LICHEN PLANUS 



475 



LICHEN PLANUS. 



The term "lichen" does not mean much more than '"papular," 

 thus lichen simplex is really a phase of eczema, and lichen tropicus 

 the same as prickly heat, &c. The word should be restricted to 

 eruptions that are papular throughout and of a persistent typical form. 



Lichen planus consists of a violet or reddish eruption of small, 

 irregularly shaped papules, flat on the top and sometimes umbilicated, 

 carrying a small scale "in the centre. It is probably of an angio- 

 neurotic origin. The papules may group themselves in lines, curves, 

 or rings. Vesicles seldom, and pustules never, appear in adults. The 

 mucous membrane may be affected, but the accompanying skin con- 

 dition will assist the diagnosis. In acute cases there is much depression 

 and irritability. 



Arsenic is useful given in increasing doses over long periods, but 

 improvement is not to be expected until after the sixth week of treat- 

 ment. Intestinal antiseptics are useful. Morris uses the following: — 



R 



Liq. hydrarg. perchlor. 

 Potass, iodid. 

 Decoct, sarsae. co. ... 



I ounce 

 40 grains 

 8 ounces 



Take one ounce thrice daily. 



LICHEN TROPICUS. 



See Prickly Heat. 



LUPUS ERYTHEMATOSUS. 



An inflammatory condition with cellular infiltration, terminating in 

 atrophy of the affected skin. It is often symmetrical, and commences 

 by primary spots having a red or pinkish elevated thickened edge and 

 a depressed centre. The redness fades on pressure. 



The face is most commonly attacked in the " butterfly area." 



The disease lasts from ten to twenty years, when it clears up. 



Patients are most frequently women from 25 to 45 years of age. 



Anv slight wound causing a disturbance in the local circulation, 

 such as a mosquito bite, will mark the site and time for its onset. 



To differentiate it from Lupus vulgaris : — 



Lupus erythematosus. 



Begins as small red spots. 

 No ulcrration. 

 Always superficial 

 Develops after puberty. 



Lupus vulgaris. 



Begins as soft apple-jelly nodules. 

 Ulceration frequent. 

 Cartilage may be affected. 

 Develops usually before puberty. 



