Pityriasis Lichenoides Chronica - Symptoms and Treatment

Pityriasis lichenoides is a rash with red or brown, raised, scaly patches that can form scarsLesions may self-involute and resolve completely over weeks, or new lesions occasionally may appear in crops, waxing and waning spontaneously for months to years thereafter. The condition can range from a relatively mild chronic form to a more severe acute eruption. The term Pityriasis lichenoides describes a spectrum of skin disorders which range from relatively benign mild, scaly papules, to more severe acute papular eruptions. The aetiology of the disorder is not yet known, however there appears to be an association with some types of infection e.g. Epstein -Barr virus and Toxoplasma gondii. The chronic form shows elevated, reddened, dome-shaped papules in a symmetrical distribution, which enlarge, flatten, and show a fine scale on their surface. The disease can run over weeks, months, or even years, with lesions continually appearing and disappearing. The disease is most common in males and usually accures in childhood, although it has been seen in every race and age group. It is not contagious and currently there is no cure for the disease, although the lesions can be treated with ultraviolet therapy as well as topical steroids and antibiotics. The awkward name 'pityriasis lichenoides' means that the rash is scaly (pityriasis) and that it was once thought to look a bit like lichen because it is made up of small bumpy areas.

Pityriasis lichenoides is probably a hypersensitivity reaction to a microorganism. Pityriasis lichenoides encompasses a spectrum of clinical presentations ranging from acute papular lesions that rapidly evolve into pseudovesicles and central necrosis to small, scaling, benign-appearing papules. The milder form of the disorder known as pityriasis lichenoides chronica is associated with small, scaling papules whilst at the other end of the spectrum, the more severe pityriasis lichenoides et varioliformis acuta is associated with an acute onset of papular lesions which progress to pseudovesicles with areas of central necrosis. Pityriasis lichenoides is probably a hypersensitivity reaction to a microorganism. Pityriasis lichenoides is an inflammatory disease, which is characterized by acute and/or chronic morphological phases and epidermal shedding of flaky scales. The disease can run over weeks, months, or even years, with lesions continually appearing and disappearing. The chronic form of the disease is called pityriasis lichenoides chronica. It is also accompanied by recurrent erythematous, round papules, hemorrhage, blisters and varioliform vesiculopustules.

Causes of Pityriasis Lichenoides Chronica

Common Causes of Pityriasis Lichenoides Chronica :

• Hypersensitivity reaction to infectious agents is the main cause of this disease. It is probably a hypersensitivity reaction to a microorganism.
• Staphylococcus aureus.
• Parvovirus B19 and adenovirus can also trigger Mucha-Habermann disease.
• A person suffering from Pityriasis Lichenoides generally has their immune system affected, as a result the rashes come out on the skin.
• Toxoplasma gondii , and HIV.
• Toxoplasma infections are asymptomatic, and toxoplasmosis may also be a cause.

Symptoms of Pityriasis Lichenoides Chronica

Some common Symptoms of Pityriasis Lichenoides Chronica :

• Fever.
• The lesions are small firm red-brown spots.
• Lethargy.
• The spots look less angry and are covered with a firm shiny scale.
• Initially a small pink papule occurs that turns a reddish-brown colour.
• Myalgia may be present in severe cases.
• Pityriasis lichenoides rarely affects the face or scalp, but it can arise at any other site.

Treatment of Pityriasis Lichenoides Chronica

Some common Treatment of Pityriasis Lichenoides Chronica :

• Antihistamines such as Benadryl by mouth will help alleviate the itching.
• Oral erythromycin or tetracycline (antibiotics) may help in the eradication of pain.
• It is found very useful to decrease fissure, cracking and scaling.
• It is very effective in the treatment of pityriasis lichenoides chronica. It includes the artificial ultraviolet radiation treatment with UVB or PUVA.
• Corticosteroid creams and ointments applied to the skin often control the rash and itching.
• Topical immunomodulators such as tacrolimus or pimecrolimus. Tacrolimus ointment applied twice daily has been used successfully to treat patients with PLC.
• Topical steroids are mainly used to reduce irritation.

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