| .............. Log on jun2002 started at Wed Jun 12 05:18:53 PDT 2002 ........... | |
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| aupton | Hi, dr c -- we'll start in just a moment |
| drmcarrozzo | Type HEREOk,thank you |
| drmcarrozzo | ..and good morning! |
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| drburkhart | Hello everyone! I usually join in from Charlotte, but today I am in sunny Dallas-great to be back for the week. |
| MJJ | Why are you in Charlotte so much of the time? |
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| drburkhart | I actually live there now, but have continued as a faculty to conduct the support group. Can't give that up! |
| MJJ | Glad you have not given that up, thanks. |
| drburkhart | Our guest is Dr. Carrozzo and we are happy that he could join us today. |
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| drburkhart | MJJ, do you have a question? How long have you had LP? |
| drmcarrozzo | Hi to everyone from a not so sunny northern Italy |
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| MJJ | I have had LP orally and vaginally for 22 years. Now spreading to hands and back |
| drburkhart | Sally, welcome do you have a question |
| DrWright | Dr Carrozzo, welcome and thankyou for participating |
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| drmcarrozzo | thank you |
| MJJ | My LP is getting worse every year, wondering if different drugs cause it to flare, like Zoloft. |
| drburkhart | Mac, welcome do you have a question? |
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| mary | I would be interested in an answer to MJJ's question. |
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| drburkhart | Rosalie, do you have a question for us? |
| drmcarrozzo | Nancy, please which is chemically Zolof?we have in Europe different drug names |
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| MJJ | Zoloft is a SSRI Antidepressant. |
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| drburkhart | Dr. Carrozzo, it is setranline-if that helps |
| aupton | HI, mcd. direct any questions you may have to the doctors, and they will answer as soon as they can. Welcome. |
| drburkhart | Rete, hello, do you have a question? |
| mary | I have suffered for over five years and mine started with menopause and the beginning of taking drugs for hypertension. I feel this is related. |
| aupton | Rete, welcome, the doctors will address your questions as soon as they can. Enter a question anytime. |
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| drburkhart | Mary, some medications do cause what is called a lichenoid reaction. We can send you a list of these if you email me after the session. |
| mary | ok. thanks |
| MJJ | I would like a list too pleasse |
| drmcarrozzo | Ok, to the best of my knowledge antidepressants are not common cause of OLP induction or exacerbation. have you done an immunofluorescent study of your lesions? |
| aupton | Welcome to those just arriving. Address your questions directly to the doctors, and they will respond as soon as they can. |
| mac | I was diag with OLP by biopsy 10 yr ago. Thin white lacy covering tounge now. Treated with triamcinolone swish. First eruption on inside of upper lip. Changed to Protopic two weeks ago. Some success. Do you have any ore info on Ptotopic?? |
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| MJJ | What are immunoflourescent studies and where can I get them. I have had it biopsied several times. |
| DrWright | Mjj There are a variety of drugs that cause or worsen LP. Zoloft does cause oral dryness that itself could worsen your LP or the dryness could lead to secondary yeast infection which could be the culprit. Zoloft also causes aphthous ulcer. I don't have my full list of drugs that directly causes LP but I thinkZoloft is on the list. I would recommend seeing your doctor who is overseeing your treatment and see if this is yeast infection, aphthous ulcer or just worsen |
| mary | MJJ can we trade email addresses? |
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| sumacray | Type is it possible to have lp in eyes |
| aupton | emails will be traded at the end of the session. |
| MJJ | I did have oral yeast infection not long ago. I have stopped it. |
| mary | thanks art |
| drburkhart | Mary, although many women who have lichen planus are post menopausal, we have not made any links with hormonal problems. Men in this age range have lichen also. |
| MJJ | Mary, yes we can trade e-mail addresses. How do we do that. |
| mary | at the end |
| aupton | TRADE EMAILS AT THE END OF THE HOUR |
| aupton | I will give everyone time to do so before closing the room. Thanks. |
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| mary | It could still be hormonal with men, right? |
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| drmcarrozzo | Eyer LP is quite uncommon |
| MJJ | I will not be on until end. Mary, I am mjlilbear@aol.com |
| GoldenFawn | Type HEREso there are others ut there with this strange disorder? |
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| mary | Is there any ongoing research ......real research ...into the causes of LP? |
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| MJJ | Doctors, do you find that LP gets worse with age. I started 22 years ago and now the worse I have ever been. |
| MJJ | I am 57 presently |
| sumacray | how do you feel about the med neoral i'm taking? |
| GoldenFawn | im 32.. was diagonozed last November |
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| aupton | Please ask specific questions of the Doctors directly. Thanks. |
| drburkhart | Mary, yes we have research going on all the time. Many people think that OLP is caused by many things and not by just one factor. Some individuals may be more prone than others. |
| drmcarrozzo | mary: yes, there are a lot of works in progress but we have to considet that probably OLP is not caused by only one things |
| Rosalie | My doctor (Univ MO School of Dentistry) has prescribed Clonazepam.5mg for my burning mouth syndrome. It is an anti-anxiety drug and I hate taking it, but sure helps the BMS. My OLP seems to be in remission, but have two scars from big-time lesions at the far back hinge of the jaw on the inside of the cheek that keep haunting me. They erupt at the same site each time along with metallic taste in my mouth. These lesions break out about every 6weeks. ENT dr. called |
| drburkhart | Chuck, hello do you have a question? |
| DrWright | MJJ I have not found LP to worsen with age, if it worsens it obviously does so over time but it is not predictable that all patients worsen and in fact many do not. |
| Joy | how does lp showlp show itself in the eyes? |
| Rosalie | Is the OLP an anxiety related problem? |
| GoldenFawn | clonazapam gets rid of the burning mouth sensation? I was already taking that...hmm |
| mac | My earlier ? was on Protopic Oint. any thing new with it?? For any dr. |
| MJJ | Can other diseases cause the LP to get worse, I have Diabetes, Fibromylgia, Chronic Fatigue, Hypertension, etc. |
| GoldenFawn | ive had Thrush several Times since being diagonozed.. |
| aupton | For those just joining, pose a brief question to the doctors directly and they will respond as soon as they can. |
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| sumacray | is it genetic ? |
| drmcarrozzo | Mac: what is chemically protopic? |
| aupton | GoldenFawn, questions only, please -- no statements like "hmmmmm" -- thank you |
| Mary | Hi! |
| drburkhart | Everyone, when we answer a question, we take time and miss the dialogue . So just ask your question again, and be sure to contact us after the session to follow up. |
| lulu | Type HEREdaughter has had biopsy indicatihg lp for several months. Nothing seems to clear it up completely, although prednisone helps some. Topical steriods don't seem to do any good. Anything else that should be tried? jDaughter is 32 s old if this makes a difference |
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| Chuck | Type HERE I have it in my cheeks, one side more than the other. What is the most effective oral paste to use? I'm assuming this is a chronic condition and can not be cured. Is that the current thinking? |
| DrWright | Rosalie 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 |
| mac | Dr. C my info sheet says common name is tacrolimus |
| GoldenFawn | m I correct when I say it cant be cured but goes in remission after several months? |
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| Mary | Immune system foul ups run in my family. |
| sumacray | what do you think of the med neoral? |
| drburkhart | The eyes and LP are reported in the literature. We have some articles on this and we can get them to you. |
| Mary | My L.P. became severe after dentist installed a bridge. |
| drmcarrozzo | Ok Mac: tacrolinus seems to be a very promising drug for the treatment of OLP, but we have only preliminary data |
| sumacray | please do |
| aupton | For those just joining, please be patient. The doctors will address your concerns as soon as they can. |
| mary | All my doctors shake their heads. Whom do I count on for treatment of vaginal and oral LP? Dentist, Internist or Dermatologist? |
| Dona | Type HERE Any information of OLP being connected to hearing loss due to scar tissue filling the ear canals?? |
| drburkhart | In general, many skin diseases appear similar to LP so it is important to make sure that you truly have lichen planus and that you are followed. Periodic biopsy may be needed. |
| Mary | Had it severely for over a year. |
| drmcarrozzo | sumacray: neoral is ciclosporine, it is good but we find more effective clobetasol ointment |
| DrWright | Lulu It would be necessar to know which specific steroids don't work. In general, we try to manage this with topical steroids and I begin with flucoinonide gel the newer gels rub into mucosa easier than creams or ointments. If that doesn't work we try drugs like Temovate or Diprolene which are more potent but have a few more side effects. Most patients get some response to these newer generation steroids |
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| drburkhart | Dona, yes we have an article on this. Although it is rare, this has been reported. If you have skin lesions as well as oral lesions, you should be evaluated. |
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| MJJ | I am going to have to leave the chat room. Can we get transcripts afterwards. How about list of participaants? |
| drmcarrozzo | sumacray: clobetasol is a very potent topical steroids |
| mary | and what about side effects |
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| drburkhart | Sheila, do you have a question? |
| mary | if it is soooo potent. |
| sumacray | thank you |
| lulu | Are there any foods or herbal medicines that might help this condition? |
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| mary | I don't like to use any corticoid longterm. |
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| DrWright | Mary A dermatiologist would be knowledgable about LP and could manage both oral and vaginal lesions. Otherwise, someone in oral medicine or oral pathology at a local dental school would be good for the oral LP and your OB/GYN good for the vaginal lesions |
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| drmcarrozzo | Mary: gerally talking, topical steroids (ointment) have only local side effects: mainly candidosis; we prevent them adding topical antimycotic drugs (e.g. miconazole gel) |
| mary | I went to the University of Virginia Oral Pathology department.......very frustrating for all of us. |
| Chuck | The screen is scrolling so fast with additional comments it is hard to keep up. Is this available in a print-out for later reading and writing down of medications mentioned? |
| sheila | mostly, I am looking this time. have had such an awful outcome due to surgery that I am still overwhelmed by all and wish to just err on the side of too much knowledge, so just observing this time, thank you |
| lulu | Does using topical steriods for oral lp make the skin thinner? And never to grow back |
| aupton | CHUCK, TRANSCRIPT WILL BE POSTED BY TOMMORROW ON THE WEB SITE |
| drburkhart | Lulu, we get emails from patients all the time about foods that they are not able to manange. What works for one person may not work for another. |
| Rosalie | Is my suceptibility to OLP passed on to my children? |
| mary | so you are saying .......use two ointments. One to control the inflammation and the other to control the cortisone effect? |
| drmcarrozzo | Lulu: no, orally applied topical steroids do not have any effect on skin |
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| sumacray | what about loss of taste? |
| lulu | Living in the St. Louis, Mo area is there anyone you could recommend who is knowledgeable and has had any sucess in treatin lp? |
| drmcarrozzo | Rosalie: at present there only sporadic case of familial LP and we do not have not conving evidence on it |
| GoldenFawn | i live in st Louis lulu |
| drburkhart | Rosalie, so far we have not made a correlation with OLP being passed on to a relative, however, I hope that from our survey, we will have more details from a large group of patients. I will say that I do get frequent emails that may point in this direction. |
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| janice | Type HEREhow do i get to the live discussion from dr. from italy? |
| Mary | I live in St. Louis, Mo area too is there anyone you can recommend? I am desparate. |
| GoldenFawn | im desperate too |
| mcd | drwright-I am 62 have just been diagnosed and am rinsing with prednisolone, seems to help but not going away. Stopped using for awhile and symptoms did not get worse. Should I be looking for something to eliminate the condition?? |
| mary | I started with OLP, not have it vaginally. What's next. It almost seems inevitable. |
| drmcarrozzo | Janice: ask me what you want |
| lennyxo | Has either of the Doctors here ever seen OLP turn into mouth cancer? I have had this since 1993 |
| drburkhart | Rosalie, as we mentioned earlier, some people may be more prone to LP, so could this also be true with relatives? Possibly. |
| MJJ | How do I go about getting an appointment with LP experts at Baylor. Do I need a referral? I have PPO insurance |
| Jay | Is there any correlation between OLP and liver disease? |
| sheila | Nancy, I do want to say thank you for the ref. to Mayo, the trip there certainly helped to define things, thanks again |
| Mary | I've had this since teen years but wasn't diagonesed. |
| mac | Dr. C, I was diag 10 years ago by biopsy. At that time and until 3 years ago just a slight lacy covering on part of tounge. Then is spread over tounge and to gums no open sores. started Triamcinolone swish at that time. 5 months ago had a sore on inside of upper lip. Dr just put me on the Protopic oint twice daily. Have been on it for two weeks. Have noted some improvement in taste ability, and lessening of white lacy cover, sore is there but not as visible. I |
| DrWright | Lulu oral steroid will not make your skin thinner. If you place some of the more potent steroids on your skin, it does cause thinning. We don't have as much of a problem placing them in the mouth because your salive dilutes them somewhat and the don't tend to cause the mucosa to thin. This is more for intermediate potency drugs like Lidex and we are still experimenting with Temovate and Diprolene over long periods of time but so far, i'm not convjnced even these h |
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| MJJ | How do I get an appt with LP experts at Baylor? Who? |
| lulu | Has anyone came up with dermatologist or any other Dr in St. Louis, MO |
| drburkhart | Lennyxo, there is a small percentage of individuals who do develop cancer. With any chronic inflammation, the tissue is open to pathogens and this is true with any disease state. This is why it is important to be monitored and to keep it in a non erosive state. |
| PSL | What is the cost of an appt with LP experts at Baylor? |
| lennyxo | thank you |
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| sumacray | is prednisone and neoral safe taken together? |
| aupton | PSL, keep questions on topic. Costs can be discussed with College later. |
| val | Type HERE I live in sydney australia and no one knows how to treat me |
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| Mary | That is scary, as my primary care dr. doesn't know or care anything about l.p. and I'm not being monitored but always have open lesions for over a year. |
| lennyxo | how can you keep it in a non erosive state? |
| MJJ | Who can I send message to about being seen at Baylor after the chat? |
| mary | my Internist compared it to a wart!!!!!!!! |
| DrWright | MJJ you can call 214 828 8146 to make an appointment at the Stomatology center at Baylor. You do not need a referral. The cost is variable depending on the severity and other complicating factors but in general it is relatively low and consideerably cheaper than a private practice visit. |
| aupton | MJJ, see the website for contact info http://www.tambcd.edu |
| drburkhart | Lulu, we can find someone for you. If you contact me again after the session, we will get a name and number to you. |
| drmcarrozzo | Sumacray: yes, they are, but not for long time. But we usually use together topically and systemically steroids |
| GoldenFawn | id like it too Dr Burkhart |
| Chuck | I have to log off now, but this is a fascinating and helpful process. I will look forward to reading the transcript tomorrow. |
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| mary | how about other parts of the country. Do you know doctors who treat it....... |
| lulu | How do I contact you regading someone in St. Louis??? |
| aupton | Dr. Burkhart's email address is on the LP Web site, too. |
| PSL | What are the latest suggested treatments available for Lichen Planus? I have been treated with Prednisone, Lidex gel, and Triamcinolone paste. None of these have done much good. The past helps keep the redness down a little. |
| Mary | drburkhart, please get a name and number to me too in St. Louis area? |
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| MJJ | Thank you. Please advise how I can get transcript. I have to log off now. |
| sheila | I have a hard time determining what is OLP and what is stretching irritation on scar tissue. It is difficult to not worry about the long term outcome, especially the possibility of cancer from chronic irritation |
| aupton | MJJ, transcript info is under Live Discussions on the Web site |
| Olsenm | ENT Doctor has put meon Clacks Solution (with nystatin)--rinse 3 times a day-I have pretty good success akthough the lesions are still there. |
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| drmcarrozzo | PSL: I suggest clobetasol ointment: from our experience and for the paper published this drug seems the better choice for OLP treatment |
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| MJJ | Thank you. |
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| mary | I am in the Washington DC area............. |
| Carole | Type HEREHow about fluocinonide gel? |
| sheila | is there any lit. on surgical intervention for removal of lesions? |
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| PSL | I always hear that LP can go into remission, but mine never has. I have oral erosive LP and it never gets better, just progressively worse. I see an Oral Surgeon every few months and have cleaning every 3-4 months. |
| mary | same here |
| rich | Type HEREsame here |
| mary | rather discouraging |
| mary | to hear this. |
| DrWright | PLS There are topical and relatively safe steroids available that are more potent than Lidex and Triamcinolone. Have your Dr try Temovate or Diprolene gel. If not we often treat systemically with prednisone to control an outr=break but alway with the intentionof getting patients back on topical therapy for control. There are a variey of more costly and experimental drugs being invesigated and time doesn't allow me to discuss them here. |
| sumacray | same here |
| mary | never any good news. |
| sheila | what do you mean by "cleaning?" |
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| GoldenFawn | how depressing :( |
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| lulu | Is there much research being done on this disease? |
| sumacray | good question |
| elm | I have been Rx Elidel for both genital and oral lp lessions. Any comment on what it is and how it works? |
| DrWright | PLS is your oral surgeon trying some of the steroids we have discussed here. |
| mary | same drug for both? |
| drmcarrozzo | Carole: fluocinonide is a good topical steroids but we suggest to use orally the ointment because gel (normally) contain alcohol and it could sting |
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| PSL | Just the prednisone which I was on several times in the last year. |
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| mary | I will NOT go on Prednisone.............. |
| LorettaAnnie | Type HEREwish someone would say I used such and such...and it CURED me |
| lennyxo | Is there any of your associates in the Chicago area? |
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| GoldenFawn | me too loretta |
| Rosalie | I've had good luck with Diprolene on the lesions if I apply it just as soon as I get that inkling that they are about to erupt. |
| mary | LOL........right. Dream on Lorette |
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| drburkhart | Everyone, be sure to read the transcipts again after they are posted. Some questions are answered that you may have missed while writing. |
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| PSL | The prednisone causes some improvement at first, but eventually I have to go off them and it returns to the same state. |
| DrWright | Lulu There is considerable research being done on a variety of issues related to LP but clearly I don't type fast enough or have the time here to go into them |
| LorettaAnnie | will the problem go away in our elder yrs or will we die with this in our mouths |
| Carole | is this disease stress related? if you control stress will it control the lp? |
| mary | mouth leisons or vaginal Rosalie? |
| Rosalie | Mouth. |
| LorettaAnnie | no reply -- not good |
| mary | Ointment in the mouth.........just gets dilutes and yuk |
| Rosalie | Will we have a chance to post our email addresses at the end? |
| PSL | I am 51 years and have had LP since I was 35. I have had 2 biospies (oral). |
| aupton | FYI For future, folks, use shortnames or initials. You will get quicker response, since the doctors like to address you by name before giving answer. Thanx. |
| aupton | ROOM WILL BE OPEN AFTER SESSION FOR EMAIL EXCHANGE. |
| drburkhart | LorettaAnnie, many people have a life time problem with LP and others have it for only a short time. There is no way to predict. |
| LorettaAnnie | thank u |
| drmcarrozzo | Carole: stress can probably influence the disease trough modification of the immuno-system: there are some pilot data on it |
| mary | we can only hope |
| Carole | ty |
| PSL | I was talking about dental cleanings. |
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| LorettaAnnie | my tongue is bald and red - anyone else have that also? |
| mary | I really appreciate the effort of Baylor........thank you ALL |
| lennyxo | :) |
| DrWright | Rosalie makes a very good point for everyone a bout treating outbreaks early before they get too bad. Also, topical meds should be used after meals and then don't eat or drink anything for at least 30 min. otherwise you just wash them off. Additionally, make sure that one of your applications if right before bedtime. You don't salivate much at night and it stays on longer |
| drburkhart | Any woman who has OLP should be evaluated for vaginal LP also. We are hearing more and more that this often overlooked and the two are not connected. |
| sheila | so, your oral surgeon cleans your teeth and monitors the olp? |
| aupton | LorettaAnnie please address the doctors individually, and not the group. |
| PSL | I just don't buy the stress factor. I have stress, but doesn't everyone and everyone doesn't have LP. Stress doesn't seem to make a difference for me. It is the same no matter what. |
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| Mary | PSL me too. |
| mary | what do you mean the two are not connected? |
| rich | I agree with PSL I don't buy the stress factor |
| mary | if you are prone one place.........why not the other Dr. Burkhart? |
| Rosalie | Is OLP classed as a systemic condition that we treat topically? |
| mac | Dr C, At same time 10 yr ago that I was diag with OLP I was also found to have low white cell and platelet counts Now have an enlarged spleen. CT scanand other tests do not show reason. Have had bone marrow biopsy and all ok there. Do you think Olp and low counts related?? |
| mcd | drwright-I am 62 and hve been recently diagnosed. Am currently on Prednisolone rinse, it has helped some. Should I be looking for complete healing or will I always have these sores. |
| DrWright | We don't think stress causes LP but in some patients, not all, it does seem to worsen their LP at times. |
| Joy | can lp effect the ears....I have just had labyrinthitis?...has anyone else had ear problems? |
| elm | drmcarrozzo: any comment on Elidel and how it works? I have been Rx for both genital and oral lp. |
| drburkhart | PSL, I have found that most patients who have OLP, do not realize that they are stressed. Probably because they have incorporated this aspect into their daily lifestyle. If you do not know what it is to be unstressed, how would you know. There is a book I added to the reading list called "The Okinawa Progam" |
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| aupton | JOY, please ADDRESS THE DOCTORS, NOT THE GROUP. |
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| drmcarrozzo | Rosalie: most of patient have only oral lesions; some of them have also genital and/or skin lesions.When you have only oral lesions topical therapy is the best |
| GoldenFawn | im stesssed BECAUSE of lp |
| PSL | Wouldn't there be some of sign of vaginal LP? How is it treated? |
| lennyxo | Dear Doctors stress could play an important role. I recently lost my father and mtolp has never been worse |
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| lennyxo | olp |
| mary | Vaginal ..........you know if you have it! |
| Mary | My grandfather had rhumatoid arthritid, my grandmother's sister had it, I had it (in remission), my son had chron's severely that's proven to be genetic, and now I have L.P. Not stress, genetic. |
| Carole | when i am really stressed...my mouth lets me know it |
| drburkhart | Golden Fawn, any chronic disease causes one to be stressed. This is normal. Have you tried some stress reduction classes, yoga, relaxation techniques. |
| PSL | Also, if the vaginal LP is left untreated, what would happen? |
| DrWright | PSL MOst vaginal lesions do product symptoms similar to those orally |
| drmcarrozzo | For everyone: stress can worse OLP but not in every case |
| aupton | For those just joining, welcome. The doctors will answer questions in order, and as quickly as they can. |
| GoldenFawn | as of yet I havent... |
| Mary | Thank you drmcarrozzo. |
| lennyxo | Are any of your associates in the chicago land area, for one one consultation |
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| sumacray | does med. bring on lp like prozac? |
| drburkhart | PSL, many women just complain of infections and sometimes these are treated as common yeast infections. Once you make it known that you have LP in other areas, the vaginal can be assessed. |
| lorna | Type HEREI was wondering if you have LP, what are odds you would get rhumatoid arthritis |
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| rich | I have just begun topical treatment of oral lp How do I know if I have used used the appropriate amount in each treatment? |
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| Mary | Doctors here know how to treat rheumatoid arthritis. I wish I had that again instead of L.P. |
| mary | I want to know why OLP and vaginal are NOT connected? |
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| DrWright | Prozac is not a common producer of LPp |
| GoldenFawn | i just want it to go away |
| Carole | when i was first diagnosed with olp...dr said would not ever be cancerous...now the thoughts have changed? |
| mary | is Atenolol? |
| PSL | I still wonder about the connection to fillings in the mouth. I have fillings from when I was a little girl, some are 40 years old. Anything new about that? Dr. Burkhart, I never have yeast infections and have no symptoms of vaginal LP, so hopefully that is not a problem. Worrying about losing my teeth is quite enough for me. I have always taken care of my mouth and this is quite distressing and hard to understand. |
| sumacray | what about synthroid? |
| drmcarrozzo | Mary: we do not know if vaginal and oral LP are connected: many woman have the two manifestation but many do not have oral or vaginal lesions. |
| mary | thank you |
| elm | drburkhard or drmcarrozzo: I was Rx Elidel for both genital and oral lp. How does it work? |
| drmcarrozzo | sumacray: please the cheminal name |
| drburkhart | PSL, there have been publications suggesting a lichenoid reaction to amalgam. I can send you some articles on this if you wish. Usually the lesion produced is in the area of contact with the restoration. |
| sumacray | its for hypothyroidism |
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| PSL | Yes, I would like to have those publications, please |
| drmcarrozzo | Elm: do you know the chemichal name? |
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| drburkhart | PSL, if you have LP generally all over, it probably is not a lichenoid reaction. |
| mary | PSL....please stay so we can exchange email addresses |
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| aupton | FOLKS, THE DOCTORS WILL BE WITH US FOR 15 MORE MINUTES. |
| lennyxo | Is it a safe assumption that percentage wise, we will die with olp not from it? |
| DrWright | Carole LP and cancer is very controversial. Many of the patients reported in our literature of LP progressing to cancer were not LP to start with, rather they were misdiagnosed by the clinician or pathologist as LP but in reality were premalignant to start with. I do believe there is a very very slight increased risk but not nearly as high as some of my colleagues think. The risk is so low that I do not tell my patients of the risk. Worrying about mough cancer wil |
| mcd | drmcarrozzo-I too was told that OLP was not precancerous. Has this changed?? |
| drburkhart | Everyone, if you want an article or if you need a list of medications that are associated with LP, contact me by email with your name and address for mailing. Since you use screen names, we have no way of knowing who we are talking to in the sessions. |
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| elm | drmcarrozzo: Elidel 1% also pimecrolimus |
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| Carole | ty...but my mother and a first cousin died of oral cancer...i amvery worried |
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| lorettaannie | Type HEREi wish dr burkhart could be my personal doctor :( |
| americamba | Dr Carrozzo: i have olp. Mydoctor tells me to stay away from spices. i like my peperoncini. Must I leave them? |
| mary | Dr Carrozzo........what is the most successful RX in your country? |
| GoldenFawn | does drinking alcohol make the condition worse? |
| Mary | I've had to quit eating all spiced foods, citrus, rough foods because they all make it worse. |
| DrWright | Carole Unlike some cancers, there is almost no evidence of inherited genetic factors at least with mouth cancer. |
| PSL | Another thing that is so hard is that this condition is actually a medical condition, but since it is in the mouth, it is treated as a dental condition and is not covered by insurance. I know that is not a question, but something that we with oral LP have to deal with. |
| lennyxo | drburkhart this is my first time logging on. I realize it would be best to just type in our actual names? |
| drmcarrozzo | MCD: we have in our files some cases of OLP with onset of oral cancer, but it seems a very uncommon event and as Dr Wright says it is a very controversial topic |
| Rosalie | I, too, would like to know if spicy foods should be avoided? or does this vary with the individual? |
| Carole | ty dr...that helps me a lot....have been so worried |
| aupton | 10 MORE MINUTES WITH THE DOCTORS. PLEASE DO NOT OPEN NEW TOPICS AT THIS POINT. |
| mary | if they hurt don't eat them |
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| PSL | Any cases of people with oral LP losing their teeth, even with good oral hygiene? |
| DrWright | PLS LP in the mouth is a medical condition and we file medical claims for it. If a dentist is managing you, that may be the problem |
| drmcarrozzo | Mary: we use mostly clobetasol ointment in adhesive medium (like orabase) |
| lorettaannie | what is one commonly known medicine that does most good for all? |
| Mary | PSL yes, me. |
| Dona | Does OLP cause sores on outer lips of mouth? |
| drburkhart | Golden Fawn, alcohol may make the condition worse if you have any oral lesion. Alcohol and tobacco use has been associated with higher rates of oral cancer. I have found that most OLP patients are very health conscious and many do not drink at all. |
| PSL | Also, I know this is not contagious, but that is always a worry. |
| drmcarrozzo | LOrettaannie: clobetasol again |
| GoldenFawn | okay.. Thanks Dr Burkhart |
| lorettaannie | thank u doctor |
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| Mary | Thanks Doctors and All. |
| americamba | on oral lesions... i found that aloe vera gel helps.Am I imagining this? |
| Rosalie | Thanks so much - I've learned quite a bit. |
| PSL | What can be done to stop the progressive lose of gum tissue besides good oral hygiene? |
| drburkhart | PSL, you can still have LP and periodontal problems at the same time. Periodic cleanings are crucial and should be conducted every two-three months. We have some good info on the site concerning all of this. |
| mary | putting something topical on my gums seems to make me salivate more........ |
| Mary | I'm extremely allergic to aloe vera. |
| PSL | Is dry mouth caused by OLP? |
| DrWright | Spicy foods and alcohol will irritate and burn any oral condition caused by inflammation. It is not necessarily worsening the LP. I advise patients to eat and drink what they choose and if they symtoms are too bad, then just avoid those things. |
| drmcarrozzo | amaricabamba: we suggest to the patients to avoid irritants including spice (if they sting) |
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| mcd | drmcarrozzo-I am currently on Prednisolone it helps some, should I be looking for complete healing or will the sores always be there?? |
| Dona | Oral Prednisone 5 mg a day helps my OLP erosions .. |
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| DrWright | PSL LP doesn not cause dry mouth but a lot of things cause dry mouth like medications so the two conditions often coexist. The dryness will worsen symptoms from LP |
| GoldenFawn | dr Burkhart, what is your email address? |
| drmcarrozzo | MCD: prednisolone may heal the erosion and the result should be maintened using topical steroids |
| rich | I asked the drs to explain how much topical treatment is enough for OLP I am afraid I am using to much) I received no answer |
| aupton | EVERYONE: THE DOCTORS WILL BE MAKING FINAL STATEMENTS NOW AND SIGNING OFF IN ABOUT 5 MINUTES. THE ROOM WILL REMAIN OPEN FOR ANOTHER FIVE MINUTES FOR EXCHANGE OF EMAILS |
| lennyxo | I Thank all of you for your time |
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| drburkhart | PSL, you may want to see a periodontist in addition to your regular dentist. That is, if there is a periodontal problem. |
| mary | thank you all too |
| PSL | I have done that also. Thank you. |
| sheila | thank you to md's and group for info. if anyone has had surgical intervention for olp, please contact me: sheilazb@aol,com |
| GoldenFawn | id like the name od a a odctor who specializez in LP in the st louis Area |
| PSL | My e-mail is Ppleonard@aol.com. |
| DrWright | Rich There is not a lot of evidence but our general rule, if a patients does not use more than a 15 gm tube of Lidex every 2 weeks then there is some evidence that this is relatively safe |
| DOT | Type HEREIs the Boiron Homedent Lemon toothpaste OK to use for this? |
| Dona | Thank you for information. |
| drburkhart | My address is on the site, but it is nburkhart@tambcd.edu |
| drmcarrozzo | RIch: we used to kind of topical treatment: the long-time (six-month of treatment) and the short-time (two months). When the symptomatic lesions heal you can stop the treatment. |
| GoldenFawn | thank you Dr. Burkhart |
| PSL | I use only regular crest toothpaste, but recently read about one called biotene. Would that be better? |
| Dona | Crest mild mint sensitive tooth paste is great.. |
| drburkhart | DOT, we find that many patients have problems with flavoring agents. We suggest Biotene. Most patients can tolerate this brand because it contains no additives and flavoring agents. |
| DrWright | PLS Biotene is a very hypoallergenic toothpaste that we often prescribe |
| drmcarrozzo | PSL: I suggest to use toothpaste that doesn't cause any discomfort in your mouth |
| PSL | Do you have to have a prescription to get Biotene? |
| aupton | THANKS TO EVERYONE FOR JOINING US. THE DOCTORS WILL BE SIGNING OFF NOW. THE ROOM WILL CLOSE WITHOUT NOTICE IN APPX 5 MINUTES. IF YOU WISH TO SHARE YOUR EMAIL, ENTER IT NOW, THEN CLICK THE "LOG OFF" BUTTON. THE TRANSCRIPT WILL BE ON THE WEB SITE BY TOMMOROW. THANKS AGAIN, EVERYONE, AND START SIGNING OFF NOW. |
| drburkhart | PSL, no you do not and we have a direct link on the site. |
| Rosalie | Rosalie - billrose@grm.net no prescription on the Biotene, but Walmart has to order it here. |
| DrWright | Unfortunately its time for me to leave to see my LP patients. Good luck |
| drburkhart | Thanks to everyone here today and that You Dr. Carrozzo for being our guest today. |
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| drmcarrozzo | Nancy, thank you for this exciting and unusual experience |
| americamba | thanks. Iwill be here next time. |
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| aupton | Thanks, Dr. Carrozzo. It's good to know there is a Dallas Mavs fan in Turin, Italy!! |
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| drmcarrozzo | Hi, art have a good champioship the next year |
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| aupton | We'll give it a go. |
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| mac | Thanks Dr. Carrozzo |
| .............. Log stopped at Wed Jun 12 06:41:37 PDT 2002 ........... |