(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy)
Abstract: Ms. Zhang, 25, came to our hospital with purplish papules on her skin. During the physical examination of Ms. Zhang, she was found to have purplish papules in the form of lines or rings intertwined into a network on her left cheek, both arms, both legs, forehead and back, with ulceration and hyperpigmentation of the skin in many places throughout her body, accompanied by pruritus, pain and dry skin. Ms. Zhang’s symptoms disappeared after 1 month of drug treatment, and the examination indexes returned to normal.
Basic information】Female, 25 years old
Disease Type】Flat moss
Hospital】Wuhan University Central South Hospital
Date of consultation】June 2019
Treatment plan] Topical medications (compound dexamethasone acetate cream, tretinoin acetate urea cream, compound ketoconazole ointment)
【Treatment period】1 month of outpatient treatment
【Treatment effect】The skin discomfort disappeared gradually and the skin gradually returned to normal
I. Initial consultation
Ms. Zhang, 25 years old, complained of more purplish red things on her skin. Through physical examination, it was found that Ms. Zhang had purplish red papules on her left cheek, both arms, both legs, front chest and back, and they were intertwined into a network. A routine blood test revealed elevated white blood cells, and a biopsy of the tissue was taken to clarify the liquefied degeneration of basal cells, which was determined to be lichen planus.
II. Treatment process
After the diagnosis of lichen planus was confirmed, I advised Ms. Zhang to use dexamethasone acetate cream regularly to suppress skin inflammation and also to improve itchy skin symptoms, and then to take symptomatic treatment with tretinoin acetate urea cream, while using compound ketoconazole ointment to apply topically on the skin lesions to avoid the condition from continuing to be serious. Avoid scratching the itchy area with hands during the treatment period to avoid serious skin lesion breakage.
III. Treatment effect
One month after Ms. Zhang used the medication according to the dosage, the papules on her left cheek, both arms, both legs, forehead and back gradually disappeared, and the small papules on her skin also gradually decreased and the pigmentation disappeared. The crusts on the lips disappeared, and the vesicles and ulcers of the skin in many places all over the body healed, and Ms. Zhang’s complaints of itching, pain and dry skin disappeared. Once again, routine blood tests and biopsy of pathological tissue revealed that the flat moss sign basically disappeared, suggesting that the disease had been cured.
IV. Notes
We are glad that Ms. Zhang’s lichen planus has been effectively treated, but we still need to advise Ms. Zhang that she should pay more attention to foods with high nutritional value, such as eggs, lean meat, etc., and also pay more attention to participate in yoga and other exercises to enhance her resistance to diseases; she should adjust her mentality and keep a relaxed and positive mood, and at the same time, she can participate in appropriate exercises to help strengthen her body and improve her antiviral ability.
V. Personal insight
Lichen planus can be induced by a variety of factors such as infection, genetics, excessive mental tension, chronic diseases such as diabetes, or autoimmune diseases such as systemic lupus erythematosus, etc. Although the onset of lichen planus is urgent, the skin symptoms can usually be effectively relieved through regular treatment with glucocorticoids, immunosuppressive drugs and antifungal drugs. However, if the skin symptoms cannot be relieved, the treatment period should usually be extended appropriately.