it is meant to change clothes more often and use antiperspirants;
- to treat the diseases that caused fungal activity - a digestive tract disorder, diabetes mellitus.
Complications of
No complications cause any complications. The appearance of colored non-inflamed spots affects only the appearance and is not a dangerous factor. However, in the absence of treatment, the mechanism of melanin production in the affected area can be destroyed. In this case, even after successful destruction of the fungus, normal skin color is not restored.
Forecast
Pityriasis is treated quite successfully both in adults and in children. It does not require inpatient treatment, but since the causative agent itself refers to a normal microflora, the risk of recurrence remains for a lifetime of up to 55-60 years. To prevent relapse, it is worthwhile to follow the recommendations described above.
Otrywed lichen is an infectious, but non-contagious skin disease. The ailment does not affect the functionality of the body, it is not accompanied by painful sensations or discomfort. It is easy to cure, but the risk of recurrence persists.
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