Pityriasis lichenoides is a rare skin disorder and characterized by multiple papules and plaques. Pityriasis lichenoides encompasses a spectrum of clinical presentations ranging from acute papular lesions that rapidly evolve into pseudovesicles and central necrosis (pityriasis lichenoides et varioliformis acuta or PLEVA) to small, scaling, benign-appearing papules (pityriasis lichenoides chronica or PLC). The condition can range from a relatively mild chronic form to a more severe acute eruption. The mild chronic form is known as pityriasis lichenoides chronica. It is characterised by the gradual development of symptom less, small, scaling papules that spontaneously flatten and regress over a period of weeks. It is a disease of the immune system. There are two types of pityriasis lichenoides chronica.
A short-lived form usually found in children which is known as pityriasis lichenoides varioliformis acuta. A more long-lasting form known as pityriasis lichenoides chronica. Pityriasis lichenoides most often affects young. It is slightly more common in males. It is rare in baby and in old age. It rarely affects infants and individuals of old age. This skin disorder usually begins to show in individual’s in their thirty’s, however, it can affect adolescents and young adults. A person who has Pityriasis Lichenoides something affects the immune system, the result of this, is that these rashes come out onto the skin. Pityriasis lichenoides rarely affects the face or scalp, but it can arise at any other site. It may last for months or even several years, with crops of new lesions appearing every few weeks.
Pityriasis lichenoides chronica most often occurs on the trunk and extremities but sometimes may also be diffuse and widespread, covering any part of the body. The best to use a combination of treatments to assure that this condition will be controlled, since it can not be entirely cured. Topical immunomodulators such as tacrolimus or pimecrolimus. Tacrolimus ointment applied twice daily has been used successfully to treat patients with PLC. Oral antibiotics used such as erythromycin and tetracycline. These antibiotics have been used to treat both PLC and PLEVA. Steroids are very useful in treatment of pityriasis lichenoides chronica. Sun exposure may help to resolve lesions but sunburn should be avoided. Infected lesions may be treated with topical mupirocin and sterile dressing changes twice daily.
Pityriasis Lichenoides Chronica Treatment Tips
1. Topical steroids to reduce irritation.
2. Sun exposure may help to resolve lesion.
3. Phototherapy - artificial ultraviolet radiation treatment with UVB or PUVA.
4. Oral erythromycin or tetracycline (antibiotics) taken for two or three months.
5. Severe cases may be treated with systemic steroids or methotrexate.
6. Corticosteroid creams and ointments applied to the skin often control the rash and itching.
Pityriasis lichenoides chronica, short form PLC, is the chronic version of the Pityriasis lichenoides et varioliformis acuta, also called Mucha Habermann's Disease. Pityriasis lichenoides encompasses a spectrum of clinical presentations ranging from acute papular lesions that rapidly evolve into pseudovesicles and central necrosis (pityriasis lichenoides et varioliformis acuta or PLEVA) to small, scaling, benign-appearing papules (pityriasis lichenoides chronica or PLC). The condition can range from a relatively mild chronic form to a more severe acute eruption. The mild chronic form is known as pityriasis lichenoides chronica. It is characterised by the gradual development of symptom less, small, scaling papules that spontaneously flatten and regress over a period of weeks. It is a disease of the immune system.
Causes:
A number of acute exanthems (eg, Mucha-Habermann disease, pityriasis rosea, acute lichen planus, guttate psoriasis, erythema multiforme) are believed to be caused by a hypersensitivity reaction to infectious agents. Familial outbreaks, clustering of cases, and comorbid symptoms have been used to support these relationships in Mucha-Habermann disease, although clear causality is lacking.
Signs and Symptoms of Pityriasis lichenoides chronica
Pityriasis Lichenoides start out as a small rash that is red-brown in color that appears to be raised. Sometimes these bumps can have a clear fluid inside them. Unlike pityriasis lichenoides et varioliformis acuta, lesions are not painful, itchy or irritable. Pityriasis lichenoides chronica most commonly occurs over the buttocks, arms and legs, trunk. It almost feels like you are coming down with a case of the flu.
Treatment of pityriasis lichenoides
Pityriasis lichenoides may not always respond to treatment and relapses often occur when treatment is discontinued. If the rash is not causing symptoms, treatment may not be necessary. Large ulcerations found in febrile ulceronecrotic Muchas-Habermann disease require local wound care.
In cases where treatment is necessary, there are several different therapies available. Current recommended first-line therapies include:
* Sun exposure may help to resolve lesions but sunburn should be avoided. * Topical steroids to reduce irritation. In more recent years concerns raised about their side effect profile has led to the increased use of nonsteroidal topical immunomodulators.
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