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| aupton | Hi, Nancy! I will welcome each new person into the session. Save your Greetings until just after the hour begins. Good to see you onscreen!! |
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| aupton | Hi, Ollie the doctors will be with us in a moment. Hold your questions until then. |
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| Ollie | Thanks....I'm pretty much a lurker today..no burning issues. |
| aupton | Welcome, Dr Mc! We'll start in a moment |
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| aupton | Welcome Dr Lynch and Dr Rees and Tom. Dr Burkhart? Whenever you are ready ... |
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| Tom | Hi. This is Tom. Should I ask a question? |
| aupton | Go ahead, Tom |
| DrBMcCartan | I'm ready when you are |
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| Tom | This is my first time online, although I have emailed both Dr. Burkhart and Dr. Rees in the past. My wife, Patricia, has had oral lichen planus since last July, and just recently developed reddish, elliptical spots on her body, which her dermatologist says is lichen planus also. He prescribed kenalog in orabase cream for her mouth, and we thought he said she could use it on her body spots too. He’s out of the country for two weeks, so we can’t ask him now, and I’m won |
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| drburkhart | Hello everyone, happy you could join us. Our guest is Dr. McCartan. Thank you for being here today. |
| DrRees | Type HE |
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| DrBMcCartan | Tom, it's un;likely that a dermatologist would use this preparation on skin. Perhaps his secretary might now if he ordinarily prescribes it. |
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| aupton | Welcome, new signins ask your questions and the doctors will get to them as soon as they can |
| drburkhart | Hello Marta, welcome. Do you have a questions for us? |
| Tom | I talked with the nurse and she wasn't sure. What would you recommend for the body spots? |
| marta | Hello everybody. I would like to watch first, thanks. |
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| drburkhart | Marta, that is fine. |
| aupton | Marta, you are most welcome. |
| DrRees | Type Here Tom, good morning. As you know from our previous discussions we do not always find kenalog in orabase to be potent enough to control oral lesions. You might want to discuss alternatives with your dermatologist when you get a chance. Terry |
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| DrLynch | Tom, try Lidex creme for the skin lesions. Also, Kenalog in Orabase usually is too weak for most symptomatic oral lesions. Try Lidex gel, massaged int othe lesions. |
| DrBMcCartan | I'm afraid I wouldn't presume to practise dermatology. Do you have a family physician who could help? In any case, not much harm is likely to happen if she doesn't treat the skin rash. |
| drburkhart | Hello Dr. Lynch, Leila and Che. Thanks for joining in. |
| sbuboltz | Hello - I'm new to this group, so I thought I'd better be on time! I am wondering if others have suffered with OLP for YEARS!! |
| Tom | OK, thanks. |
| aupton | Welcome to all those just signing i Tthe doctors will get to your questions as soon as they can |
| Ollie | Tom, FWIW, my dermatologist has me using Protopic for both the oral lesions and skin spots. It's also good for any atopic dermatitis. You might ask him about this. It's been somewhat successful for me. |
| Tom | Thanks, Ollie... I will |
| DrBMcCartan | There is a school of thought with which I agree that says that oral LP lasts for ever in many patients. |
| Che | Type HERHello I am also new to the group so I will watch for a while |
| DrRees | sbuboltz, yes lichen planus can linger for years. Maybe we can offer you some suggestions if you tell us more about your situation. It it is too long, contact Dr. Burkhart with the info. |
| aupton | Guests, please do not cross talk, but address your comments directly to the doctors. There will be time for exchange of addresses at the end. Thnkks! |
| sbuboltz | Hello? |
| Ollie | For me, its been around for 3 yrs....Last "chat" there was a participant with 23 years. |
| aupton | sbuboltz, you are most welcome to ask your questions of the doctors |
| twiz | Type HEREcan you give advice on keeping teeth clean.Have tried the softest toothbrush but still too painful.I am developing pocketing of teeth. Have found a toothpaste "Kingfisher" as Biotene n/a here in Britain. |
| Leila | Hi! Can you tell me what the different types of OLP are? And are these distinct kinds or different stages? |
| Tom | Patricia has about 8 of the reddish spots on her body now and she’s wondering how bad this could get. Will her body end up covered with them? Will she get them on her face? Right now they’re only on her lower back, stomach and upper thighs. |
| drburkhart | sbuboltz, from the research and from our participants, some people have LP for many years and some people have lesions for only a short time. Often they appear at times of stress or lifestyle changes. |
| Che | twiz-could you please give me more info on Kingfisher toothpaste ie who makes it? etc |
| Ollie | Dr.'s: is there any wexperience with chocolate as an OLP trigger? |
| DrRees | twiz- I don't know what Kingfisher is. Check the contents when you get a chance and let us know. |
| DrLynch | Tom, the skin lesions usually don't affect the face. |
| DrBMcCartan | twiz, Kingfisher is meant to be allergen and irritant free but I never trust manufacturer's statements |
| aupton | Che, no cross talking please. |
| sbuboltz | Am I alone here? |
| aupton | sbuboltz, did you get this from aupton? |
| DrRees | Ollie, chocolate is notorious for being associated with canker sores but not OLP |
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| Che | I can second the trigger of chocolate! |
| drburkhart | twiz, we do know that regular professional cleanings help with lichen planus. Some individuals see their dentist/hygienist every two to three months. Please read our info on the site regarding products and cleanings. |
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| PhilnNY | Good morning. |
| DrBMcCartan | Che, it's difficult to tell if certain substances are triggers or if they just make you notice a new lesions by being irritant to broken mouth lining. |
| aupton | Welcome, PhilinNU |
| drburkhart | Hello Phil, Thank you for joining us. Do you have a question or comment. |
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| PhilnNY | Not yet thanks, I prefer to watch first. |
| Tom | Drs. Patricia is very worried about her lichen planus turning into cancer. What are the chances of that? |
| Che | Dr Rees- what is the difference between canker sores and OLP? |
| drburkhart | Phil, yes that is fine. |
| DrRees | twiz, there is at least one study that shows that good oral hygiene is important in controlling OLP. A soft brush, a bland toothpaste and a non-alcohol containing mouthrinse may help. |
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| PhilnNY | I use children's. (toothpaste) |
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| twiz | Hello, Kingfisher is made in UK ,it is only one I've found without mint - www.kingfishetoothpaste.com |
| DrBMcCartan | Tom, there is a very small cancer risk associtaed with oral LP especially if there are persistent raw areas in the mouth. Skin LP is now known not to develop into cancer. |
| aupton | Welcome, Mori |
| drburkhart | Twiz, there is a link on our site that goes into the Biotene products departments. At the stomatology center, we recommend Biotene toothpaste. |
| DrRees | Che-Canker sores are those occasional mouth ulcers that occur in about 20% of the population. They last a few days then disappear even without ttreatment although treatment will help. |
| DrLynch | Phil, there is continued debate about the relationship of LP to ora l cancer. The strongest relationship seems to be with the erosive variant, but teh risk (if it exists) is still small (1-2% at most).. Tobacco use isa MUCHbigger risk factor. |
| drburkhart | Hello Moni. |
| DrBMcCartan | Tom, the cancer risk per year is probably less than 1 in 1000. |
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| drburkhart | Suzi, hello. Welcome. Do you have a question or comment? |
| Che | drburkhart- is OLP familial |
| Moni | Type HEREDr Burkhart thanks for the Support group Letter,keep us up to date on research |
| Leila | I use Biotene toothpaste and I am getting extra cleanings from my periodontist - who is monitoring my OLP - I use "magic mouthwash" when I get bleeding . Should I use another nonprescription mouthwash like the one from Biotene as part of my regular routine? |
| DrLynch | Leila, what is "magic mouthwash"? |
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| drburkhart | Che, interesting question. We are in the process of tabulating our data on the site survey. We ask this question and the results will be interesting. There have been several publications with this suggestion. We have had a few families that have contacted us and their reports may suggest this. However, it is not contagious, we know. |
| twiz | Thankyou Dr B but biotene n/a - though I have had a sample pack thro their website. Have also discovered that cardomom seeds irritate - any minty |
| DrRees | Leila, there are many formulas for so called "magic mouthwash" so I don't know how effective the one you are using really is. This is just an opinion but we haven't found the Biotene mouthrinse to be very effective although the other products are |
| Suzi | Sorry - I am not seeing any discussion on the screen. I will try this another time |
| DrBMcCartan | Che, if about 1-2% of the population have oral LP then you are goin to have families where several members will have it by chance. |
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| Leila | It's a prescription mix, a corticosteroid (?), benedryl, a numbing agent and tastes like cherry cough syrup. Not sure if it's Dr. Braswell's mix or something broadly used |
| drburkhart | Moni, thank you. We intend to introduce a page with abstracts and articles soon. These will be updated with current research. |
| PhilnNY | Drs. A Q' (long one, so bear with me please)... |
| PhilnNY | After @ 36 years of relatively good health, I can’t help but see a coincidence... |
| PhilnNY | ... between the onset of the disease for me... |
| DrRees | Leila- That mixture may help sooth your mouth and might even help the OLP but it won't help control bacterial plaqure on your teeth. |
| PhilnNY | ... and the extensive dental work that preceded it over the previous few years. |
| DrLynch | Leila, that's what I thought. I like Biotene products and if you like to use them, keep doing so. If it's not working for you, try some other alcohol-free ones. |
| PhilnNY | Any thoughts on this? |
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| DrRees | PhilnNY- We sometimes see patients who have a lichenoid reaction to dental products. If you can find an allergist or dermatologist who is willing to test you we can provide info on the tests we use for dental materials. |
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| Leila | I think my first question got lost -- I understand there are 6 types of OLP, can you list what they are? And are they distinct types or stages of OLP? |
| DrLynch | Phil, lichen planus doesn't cause dental diseae, but ifit keeps you from keeping up good oral hygiene, you're more likely to develop cavities and gum disease. |
| drburkhart | Phil, Dr. Rees may have some other comments. We have a dermatologist on staff at the stomatology center and testing for allergic reactions are conducted to see if the patient may have a reaction to a metal or dental product. Sometimes lichenoid reactions occur. This is not true LP. |
| DrBMcCartan | PhilnNY, the first thing to say is the LP is more likely as you get older so it may be coincidence. However, if your oral lesiona are in areas where new dental work has been placed and not elsewhere, it may be useful to be PROPERLY tested for allergies to dental metals and plastics. |
| PhilnNY | Thank you. How do I get that from you? |
| Leila | Plaque control -- yes , should I use an everyday mouthwash for plaque control? |
| Moni | Dr. McCartan I've been on lagunil for 7 months, am really doing well, are there any problems with eyesight damage by taking this for a long time. like years ? |
| PhilnNY | Yes, this is the case... initially and only in the area of most recent work. |
| drburkhart | Phil, we have some excellent people in NY that we can recommend. |
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| drburkhart | Hello Mara. |
| DrRees | Leila- reticular (lace-like) plaque-like, atrophic, vesicular, ulcerative and papular. |
| PhilnNY | Thank you.. Please do. I may even know some of them. |
| DrLynch | Leila, non-prescription mouthwashes won't do much for plaque control. You have to mechanically remove it with a toothbrush and floss. |
| DrBMcCartan | PhilnNY, your oral pathologist/oral physician should be able to refer you for patch testing. Beware of alternative allergy testing - it is unlikely to answer the question. |
| mara | I'm new! What are we discussing? |
| twiz | I have found Metosyn Ointment and orabase equal parts to be most effective for me, I was prescribed from Wales Dental Hospital, Does Corsody |
| drburkhart | Phil, yes, but could you contact me after the session. Two of our previous guest are right there in the city. |
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| mara | What is the topic? |
| PhilnNY | Thanks Dr. B' |
| drburkhart | Mara, how long have you had LP? What type? |
| aupton | Mara, we cannot recap. Just watch the screen and join as you can. |
| PhilnNY | Another comment/question... |
| PhilnNY | I also suspected that the relatively large amount... |
| Leila | Do people with OLP tend to have other autoimmune diseases or conditions? |
| PhilnNY | ... of man made items in my mouth after all the aforementioned dental work... |
| PhilnNY | ... have possibly caused a rejection by my body along the lines of graft/host. Is this likely? |
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| drburkhart | Phil, Dr. McCartan may want to answer this part. |
| Tom | Another thing we have noticed is that Patricia's face and neck area become flushed when she eats certain foods. She never had that before the lichen planus. Is that a normal symptom? |
| DrRees | PhilnNy- not to our knowledge but OLP in a sense may represent an autoimmune disorder in which the body tries to reject part of itself, in this case the bottom cells of the epithelium |
| Ollie | for twiz: You might want to try drugstore.com as a source for Biotene products. |
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| drburkhart | Ollie, we have a link on line and I believe that there is a number and address. Go to our links page-good information. |
| DrRees | Tom, I have not had patients make that observation but it may be important so have her develop a list of foods that cause that reaction and we can talk about it. |
| PhilnNY | Thanks, Drs. |
| Tom | Thanks, Dr, Rees. We'll do that. |
| DrBMcCartan | Leila and PhilnNY, In a condition called graft versus host disease there is a rash like lichen planus but its immunological picture is a little different. It might be best to think in terms of allergy rather than autoimmunity. |
| drburkhart | Phil, we get emails from patients frequently about certain foods and reactions. Again, we hope to sort through all of this on our survey. For anyone who has not completed the survey, please do. |
| DrRees | Dr McCartan- How do you feel about the research you have conducted attempting to differentiate between routine lichen planus and a lichenoid drug reaction? |
| Che | Dr McCartan- I have been taking at intervals Immudon which does alleviate symptoms and give a remission. What are thoughts on this? |
| DrBMcCartan | Thsi si a difficult subject. The only way to differentiate truely is to withdraw the drug AN |
| DrBMcCartan | aND WAIT FOR RESOLUTION, THAT CAN TAKE UP TO A YEAR |
| DrBMcCartan | and then rechallenge and look for a reaction that can take several months and then ... withdraw again |
| Che | Dr McCartan I have also heard that drugs such as Ibobrufen can trigger the disease, is this true? |
| DrRees | Che I am curious since immudon is not a product we use here in the US. Do you know what it is? |
| DrBMcCartan | The test that Philip Lamey and I reported is not very specific but I have a graduate student trying to make sense of it so, if you can wait three years!! |
| Che | Dr Rees-it is an immusuppressant |
| Tom | Drs... Another question: Patricia's oral LP seems to vary in intensity, subsiding to a level where she barely notices it and then flaring up to become really irritrating. Are these swings normal... do they depend on anything? Maybe what she eats? stress? |
| drburkhart | Dr. McCartan, for any patients or clinical practitioners who may read the transcipts, there are certain features that would suggest a lichenoid reaction? |
| PhilnNY | I've noticed these swings as well, Tom. |
| Leila | I am very interested in information about allergic links to OLP as I was successfully treated at UVA for allergy related eczema about 10 years ago. If you have any references to work on allergy ties I would love some references. |
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| DrBMcCartan | Che, there is a very large list of drugs that cause skin LP and a shorter list that cause oral LP. It includes a lot of heart drugs, drugs used in diabetes and drugs used in rheumatism (by the way, apologies for the awful typing) |
| drburkhart | Tom, Is she able to link the episodes to any stress connection? |
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| DrRees | Tom, there do seem to be unexplained swings in severity and they may relate contact with an allergen to include food. Dr. Burkhart has done work and found a probable association with stressful events. |
| DrLynch | Tom, patricia sounds very "typical" in her "ups and downs". When she does well, she may require no treatment at all. When she is isn't doing well, she needs to be treated aggressivley. |
| Tom | Actually she is having a rough time now, and her mother is very ill and I know she is worried about her.one |
| DrBMcCartan | Leila, I should say that patients don't seem to be allergic to these drugs in the normal sense, so they can keep on taking them without risk of a severe allergic reaction. |
| Che | Dr McCartan-anumber of years ago I sustained aback injury and took Ibubrofen for a number of years as an antiimflammatory. Could thius have been a trigger? |
| Ollie | Can lichenoid reactions be erosive? |
| PhilnNY | I've found a more definite relation to diet, than stress, in my own case... |
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| DrBMcCartan | Ollie, if you have been off it for more than one year and the LP is still there, then it is probaly very unlikely |
| PhilnNY | I even noticed that while a certain medicine may work one day, it doesn't at another time. |
| PhilnNY | I sometimes rotate among several for relief. |
| drburkhart | Tom, read our new material on lifestyle changes. We have some good information and we will continue to add new material. In most cases, I believe that it is not the stress so much but the individual reactions to the stress. |
| DrRees | Leila, Things disappear off the screen so fast that sometimes questions get lost. You asked about allergies. Yes there are some drug allergies that produce a lichenoid reaction and we have found some food substances which may as well. Contact Dr. Burkhart and we can talk about it more although there is considerable material regarding this on the website |
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| DrBMcCartan | Ollie, lichenoid reactions are more likely to be erosive than 'true' LP. They also tend to affect one side of the mouth only, unlike 'true' LP |
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| LeilaP | I didn't mean to address a drug connection --I am Leila (got booted off!) I mean non- dru grelated allergies. My eczema for example was a reation to a fungal infection |
| PhilnNY | Dr. BM, is there a difference between OLP and lichenoid reactions? |
| DrBMcCartan | My reseacrh on stres showed that not only were the patients stressed but they weremore likely to be of a personality type with high stress potential. |
| DrRees | PhilnNY-That is curious, it might be important to know what medicines you are using. Sometimes improvement is spontaneous and has little to do with the meds used. |
| PhilnNY | I agree, Dr Rees. This has been my experience. |
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| LeilaP | are the types of OLP different stages? |
| Ollie | DrMc: Can there be lichenoid reactions overlaying true LP, or at that point are they indistinguishable? |
| DrRees | Leila-As far as we know infections of any kind are not related to OLP |
| drburkhart | Dr. McCartan, yes, this has been my observation also. Therefore, it is very important to help the individual identfy ways of coping with stress and lifestyle changes. |
| DrBMcCartan | PhilnNY, I'm afraid I'm going to give you the old politician's chestnut "It depends what you mean by lichenoid". Some pathologists never report lihenoid only lichen planus. Our pathologist, Dr Mary Toner, often reports lesions as "more suggestive of lichenoid drug erution than true LP" |
| DrRees | Leila- Quite often that is the case. The lesions may start off very mild and then weeks, months or years later become one of the more severe forms. By the same token, some studies suggest that it can change back and forth from one type to another, |
| PhilnNY | I only ask Dr. because I never saw that term "lichenoid reactions" before today. |
| Moni | Type HEREDr Mc Cartan any amswer on Plaquenil about eye damage |
| PhilnNY | I have been diagnosed with a biopsy. |
| DrLynch | Dr. McC raises an important point. The microscopic diagnosis of LP can be very difficult at times, even for experienced pathologists. |
| drburkhart | Dr. Lynch or Dr. McCartan, could you give us some usual indications that the pathologists may be dealing with lichenoid (such as plasma cells, colloid bodies, etc.) |
| Che | Dr Rees/McCartan-please come back to me re my questions on Immudon(immunosuppressant) and Ibobrufen |
| DrBMcCartan | PhilnNY, we try hre to distinguish between lichen planus, lichenoid eruptions and lupus erythematosus (a similar skin disease) by sending biopsy material to both pathologists and immunologists and blood to immunologists. Our final diagnosis is often a consensus of experts. ... and we could all be wrong |
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| LeilaP | Yes , not infections but allergies. Perhaps this isn't a good example but I had eczema on my hands because of an allergic reaction to a fungus in my foot. Could OLP be an allergic reaction to something else? One of the previous chats suggest OLP as an allergic reaction (that's why I am being so persistant!) |
| DrRees | Che- I don't know about immudon but ibuprofen is in the family of drugs which has been identified as the most freauent cause of a lichenoid drug reaction. |
| PhilnNY | Hmmm. Interesting, Dr. |
| twiz | To Doctors - Re Ibuprofen/NSAIDs (Diclofenac Retard) i cannot manage without these are there alternatives or any definite research to link these drugs and flare ups - it can be so tricky to make connectioins because of OLP's up and down narure.I don't want to suffer with my joints as well as OLP. |
| Che | Thanks Dr Rees, I havenot taken any for almost a year now and will not take them again! |
| DrBMcCartan | Che, a problem that I have is that you guys are using US trade names fror drugs and I often don't know what they would be in Europe |
| PhilnNY | Is it safe to say that I may only have lichenoid reactions as in my case it's only on one side of the mouth? |
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| DrBMcCartan | PhilnNY, I would need a positive drug history plus at least three different positive lab tests before I would say that |
| DrLynch | DrB, DrMcC is right on target wit hthe need to occasionally get tissue and serum findings and then still get a "Supreme Court decision". It is important to get as much clinical indformation as you can, as this often tips the scales |
| Che | Dr McCartan- actually I live an France and the drug is available in most European countries as far as I know |
| Tom | Keep getting knocked off! I would still like to know how Patricia's OLP was triggered. She is 56 and never had it before. She had a peridontal procedure done last July in which citric acid and tetracyclene were used. She immediately got the oral lesions on both sides of her mouth and still has them. How can this happen? |
| DrRees | twiz-You are right but perhaps the newer so-called Cox-2 inhibitor NSAIDS can be used. That decision should be made by your physician however. |
| DrLynch | Tom , I doubt that Patricia's OLP had any causal relationship with her periodontal surgery. |
| PhilnNY | Thanks Dr. BMc' |
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| DrBMcCartan | Tom, neither citric acid nor tetracyclines are regards as lichenoid triggers. Your wife is right in the middle of the susceptible age group and it's probably pure coincidence |
| aupton | 15 MINUTES TO GO, FOLKS - Reminder: The Transcript for this session should be on the website by tommorrow. |
| Tom | That's interesting. She had the lesions withiun a day or two of her procedure. What does usually trigger the first appearance of LP? |
| DrRees | Can it be that all have run out of questions? |
| drburkhart | Dr. McCartan, could you tell us a little about the usual proceedures for treatment in your hospital clinics for LP. Do you recall the patients for additional biopsies at certain intervals? |
| Che | Dr McCartan-Imudon is made by SOLVAY PHARMA in France |
| PhilnNY | Dr. BMC', are you saying (To Tom) that citric acid, etc, aren't a cause of OLP? |
| DrBMcCartan | PhilnNY, yes, as far as we can tell |
| PhilnNY | They are at least something that inflames mine. Or so it seems. |
| DrRees | Tom, as you and I have discussed preveiously there is a possibility the the lesions on her tongue are not OLP. Remember that citric acid can burn and burns will sometimes persist for some time. |
| twiz | Dr Rees- I have been prescibed these but am wary, I take it that Cox-2 have a different chemical do-dah.I there reaearch on NSAIDS I could look up. I beleive that NSAISs affect the stomach because they affaect the mucosa - is that right? |
| PhilnNY | I avoid them at all costs. |
| DrLynch | Phil, citric acid may irritate an existing OLP lesion, but not cause it. |
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| LeilaP | My OLP is definitely cyclical, but disen't seem to be triggered by any specific foods |
| PhilnNY | I see, thanks Dr L'. |
| Tom | Dr. Rees. Is it possible that the body spots are not LP either? |
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| DrRees | twiz, they can irritate the stomach lining sometimes but that does not appear to be why they cause a lichenoid reaction. For example aspirin will iritate the stomach mucosa but is not known to cause lichenoid reactions |
| PhilnNY | Really, Leila? I associate many foods with causing trouble for my OLP. |
| drburkhart | Phil, we hear from many patients that they can not eat oranges, apples and certain other fruits. Some flavoring agents such as cinnamon and wintergreen cause problems also. |
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| PhilnNY | Yes, definitely for me, Dr. B'. |
| DrBMcCartan | Che, Imudon is not in the standrad drugs lists available to me (I've just checked). It may be azothiaprine which we call Immuran. It's not known to cause LP |
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| DrLynch | Leila, I have had some female patients who have some ups and downs with their OLP that seems to be related to their menstrual cycle. I have no idea whether it's the hormones or the "stress". DrMcC or Dr. R, have you noticed this? |
| aupton | Welcome Mac, the docotrs will be with you in a moment |
| Che | Dr Burkhart/Phil as an example I have just eaten an Xmas mince pie and I now have blisters on the roof of my mouth |
| DrRees | Tom, From what you've told me they certainly sound like skin LP. I don't remember though, was one of those sites biopsied? |
| PhilnNY | In fact, there are very foods I'm willing to even try and eat, due to the pain. |
| LeilaP | If I am at a point where my gums are blleding and irritated some foods will irritate it further but I can eat those same foods a few weeks later when the OLP has regressed some with no problem |
| drburkhart | Hello Mac. Do you have a question or comment? |
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| aupton | Mac, ask your question and the doctors will be with you as soon as they can |
| LeilaP | No, I don't think it matches my menstrual cycle |
| Tom | Dr. Rees, the oral spots were biopsied and the diagnosis from the Gainsville. FL lab was OLP. The body spots were identified as LP by our dermatologist. |
| DrBMcCartan | Dr Lynch, the oral lining thickens and thins at different points of the menstrual cycle. This may be relevant or, more simply, premenstrual tension might play a role. |
| PhilnNY | not eat, as per my last entry. |
| DrRees | Che and Leila-If you do have OLP the tissue of the mouth is easily irritated and many foods will cause blistering, burning or sloughing. Here in Texas it often occurs with salsa |
| PhilnNY | I miss southwestern food. :-( |
| Ollie | ditto |
| mac | For anybody, I am a 67 yr old male diagose with olp by biopsy 8 years ago now being treated with Triamcinolone acet-ing as a swish in saline, no open sores have metalic taste no remission in past any suggestions? |
| drburkhart | Phil, we have had patients from India and curry is large part of their diet, and they also miss their food. |
| DrLynch | Mac, does your OLP hurt? If not ,why are you treating it? |
| DrBMcCartan | The metallic taste may be unrelated. Talk to your specialist. There may be other ueful investigations. |
| DrRees | Tom, you and I will communicate some more regarding your wifes situation. I appreciate the latest e-mail you sent but haven't had a chance to fully digest it. Remember though, you need to be in the hands of an expert in oral diseases and I think your wife is so please follow up with him. |
| aupton | ABOUT 5 MINUTES TO GO. Please begin your final comments, folks. I will leave the room open for a few moments afterwards so that anyone who wishes may exchange emails. |
| PhilnNY | Yes, I understand, Dr. B' I try to perservere like most, I guess. |
| DrRees | mac- several medications can cause a metallic taste and some local or systemic disorders will as well. Please have that checked out. |
| mac | tounge burns when olp at worst. tounge covered with thin white streaks, worse during allergy season because of dry mouth, what is opinion of the swish I am using, it seems to lessen effects of olp slightly, have been using for over a year? |
| twiz | Drs -does the oral lining thicken and thin at different points? my OLP started at menopaese and now I'M on the right dose of HRT it seems to flare up less. re food - I can eat curry like Korma,without chilli or cardamom. so can eat some spicy foods. Experiment - I find that as long as I rinse with enough water,it is sometimed bearable |
| Ollie | Dr Lynch: Good point. I keep using the meds in hopes that the LP will go away...not merely that it will alleviate some of the symptoms. |
| LeilaP | I think you said earlier you are going to put OLP article references on the site -- that would be great |
| Che | To ALL Docs- i would like to thank you all for your help and advice. Its great knowing someone is there to help |
| Tom | Thanks, Dr. Rees, I will. By the way, many thanks to everyone for all the great info. This is a wonderful forum.s. |
| drburkhart | Everyone, we appreciate your comments and the frequent emails. Please keep us updated as members of our group. Your comments and information helps everyone. Merry Christmas and happy holidays to all of you. Thank you Drs. Lyhch, McCartan for being with us today. Good information! |
| DrRees | mac, since you are continuing to have problems it may be time to switch to another treatment such as a steroid gel or ointment. Talk to your physician or dentist about that. |
| LeilaP | You can make curries from scratch and leave out the chili powder - |
| DrBMcCartan | Che, if you wan to contact me via Dr Burkhart, I may be able to put you in touch with French sourcs of help |
| PhilnNY | Thank you very much Drs. and everyone else... This was worthwhile. Enjoy your holidays. |
| Che | Dr McCartan- thanks a million! |
| LeilaP | Thanks for being here to answer all our questions! Have a great holiday! |
| twiz | Thanyou everyone. Happy Xmas and an OLp free 2002.twizE@hotmail.com (Britain) |
| DrLynch | Ollie, if it's not painful, is there any reason to not just leave it alone? It will almost certainly be present for a long time, so why spend the money on medication that isn't doing much for you? Just a thought. |
| drburkhart | Please contact us with any additional questions for any of our participants and we will get back to you. Keep checking our site. |
| DrLynch | Bernard, Terry and Nancy, and the other chat room members, happy holidays to you! |
| mac | Thanks, I just found this site and will closely monitor in future mery xmas everyone Thanks to all the Drs. |
| Che | Bye everyone Happy Xmas and New year |
| PhilnNY | email for me... for anyone wishing, is surfing@optonline.net |
| Ollie | Thanks all...keep looking for the silver bullet...fobarrett@yahoo.com |
| DrRees | Thank you all for participating. Especially you Dr. McCartin. It is most beneficial to have input from around the world. Please give my regards to Philip Lamey the next time you talk with him. Happy holidays to all. |
| DrBMcCartan | Thanks everyone for listening to me. It's a bit like juggling with your eyes losed trying to keep up. Best wishes to Dr Rees and Dr Lynch. See you soon. |
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| aupton | Time to sign off, Folks. Thanks to all for participatiing. Transcripts will be online by tommorrow. The room will be shut down in apx 5 more minutes. |
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