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[Tue Feb 05 09:22:46 PST 2008]
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| chat-admin | Hi, Dr. N! |
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[Tue Feb 05 09:22:53 PST 2008]
[209.21.120.10]
| chat-admin | Can you see my chat? |
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[Tue Feb 05 09:23:09 PST 2008]
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| Dr._Yarom | Hi it seem to work OK |
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[Tue Feb 05 09:23:22 PST 2008]
[209.21.120.10]
| chat-admin | That's great. That's all there is to it. |
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[Tue Feb 05 09:23:28 PST 2008]
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| chat-admin | Do you have any questions? |
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[Tue Feb 05 09:23:34 PST 2008]
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| Dr._Yarom | No |
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[Tue Feb 05 09:23:46 PST 2008]
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| chat-admin | See you in a couple of hours for the session! |
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[Tue Feb 05 09:24:02 PST 2008]
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| Dr._Yarom | Great |
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[Tue Feb 05 09:24:09 PST 2008]
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| chat-admin | Sign on about 15 mintes early. |
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[Tue Feb 05 09:24:16 PST 2008]
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| Dr._Yarom | OK |
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[Tue Feb 05 09:24:23 PST 2008]
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| chat-admin | See you then. |
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[Tue Feb 05 11:52:46 PST 2008]
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| drburkhart | Hi
everyone and welcome to the discussion session. We have a special guest
to day, Dr. Yarom Noam, from Sheba Medical Center. We will begin
shortly. Also, Dr. J. Plemons is with us today from the stomatology
center here at Baylor. |
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[Tue Feb 05 11:54:23 PST 2008]
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| drburkhart | I
would like to thank you all for the nice emails that I get daily from
you. I have been doing a lot of traveling lately and if I have not
gotten back to you, I am sorry. If you do not hear from me within 48
hours please email again. Sometimes emails get lost! |
|
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[Tue Feb 05 11:56:21 PST 2008]
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| drburkhart | If
you need a referral, we will help you find someone in your area of the
world. Dr. Noam treats a lot of patients with lichen and so does Dr.
Plemons so please just hold your individual questions until we ask for
them. |
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[Tue Feb 05 11:57:38 PST 2008]
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| drburkhart | Because
of the time of day, we may have less people on the site so you may have
the opportunity to ask more individual questions. |
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[Tue Feb 05 11:58:22 PST 2008]
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| drburkhart | Art, are we ready or do we need to wait a few min.? |
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[Tue Feb 05 11:59:25 PST 2008]
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| drburkhart | Welcome Dr. Noam-we are happy to hear from and get information. Thanks also to Dr. Plemons. |
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| dryarom | Good evening everyone from Tel-Aviv I'm pleased and honored to join you |
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| drplemons | Hi - glad to join in! |
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[Tue Feb 05 12:00:10 PST 2008]
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| drburkhart | Dr. Noam, would you begin by telling us about your patient population and what you standard treatment involves? |
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[Tue Feb 05 12:00:57 PST 2008]
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| drburkhart | Dr.
Plemons, we have a question from a patient who wants to know if it is
okay to bleach the teeth if you have a mucosal disease? |
|
[Tue Feb 05 12:01:16 PST 2008]
[69.40.36.160]
| drburkhart | Hi everyone and welcome! |
|
[Tue Feb 05 12:02:20 PST 2008]
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| dryarom | We
are running a very busy oral medicine clinic. We are following a few
hundreds of OLP patients. Most patients are treated with topical
steroids. |
|
[Tue Feb 05 12:02:52 PST 2008]
[209.21.121.65]
| drplemons | Bleaching
is often painful when lesions are active. As a result, most patients
should probably avoid these types of products during a flare-up.
However, once the lesions are in remission I think bleaching is
possible with little more irritation than usual. |
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[Tue Feb 05 12:03:14 PST 2008]
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| drburkhart | Dr. Noam, do you classify the types of lichen and what medications are you using? |
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[Tue Feb 05 12:03:27 PST 2008]
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| dryarom | We are also using some other treatment modalities, some are novel |
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[Tue Feb 05 12:03:55 PST 2008]
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| drburkhart | Dr P, do you recommend over the counter or other types? |
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[Tue Feb 05 12:04:51 PST 2008]
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| drburkhart | Dr. P. Have you seen any patients that have had this performed during treatment. I get a lot of emails on this issue. |
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[Tue Feb 05 12:05:07 PST 2008]
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| dryarom | Most are erosive or atrophic OLP seeking for a relief of their symptoms |
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[Tue Feb 05 12:05:09 PST 2008]
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| drplemons | Most
over the counter products cover not only the teeth but some of the gum
tissue. The best bet is custom-made trays from your dental care
professional with a low concentration of bleach. |
|
[Tue Feb 05 12:05:24 PST 2008]
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| drburkhart | Dr. Noam, how often do you biopsy and do you perform immunofluorescence? |
|
[Tue Feb 05 12:06:24 PST 2008]
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| drplemons | Many
patients with lichen planus suffer from chronic irritation and don't
often want to "test the water" by adding a product. However, some
choose to try the various bleaching devices. |
|
[Tue Feb 05 12:06:50 PST 2008]
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| drburkhart | Dr.
Noam, we hear a lot from patients who have tongue lesions, why do you
think that this is true and is it due to some factor not reported?? |
|
[Tue Feb 05 12:07:50 PST 2008]
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| dryarom | We usually establish our clinical diagnosis by a biopsy. we use immunofluorescence for the erosive cases. |
|
[Tue Feb 05 12:08:19 PST 2008]
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| drplemons | Another
thought - bleaching products are caustic and can thin the tissue. Many
patients with lichen planus experience recession secondary to the
disease or even topical steroid therapy itself. |
|
[Tue Feb 05 12:08:21 PST 2008]
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| drburkhart | Dr.
Plemons, I just received an email from a patient who has both introral
and extraoral lesions (severe) as do his co workers. They have said
that it is from working with types of wood in manufacturing. Have you
any thoughts on this? |
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[Tue Feb 05 12:09:05 PST 2008]
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| drburkhart | Dr. Noam, do you see many patients with lip lp and what is recommended? |
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[Tue Feb 05 12:09:20 PST 2008]
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| drplemons | My first thought is possible lichenoid drug reactions from chemicals - any chance of exposure to substances? |
|
[Tue Feb 05 12:10:07 PST 2008]
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| drburkhart | Dr. P, the person could be on-line so I will let him direct that to you when we open it up for questions. |
|
[Tue Feb 05 12:10:07 PST 2008]
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| dryarom | As
far as I know there is no scientific explanation for the predominance
of tongue lesions. In my opinion this could be because of chronic
irritation by the teeth during tongue movements. |
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[Tue Feb 05 12:11:28 PST 2008]
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| drburkhart | Dr. Noam, what do you believe may cause lichen planus? Do you believe it to be a cell-mediated response in most cases? |
|
[Tue Feb 05 12:11:56 PST 2008]
[79.178.65.243]
| dryarom | I'm
occasionally seeing patients with lip OLP. Usually I'm recommending an
ointment which is a combination of steroids, anti fungal and anti
bacterial agents. |
|
[Tue Feb 05 12:12:09 PST 2008]
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| drburkhart | Dr. Plemons, would you comment on the standard treatment at Baylor? |
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[Tue Feb 05 12:12:31 PST 2008]
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| drplemons | Do you worry about thinning of the lip mucosa? |
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[Tue Feb 05 12:13:24 PST 2008]
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| drburkhart | Dr. Noam, Is the lip ointment medications that we have here in the USA? |
|
[Tue Feb 05 12:13:32 PST 2008]
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| drplemons | After
biopsy confirmation, most patients are managed with topical steroids
alone or in combination with systemic steroids. In severe or refractory
cases, other immune-modulating drug are used. |
|
[Tue Feb 05 12:13:53 PST 2008]
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| dryarom | I
believe it is T cell mediated disease and targeting our search for new
treatments for drugs that inhibit T cell proliferation and activity. |
|
[Tue Feb 05 12:14:03 PST 2008]
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| drburkhart | Dr. P thanks for asking-the patients want to know about lip thinning. |
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[Tue Feb 05 12:14:20 PST 2008]
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| dryarom | I'm not sure you have it in the US |
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[Tue Feb 05 12:15:12 PST 2008]
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| drplemons | We tend to use a less potent topical steroid on the lips (desonide) compated to stronger one inside the mouth. |
|
[Tue Feb 05 12:15:13 PST 2008]
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| dryarom | We ask them to use it only when they have symptoms |
|
[Tue Feb 05 12:15:33 PST 2008]
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| drburkhart | Dr.
Noam. with all the chemicals that we are bombarded with today, at least
in the USA, are people just over come with attacks on the immune
system? I personally am going GREEN! |
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[Tue Feb 05 12:15:54 PST 2008]
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| dryarom | we are also using less potent steroids on the lips |
|
[Tue Feb 05 12:17:09 PST 2008]
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| drburkhart | Dr. Noam, how often do you biopsy lesions? Or if initially, when any change occurs? Do you take intraoral slides for comparison? |
|
[Tue Feb 05 12:17:40 PST 2008]
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| drplemons | Dr. Noam - Do you think there are any circumstances in which asymptomatic lichen planus should be treated with medications? |
|
[Tue Feb 05 12:18:00 PST 2008]
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| drburkhart | Dr. Noam, do you believe that stress is a major factor in the development/outbreaks of OLP? |
|
[Tue Feb 05 12:18:28 PST 2008]
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| dryarom | We biopsy everyone on diagnosis and later only if we locate a suspicious lesions |
|
[Tue Feb 05 12:18:55 PST 2008]
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| dryarom | Some
studies show no relation to stress but many of my patients report
worsening or flare up of their LP in periods of high stress or anxiety |
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[Tue Feb 05 12:19:23 PST 2008]
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| drburkhart | How often do either of you believe a patient should be monitored? |
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| dryarom | 2-4 times a year |
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[Tue Feb 05 12:20:55 PST 2008]
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| drplemons | During
active therapy, we usually see patients every 3-4 weeks. Once they are
stable and have been able to control their outbreaks with medications,
we see them on a 3-6 month recall. Everyone knows they can call if they
have a flare-up that doesn't respond to normal treatment. |
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[Tue Feb 05 12:21:55 PST 2008]
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| dryarom | We usually don’t treat asymptomatic patients |
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[Tue Feb 05 12:22:22 PST 2008]
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| drplemons | REcall intervals also vary based on where the lesions are located (ie - the tongue) and how unusual they look. |
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[Tue Feb 05 12:22:22 PST 2008]
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| drburkhart | I
am hearing from patients, more and more, about misdiagnosis. We do know
that sometimes what started out as OLP took a turn in the road. Do you
have any thought on this and what advice do you have for the actual
pracitioners? |
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[Tue Feb 05 12:24:11 PST 2008]
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| drburkhart | Dr.
Noam, Do you see many patients who have a combination of external and
intraoral lesions? We just had Dr. Eisen as aguest last session and he
comments on the vaginal connection. We encourage all women to let their
OBGYN's know about the oral lesions. |
|
[Tue Feb 05 12:25:10 PST 2008]
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| drburkhart | Okay, everyone please ask your questions. |
|
[Tue Feb 05 12:25:13 PST 2008]
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| george_b | Hi
Thanks for this session. I recently was diagnosed with OLP following a
biopsy. About 30 days before diagnosis I had started taking Atacand®
(candesartan cilexetil) a angiotensin receptor blocker (ARB) for
hypertension. I have been known to have allergic reactions to other
meds in the past. Is |
|
[Tue Feb 05 12:26:10 PST 2008]
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| drburkhart | Dr. Noam, please select questions to answer |
|
[Tue Feb 05 12:26:32 PST 2008]
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| suejo | Thanks for this support. Any experience or knowledge of curcumin in treatment of OLP? |
|
[Tue Feb 05 12:26:37 PST 2008]
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| drburkhart | It is okay to ask questions now. |
|
[Tue Feb 05 12:26:44 PST 2008]
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| Missy | Please explain Drburkhart what you meant by misdiagnosis and taking a turn in the road ....to what road? |
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[Tue Feb 05 12:27:09 PST 2008]
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| dryarom | Any new drug may cause a lichenoid reaction |
|
[Tue Feb 05 12:27:18 PST 2008]
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| ev | How does OLP manifest on the tongue and lip? Is it known to spread through all mucosal membranes? |
|
[Tue Feb 05 12:27:58 PST 2008]
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| vic | Will a lichenoid reaction from a drug stop as soon as the drug is stopped? |
|
[Tue Feb 05 12:28:18 PST 2008]
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| drplemons | OLP
can manifest as asymptomatic white lsesions to painful red and
ulcerative lesions. It does not really spread but develops in multiple
sites. |
|
[Tue Feb 05 12:28:41 PST 2008]
[79.178.65.243]
| dryarom | The
clinical appearance of OLP could be various. In some cases what is
appeared to be OLP is diagnosed later as other mucosal disease. In my
opinion a thorough explanation for the patient is the best way to avoid
any controversy |
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[Tue Feb 05 12:29:06 PST 2008]
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| dryarom | it stops after a few days to weeks |
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[Tue Feb 05 12:29:15 PST 2008]
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| drburkhart | Patients
may have developed dysplasia or something that is not the typical OLP.
That is why you should be monitored and this is especially true if
lesions are "ulcer-like" or erosive in nature. |
|
[Tue Feb 05 12:29:37 PST 2008]
[131.104.217.50]
| lichenmon | My
son, aged 14, has OLP. He had lesions in October and has been taking
Oracort. He recently mentioned that his inside check is sore again so
he may be developing another lesion. How close are episodes when
lesions appears. He also has very dry, cracked lips and I'm not sure
this is part of the |
|
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[Tue Feb 05 12:30:22 PST 2008]
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| vic | I had a skin biopsy but not an oral one. I do have my dentist keeping an eye on it. Should I request an oral biopsy?? |
|
[Tue Feb 05 12:30:43 PST 2008]
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| dryarom | Lesions come and go in a matter of weeks |
|
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[Tue Feb 05 12:30:53 PST 2008]
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| drplemons | The
frequency of lesions is variable and flare-ups are often related to the
foods and cleaning products we use as well as stress. |
|
[Tue Feb 05 12:30:59 PST 2008]
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| ev | What is immunofloressence? |
|
[Tue Feb 05 12:31:39 PST 2008]
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| mssl | When you use the word lesions- are these sores on the gum and when they ooze or are open sores are they then called erosive? |
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[Tue Feb 05 12:32:04 PST 2008]
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| drplemons | I
think another biopsy is probably not necessary unless the mouth lesions
are significantly different than the usual clinical appearance. |
|
[Tue Feb 05 12:32:08 PST 2008]
[79.178.65.243]
| dryarom | Immunofluorescent studies can differentiate OLP from other ulcerative conditions of the oral cavity |
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[Tue Feb 05 12:32:28 PST 2008]
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| george_b | If I stop taking Atacand to see if it is an alergic reaction will the OLP go away--how long to tell? |
|
[Tue Feb 05 12:32:45 PST 2008]
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| dryarom | 2-4 weeks |
|
[Tue Feb 05 12:33:11 PST 2008]
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| drburkhart | I
receive emails frequently from patients who keep a diary of anything
that they come in contact with so that they may search for trigger
mechanisms. The stomatology center treats/sees many such patients and
it is not often that easy to find the offender. |
|
[Tue Feb 05 12:33:16 PST 2008]
[209.21.121.65]
| drplemons | We
call sores on the gums desquamative gingivitis - they appear red and
raw. On the other tissues of the mouth, they are often patches of
redness or open sores (ulcers). |
|
[Tue Feb 05 12:33:24 PST 2008]
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| bessel | Since oral corticosteroids did not work, my doctor wishes to start a therapy of hydroxychloroquine. (anti malaria pills). |
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| lichenmon | Is it worthwhile to be tested for allergies? |
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[Tue Feb 05 12:34:50 PST 2008]
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| dryarom | Anti malaria medication may help in some cases. Have you used other systemic treatments? |
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| drburkhart | Patients
are often using dental products, mouthrinses and foods that are
irritating. We recommend discontinuing anything that burns. |
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[Tue Feb 05 12:35:04 PST 2008]
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| lichenmon | My
previous message was truncated so I may repeat myself. My son has small
bumps allover his checks which the dermatologist tells is dry skin.
Could this be related to OLP? |
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[Tue Feb 05 12:35:15 PST 2008]
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| drplemons | Good
question about allergy testing - it has been my experience that lichen
planus lesions correlate well with allergy tesing. I believe being
"kind" to the tissues is important. |
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[Tue Feb 05 12:35:15 PST 2008]
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| alessandracamargo | Do you have any cases of oral lichen planus and hepatitis C, what do you yhink about it |
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[Tue Feb 05 12:35:39 PST 2008]
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| lichenmon | My
son is now using Biotene toothpaste. It is not as minty (although it
has some mint). Is there something else that may be better? |
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[Tue Feb 05 12:35:56 PST 2008]
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| drplemons | Sorry !!! I ment to write that allergy testing and lichen planus lesions DON't correlate well...... |
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[Tue Feb 05 12:36:05 PST 2008]
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| bessel | Yes, I have but without success.. |
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[Tue Feb 05 12:36:11 PST 2008]
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| lichenmon | Is a dermatologist the best health care professional to deal with OLP? |
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[Tue Feb 05 12:36:13 PST 2008]
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[Tue Feb 05 12:36:17 PST 2008]
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| george_b | Are blocked saliva glands related to OLP - both seemed to happen to me within weeks of each other. |
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[Tue Feb 05 12:36:47 PST 2008]
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| drburkhart | Biotene
products are great and used by many patient with mucosal diseases. They
are less flavored and don't have some of the harsh ingredients others
do. |
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[Tue Feb 05 12:37:26 PST 2008]
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| dryarom | The prevalence of HCV if quite low in Israel. We have found that the prevalence of HCV is much higher in our OLP patients. |
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[Tue Feb 05 12:37:34 PST 2008]
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| drplemons | A
dermatologist is great for skin lesions, but I believe an oral health
care providers is best for OLP. Many physicians are not comfortable
dealing with the mouth. |
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[Tue Feb 05 12:38:02 PST 2008]
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| mssl | do you find that some patoents after time just give up any form of medication and live with the red gums and sore jaw area? |
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[Tue Feb 05 12:38:31 PST 2008]
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| ev | HCV? |
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[Tue Feb 05 12:38:43 PST 2008]
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| Norma | Does aloe vera have a useful part to play in OLP |
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[Tue Feb 05 12:38:58 PST 2008]
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| drburkhart | lichenmon,
many patients go to ENT, Dermatologist, Oral Medicine Practitioners,
Basically, I get emails constantly thanking us for being here because
patients have not been given any information about the OLP. Find
someone who does not give you a sentence such as "Learn to Live with
It!" and does no |
|
[Tue Feb 05 12:39:31 PST 2008]
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| dryarom | Some get used to it, but most of them are still seeking for the magic pill that we make the OLP go away |
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[Tue Feb 05 12:39:49 PST 2008]
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| lichenmon | I've
read that orange juice may be problematic for patients with OLP. Should
my son avoid citrus products? What about tomato based products. |
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[Tue Feb 05 12:40:49 PST 2008]
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| drburkhart | Raw,
red lesions in the mouth are like any area on the body that is open,
such as a cut on your hand. Chronic inflammation should be delt with
and kept in a non-ulcerative state. |
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[Tue Feb 05 12:41:16 PST 2008]
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| dryarom | We
are looking all the time for new treatments and I think the development
of new immunobiological agents will help as dealing with OLP in the
future. |
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[Tue Feb 05 12:41:23 PST 2008]
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| Missy | Salty foods are irritating as well lichenmon. |
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[Tue Feb 05 12:41:45 PST 2008]
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| drplemons | Any acidic foods have the potential to burn when OLP is active - also alcohol containing products, etc... |
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[Tue Feb 05 12:42:59 PST 2008]
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| drburkhart | Norma,
there is some information on the Academy of General Dentistry related
to aloe vera. Also, a British Journal just reported on this as well.
Most health food stores and even food markets have the product. If you
email me I will send the link to the journal. |
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[Tue Feb 05 12:43:09 PST 2008]
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| george_b | (Asking again sorry) Are blocked saliva glands related to OLP - both seemed to happen to me within weeks of each other.- george |
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[Tue Feb 05 12:43:14 PST 2008]
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| mssl | yes
but if the creams take away precious cells from the gums and leave them
raw is it not perhaps better to leave well enough alone. After many
attempts at helping my mouth settle, I have given up and for the last 3
years have basically left it alone and I do not notice much difference-
it still mov |
|
[Tue Feb 05 12:43:51 PST 2008]
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| drburkhart | George, what did your healthcare provider tell you about the salivary ducts? |
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[Tue Feb 05 12:44:29 PST 2008]
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| drplemons | I
am not aware of the correlation between OLP and blocked salivary ducts.
If the lesions are located around the duct, I guess swelling and
inflammation can cause a problem. |
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[Tue Feb 05 12:44:34 PST 2008]
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| drburkhart | mssl: Is anyone evaluating your mouth? How often are you seen? |
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[Tue Feb 05 12:44:41 PST 2008]
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| george_b | DRB - he said not related doesn't know why it is happening but he frankly is like the one you described - just tough it out etc |
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[Tue Feb 05 12:45:02 PST 2008]
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| george_b | They ARE near the OLP |
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[Tue Feb 05 12:45:51 PST 2008]
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| drburkhart | Dr. Noam, how many people work in your facility treating mucosal disease? What research are you working on related to OLP? |
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[Tue Feb 05 12:45:53 PST 2008]
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| Norma | Dr B I sent the abstract to you - I was wondering if you or Dr Noam had any personal experience of its value or otherwise? |
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[Tue Feb 05 12:46:20 PST 2008]
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| dryarom |
Our main research topics in OLP are: novel treatments for OLP and early
diagnosis of malignant transformations using genetics methods. |
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[Tue Feb 05 12:46:37 PST 2008]
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| drburkhart | How many of you have family members with some type of OLP or skin lesions? |
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[Tue Feb 05 12:47:01 PST 2008]
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| vic | No family members with LP. |
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[Tue Feb 05 12:47:05 PST 2008]
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| george_b | I am the only one with OLP in my very large family. |
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[Tue Feb 05 12:47:09 PST 2008]
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| Missy | No history of anyone in family having anything...nor have I ever heard of OLP until I got it. |
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[Tue Feb 05 12:47:23 PST 2008]
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| fredly | none in my family, yet |
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[Tue Feb 05 12:47:33 PST 2008]
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| mssl | No one I have ever met has this disease |
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[Tue Feb 05 12:47:41 PST 2008]
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| bessel | A Dutch dermatologist tried a treatment with tacrolimus cream..Are you familiar with this? |
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[Tue Feb 05 12:47:55 PST 2008]
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| dryarom | I'm following 3-4 families with few members with OLP |
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[Tue Feb 05 12:47:56 PST 2008]
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| drburkhart | Dr. Noam, the screen is scrolling, so I may be redundant, but what are you finding with regard to novel treatments? |
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[Tue Feb 05 12:48:14 PST 2008]
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| george_b | Interestingly enough my daughter who is a dental hygeniest first discovered mine--how's that for irony? |
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[Tue Feb 05 12:48:31 PST 2008]
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| drplemons | Tacrolimus and pemicrolimus have both been used with success in OLP patients. |
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[Tue Feb 05 12:48:50 PST 2008]
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| Missy | I
would have through I would have run into someone at the doctors office
I go to with OLP...in 10 years I never have run into another patient
although he claims he has a few. |
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[Tue Feb 05 12:48:56 PST 2008]
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| dryarom | mostly phototherapy and immunobiological agents |
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[Tue Feb 05 12:49:00 PST 2008]
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| ev | I
had great success with acupuncture and herbs for cheek lesions.
However, after not going for treatments for 6 weeks, I got tongue
lesions: last night's treatment did not help it. Any research on this? |
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[Tue Feb 05 12:49:02 PST 2008]
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| drburkhart | mssl, most patient do feel alone and that is why we are here-anytime of the day. |
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[Tue Feb 05 12:49:30 PST 2008]
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| vic | My dentist said he sees OLP from time to time. I have not met another person with it. |
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[Tue Feb 05 12:49:35 PST 2008]
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| dryarom | Targeted
phototherapy - the use of ultraviolet light is a known treatment
modality in LP. We are now treating our symptomatic patients with a new
devise that can deliver the light into the oral cavity by a special
optic fiber. Most of the patients are very satisfied with the results. |
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[Tue Feb 05 12:49:45 PST 2008]
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| drburkhart | george, I am proud of your daughter! |
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[Tue Feb 05 12:50:00 PST 2008]
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| george_b | lol thanks! |
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[Tue Feb 05 12:50:29 PST 2008]
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| dryarom | Immuno-biological
agents are drugs that are use for targeting a specific molecule or a
protein that have a pivot role in the pathogenesis of some diseases.
There are some anecdotal reports of using these drugs in OLP. We have
used "Enbrel" in one of our patient with a recalcitrant disease with
great |
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[Tue Feb 05 12:50:29 PST 2008]
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| george_b | How can I find a good LP Doc in Philadelphia? |
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[Tue Feb 05 12:50:56 PST 2008]
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| Missy | The Mystery Disease...maybe we should submit this to that TV show to get some publicity and some research going. |
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[Tue Feb 05 12:51:17 PST 2008]
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| dryarom | Try the american academy of oral medicine website |
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[Tue Feb 05 12:52:04 PST 2008]
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| bessel | Dr. Burkhart, did you receive my question concerning the possible help of a cream called Tacrolums? Bessel |
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[Tue Feb 05 12:52:14 PST 2008]
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| ev | Dr. Yarom, is such a light device available for home use? Could you recommend? I purchased an LED device, haven't used it. |
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[Tue Feb 05 12:52:17 PST 2008]
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| drburkhart | To
everyone, it is amazing what we use everyday with regard to our
environment. I have started to carefully weigh all the chemicals in my
world and if you really do not need it, don't us it. I even discovered
the lipstick I used for years has lead in it! Start paying attention.
If you can afford org |
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[Tue Feb 05 12:52:28 PST 2008]
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| trapper | What parts of the body does olp ocurr |
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[Tue Feb 05 12:52:57 PST 2008]
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| ragamfn | what wavelength UV light are you using? |
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[Tue Feb 05 12:53:07 PST 2008]
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| drburkhart | George, I can help you with a referral-email me. |
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[Tue Feb 05 12:53:28 PST 2008]
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| ev | Dr. B, what lipstick is this to avoid? |
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[Tue Feb 05 12:53:36 PST 2008]
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| george_b | OK thx this was of great encouragement to me. TY |
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[Tue Feb 05 12:53:45 PST 2008]
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| dryarom | the device is very expansive you can address your dermatologist for the nearest phototherapy institue |
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[Tue Feb 05 12:53:48 PST 2008]
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| drplemons | Lichen planus can basically affect any surface covering from the skin to the mucous membranes. |
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[Tue Feb 05 12:53:50 PST 2008]
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| drburkhart | trapper, lichen can be in any lining mucosa such as the throat, vaginal, etc. |
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[Tue Feb 05 12:53:58 PST 2008]
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| dryarom | We are using UVB |
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[Tue Feb 05 12:54:02 PST 2008]
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| vic | Thanks everyone - this was very helpful. I wish you all the best!! |
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[Tue Feb 05 12:54:10 PST 2008]
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| ragamfn | thaNKS |
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[Tue Feb 05 12:55:07 PST 2008]
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| drburkhart | How
times gets away! Before we get cut off, I want to thank Dr. Noam and
Dr. Plemons for the information that was given. If you have any
follow-up questions, email me. |
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[Tue Feb 05 12:55:11 PST 2008]
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| ev | Thank you all for sharing your information and giving us your time! |
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[Tue Feb 05 12:55:46 PST 2008]
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| dryarom | Its been a pleasure |
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[Tue Feb 05 12:56:19 PST 2008]
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| drburkhart | I
just published an article on "The many faces of oral lichen planus" for
P&G and hope that many people in practice read the article because
there is great information in the CE course. |
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| mssl | this
fall I was in florida for 6 weeks- not tanning particularily but when I
returned home I experienced real ichy skin especially and night and in
the morning- I needed to take Benedryl and creams to quiet it down. Is
this related to Lichen PlaNUS? |
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[Tue Feb 05 12:56:59 PST 2008]
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| Missy | How to find your article Dr. B? |
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[Tue Feb 05 12:57:10 PST 2008]
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| drburkhart | Thank you all for participating-this is the most calm session we have had - I think we were able to share a lot of information. |
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[Tue Feb 05 12:57:34 PST 2008]
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| drplemons | Thanks and have a good day! |
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[Tue Feb 05 12:57:40 PST 2008]
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| drburkhart | I think that you can go to the P G site, but email me and I can help you. |
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[Tue Feb 05 12:58:15 PST 2008]
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| mssl | THANKS YOU FOR THIS VERY VALUABLE SERVICE |
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[Tue Feb 05 12:58:36 PST 2008]
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| drburkhart | mssl-I grew up in a beach town and it sounds like sun exposure to me with the small red bumps. |
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[Tue Feb 05 12:58:48 PST 2008]
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| maryc | the new format was much easier to follow, less cross chat - thanks |
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[Tue Feb 05 12:58:58 PST 2008]
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| ev | Dr. Yarom, Todah Rabah!(Thank you) |
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[Tue Feb 05 12:59:06 PST 2008]
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| mssl | NO NO INDICATION OF SUN HERE |
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[Tue Feb 05 12:59:34 PST 2008]
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| drburkhart | Dr. Noam, thanks so much! |
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[Tue Feb 05 12:59:35 PST 2008]
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| dryarom | Ein Bead Ma (you wellcome |
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[Tue Feb 05 13:00:57 PST 2008]
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| Missy | Doctors,thanks for your time and interest in this disease |
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