Pink deprive: causes, symptoms, diagnosis, treatment

Pink lichen (synonyms: Titra's disease, roseola scaly) is an infectious-allergic skin disease, a stream of leaking dermatosis characterized by spotty rashes.

[1], [2], [3], [4]

The causes of pink lichen

The most recognized is the infectious theory, since the disease most often develops after a cold, SARS and a positive intradermal reaction with streptococcal vaccine is noted. Stress reactions, pregnancy, atopy can provoke the development of the disease. The disease may be due to a viral infection.

Pathomorphology of pink lichen

In fresh elements, the histological picture resembles an eczematous reaction. There are swelling of the papillary dermis, perivascular inflammatory infiltrates from lymphocytes with an admixture of neutrophilic and eosinophilic granulocytes. In the formed foci there is a small acanthosis, in places spongiosis and focal parakeratosis. In 50% of cases, migration of lymphocytes into the epidermis is observed with the formation of vesicles in its upper part. If the vial is filled with exudate cells, it looks like a microabscess. A similar picture may resemble contact dermatitis. In later stages, focal parakeratosis is combined with acanthosis and lengthening of the epidermal outgrowth, which may resemble psoriasis, but the presence of vesicles in the epidermis and significant intercellular edema distinguish pink lichen from psoriasis. In the final stage of the disease, the histological pattern resembles that of plaque parapsoriasis.

Histogenesis has been studied little. On the basis of immunophenotyping of cellular infiltrates, the opinion was expressed that the inflammatory reaction is associated with activated T-lymphocytes and dendritic cells.

Symptoms of pink lichen

Pink lichen is a common dermatosis and is found mostly in people 20-40 years old. The outbreak is usually observed in the spring and autumn. Clinically, it is characterized by development against the background of unsharply expressed general reactions in the form of malaise, colds. Dermatosis often begins with the appearance of a "mother plaque", or "mother spot", which is characterized by large dimensions (about 2-3 cm and more) and a bright pink color. At the same time, the central part somewhat sinks, its surface looks like wrinkled tissue paper, a yellowish tint, is covered with small scales. On the periphery of the spots, their original pink color is preserved, which gives the spot a resemblance to the medallion. Usually, a few days after the appearance of the maternal spot, disseminated disseminated, multiple, sometimes scattered throughout the skin, oval or rounded pink or pink-red spots with a diameter of 5-1 cm, not prone to fusion. Then, on average 6-7 days later, multiple smaller spots appear, similar in morphology to the maternal plaque, located mainly on the trunk parallel to the lines of Langer. Sometimes palms and soles are affected, as well as the mucous membrane of the oral cavity. Rare variants - urticarum, vesicular, papular, miliary, follicular. There may be giant spots (pityriasis circinata et marginata Vidal). After 1-2 months the process is resolved. With irrational (irritating) treatment, regression occurs much later.

During the eruption of fresh elements, there is sometimes a slight malaise and a slight increase in body temperature, an increase in the cervical and submandibular lymph nodes. Pink lichen runs cyclically, that is, in the first 2-3 weeks of its existence several outbreaks of new rashes are noted.

On the site of the resolved rash, hyper- or depigmented spots may remain, which then disappear without a trace. Subjective feelings are absent in most cases. Relapses of the disease, as a rule, is not observed. After recovery, a fairly persistent immunity remains.

Differential diagnosis

Disease pink lichen should be distinguished from psoriasis, seborrheic eczema, secondary syphilis, superficial trichophytosis.

[5], [6], [7]

Treatment of pink lichen

It is necessary to comply with the hypoallergic diet (exclude from the diet irritating food: alcohol, smoked products, pickled and pickled foods, coffee, chocolate, strong tea, etc.), limit water procedures. In uncomplicated pink deprive, according to a number of dermatologists, active treatment of pink lichen is not performed. When acute and common forms are prescribed antibiotics of a wide spectrum of action, vitamin (A, C, PP, group B) and antihistamines. Locally recommend water and oil stirring suspensions, corticosteroid ointments or creams.