Pemphigus foliaceus is commonly known as “sweat spot”.
It is a chronic skin fungal disease caused by a fungus called Malassezia furfur (also known as Malassezia furfur) that invades the superficial stratum corneum. This fungus is a conditional pathogen, it only causes disease under the conditions of a variety of factors, such as high temperature and high heat, local greasy, sweaty, unhygienic, less cleaning, poor nutrition, chronic infection, etc. Clinical features] Lichen planus is most often seen on the chest and back, but can also involve the neck, armpits, abdomen and proximal extremities, and is more common in men. The initial rash is a round dotted rash around the pores, which may gradually increase in size with clear edges. Adjacent lesions may fuse with each other to form large irregular patches, surrounded by a new rash. The rash is accompanied by a small amount of easily peelable gray or brown bran-like flaking. The color of the rash depends on the patient’s skin tone and sun exposure, and can be grayish white, yellowish, reddish, brownish, or sometimes a mixture of colors, while some may appear as hypopigmented spots only. It forms a florid patchy pattern on the trunk. The course of lichen planus is chronic, and the rash decreases or disappears in winter, leaving light-colored spots that can recur in summer when it is humid and sweaty. Diagnosis】According to the characteristics of skin performance, the rash is a round or irregular shaped macular rash of soybean size or larger with clear boundaries, pale white, pale red, pale brown or even black, with bran-like, slightly shiny fine scales attached to it. The diagnosis can be made by scraping the dermis from the suspected area again, and the mycelium and spores can be seen under the microscope. 【Treatment】There are many treatment methods for lichen planus, divided into oral and topical administration. The key is to master the method of medication and stick to it for a certain amount of time to ensure that it is cured. The topical medication is more effective, while the oral medication has some side effects while it is effective. Therefore, it is recommended that, except for those who are in serious condition and have not been cured for a long time, external medication is the mainstay. (The old treatment method is to use 20% sodium thiosulfate and 4% dilute hydrochloric acid for external application. Specific method: first apply sodium thiosulfate solution, and then apply dilute hydrochloric acid after drying, twice a day. If there is no 4% dilute hydrochloric acid, 5% glacial acetic acid can be used instead. 2.2.5% selenium disulfide solution, its use: the skin below the neck all coated with this drug, 1 to 2 hours later wash off, once every other day, a total of 5 times. Or bath with selenium disulfide solution to do bath rubbing the whole body, stop 5 to 10 minutes after rinsing, 1 time a day, 10 times a course.
Times, 10 times a course of treatment. 3.4% salicylic acid alcohol solution, local topical application, once a day for 3 days, stop 4 days, for a course of treatment, 3-4 courses of treatment. The solution can cause the epidermis to peel off and make the bacteria detach from the body. 4. Salicylic acid ointment 6% salicylic acid ointment applied externally, once a night for 1 to 2 weeks. 5. Ketoconazole lotion (Celebrex) is used for washing, once a day for 5 to 7 days. Ketoconazole is not absorbed transdermally and has no systemic side effects, so it can be applied for long-term prevention. 6. Imidazole creams
There are such as 1% clotrimazole cream, 1% econazole, 1% bifenbendazole cream, 2% miconazole cream, 2% ketoconazole cream, 1% terbinafine cream, etc.. Usage: Apply on the affected area, once a day for 3-4 weeks. 7, can be treated with UV local irradiation. Irradiate the amount of erythema in several fields. (B) Systemic treatment 1. Itraconazole, 100mg daily for 2 weeks, or 200mg daily for 1 week. The total amount should be more than 1000mg, and the drug should be kept in concentration in the epidermis for at least 4 weeks or longer after the cessation of treatment. 2. ketoconazole.
Ketoconazole is superior to itraconazole in its inhibitory effect on oval spores of S. furfur and is excreted into the skin via the sweat glands after oral administration and is recommended as the first-line oral drug for the treatment of lichen planus. A total of 400 mg orally in 2 doses per week for 2 to 3 weeks is sufficient for a total of 1200 mg. Pay attention to check liver function. Gastrointestinal symptoms such as nausea may be present and may disappear after stopping the drug. 3. Fluconazole, 150mg per week orally for 4 weeks. Prevention】Sporphyromonas furfur can be found everywhere in the world and can multiply on the skin when they encounter suitable conditions to cause disease. To prevent infection, avoid contact with the household goods of patients with lichen planus, and take care to rinse thoroughly in the shower when swimming and bathing in public baths. Increase your body’s resistance, reduce sweating, and dry up soon after sweating. Pay attention to personal hygiene, bathe regularly and change your underwear regularly. It is important to treat lichen planus as early as possible, and to wash and disinfect the clothes and sheets that you change separately from others, because a large amount of dander is attached to the clothes and blankets, and if you don’t treat them, they will become infected again and recur.