Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Usually, lichen planus is relatively straightforward to diagnose. Physicians can make the diagnosis in typical cases simply by looking at the rash. If necessary, a skin biopsy may be done to help confirm the diagnosis because, under the microscope, lichen planus is distinctive in appearance.
Because there are a number of other lichenoid eruptions that to resemble lichen planus a biopsy confirmation is frequently necessary. Persistent oral or vaginal lichen planus, with spots that thicken and grow together, can sometimes be difficult to distinguish clinically from whitish precancerous plaques called leukoplakia. A biopsy can be helpful in this situation. There seems to be a few patients in whom ulcerative lichen planus
precedes the development of oral cancer.
What is the treatment for lichen planus?
Most cases of lichen planus are relatively mild. Affected
individuals who do not have symptoms do not need
treatment. Ultimately, there is no agreed upon cure for this condition.
If the itch or appearance of the rash are unpleasant, topical
corticosteroid creams may be of help. Topical steroid creams that,
for example, are under wrapping or taped at bedtime may also be
useful when possible. For localized, itchy, thick lesions, injections of
corticosteroids may be given. Antihistamines may blunt the itch,
particularly if it is only moderate. This effect is in part due to
the sedative effect of antihistamines.
In more severe cases, physicians may recommend oral medications or
therapy with ultraviolet light. Oral medications may include
a course of oral corticosteroids such as prednisone or metronidazole
(Flagyl). Occasionally, other immunosuppressive agents may be employed. However, the
itching may return after the drug has been discontinued. A low-dose
oral corticosteroid every other morning may be also prescribed. With
continued itching, ultraviolet light (PUVA) treatment may help. For
painful lesions within the mouth, the use of special mouthwashes
containing a painkiller (such as lidocaine) before meals may provide
some relief. Any drug or chemical suspected of being the cause of the lichen planus should be discontinued.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
There are a variety of diseases and conditions that can cause tongue problems, discoloration, and soreness. Though most tongue problems are not serious. Conditions such as leukoplakia, oral thrush, and oral lichen planus may cause a white tongue while Kawasaki syndrome, scarlet fever, and geographic tongue may cause the tongue to appear red. A black hairy tongue may be caused by overgrown papillae on the tongue. Canker sores, smoking, and trauma may cause soreness of the tongue.
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