Skin problems

Q: I have the following skin disorders. Lichen Planus, Schambers Disease Echymosis and Keloid.
Lichen Planus was first noticed 16 years ago after a single dose of anti rabies injection due to a dog bite. Doctors said that it was not related to the injection. Lesions developed mostly in the feet and some on the hands. Though fresh lesions have not erupted for the last ten years, occasional lesions do appear under stress. The lesions are bad to look at and embarrassing especially when swimming. On two occasions lesions appeared on the genitals also but were treated with steroids. I am not under medications now but they quite often itch. Can I get over these lesion marks. No treatment has helped. How can I prevent lesions from appearing. I am in a senior Government position and the work is stressful. Schambers disease developed over the last ten years. Marks are prevalent on the feet especially around the ankle. They are not problematic. Can I get over these marks?
Echymosis was first noticed nearly 25 years back when the recoil of a gun on the shoulder while firing caused rupture of the capillaries. Today any weight on the shoulder or even an small pressure breaks the capillaries. This is mostly confined to the upper portion of the body. My HB A2 quantification is 4.62. Bleeding time and clotting time are normal. All other haemotological parameters are within normal ranges.
Keloid is prevalent in the family. Dark marks remain when a wound or even a scratch gets healed. The mark remains permanent. Any treatment or solution or prevention.

A:Lichen Planus is a self limiting disorder which leaves behind pigmented scars. Treatment is given only when the disease is active and not for the stains. One has to learn to live with them. Local steroids should be enough for the odd new lesion which erupts now and then. Progressive pigmentary purpura is also a self limiting harmless disorder. In the active phase, application of local steroids and oral Vitamin C helps to minimise the sequelae. If no underlying hematological disorder is found for purpura over the body and if they are not palpable, then you need not worry. Maybe the connective tissue support around the blood vessels is not adequate. Treatment of keloids is unsatisfactory. However, some patients respond very well to local pressure, local application of silicone gel sheets, intralesional steroids, etc.


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