Hi Declan,
The actual cause of lichen planus is still unknown, but it often
occurs after or during a bout of Hepatitis C. Your doctor should have
tested your girlfriend for Hepatitis C. Thelichen planus attack may
last for a few weeks to many months, clear up, only to return again in
a few years.
To help with the itching, the doctor can prescribe oral prednisone,
or clobetasol proprionate and betamethasone proprionate ointments.
These can help heal the skin, and keep the rash from spreading. In
the meantime, your friend can use over the counter cortisone creams,
bathe in Aveeno Colloidal Oatmeal bath powder, and dab the rash wth
Burrows Solution. Oral Benadryl can be taken to alleviate the itch.
Follow the package directions, and be aware that this medicine can
cause drowsiness. Talk to the doctor about phototherapy with
ultra-violet light to soothe the skin. Some "natural" products that
are safe to use and calm itchy skin are MSM creams, or creams with tea
tree oil, evening primrose oil, or flaxseed oil. If you use
alternative creams every third day, instead of cortisone creams, you
can prevent resistance to cortisone.
If your pharmacy does not carry Burrows, ask the pharmacist if they
have some behind the counter, or if they can order it for you. No
prescription is needed. If not, you can order it online, here:
http://www.americarx.com/index.asp?PageAction=VIEWPROD&ProdID=4004
Some people develop lichen planus after exposure to certain
medications (Some antibiotics, chloroquine, quinidine, phenothiazines,
and diuretics) chemicals, hair dyes, and emotional stress. You are
correct about the potential for hair loss. Some people may have
permanent hair loss if the rash reaches the scalp.
"Lichen planus may also affect the scalp, the nails or the inside of
the mouth. On the scalp, lichen planus may cause hair loss. Lichen
planus of the nails can cause brittle or split nails. In the mouth, it
looks like lacy white patches on the inside of the cheeks or on the
tongue. Sometimes lichen planus affects areas of skin where you had a
cut or burn."
"In many cases, the cause of lichen planus can't be found. However,
you can't "catch" lichen planus from someone else or "give" it to
someone else. It is not caused by stress, but sometimes stress makes
it worse.
Some cases may be linked to a virus called hepatitis C. This virus can
cause liver disease. Your doctor may need to order a blood test to
check for hepatitis C virus. Some medicines can cause lichen planus.
It is important to tell your doctor all the medicines you are taking."
"There is no cure for lichen planus, but medicine can help the itching
and rash get better. If your itching is very bad, your doctor may
suggest an antihistamine (one brand name: Benadryl).
Most of the time, the bumps go away without any treatment after about
a year. However, treatment can make your skin look better. If lichen
planus is only on a small part of your body, you can use a medicated
cream that you apply directly to the bumps. Because these creams are
strong medications, you should not put them on normal skin. You should
be careful when putting the cream on your face, under your arms or on
your genital area.
If the bumps don't go away, or if you have many bumps, you may need
stronger medicines. Your doctor may give you a medicine called
prednisone (say: "pred-ni-zone"). It comes in shots or pills.
Prednisone has many side effects, so take this medicine just as your
doctor says."
If the doctor prescribes prednisone, be sure to taper it off, when
going off this medication. It's very important to take the medicine
exactly as prescribed.
http://familydoctor.org/600.xml
"The onset may be gradual or quick, but its cause, like many skin
diseases, is unknown. It appears to be a reaction in response to more
than one provoking factor. Theories include stress, genetics,
infective (viral hepatitis C) and immunologic (autoimmune). There are
also drugs that produce lichen planus-like allergic reactions to high
blood pressure, heart disease, and arthritis medications. There is an
inherited form also which is often more severe and can have a
protracted course."
"Since every case of lichen planus is different, no one treatment does
the job. Topical corticosteroids are very useful. Antihistamines may
be prescribed to relieve itching. Extensive cases may require the use
of oral corticosteroid (cortisone, prednisone) for a number of weeks.
This usually shortens the duration of the outbreak. For severe cases
powerful treatments include photo chemotherapy light treatment (PUVA),
the retinoids drugs (Soriatane and Accutane), Neoral and Plaquenil."
"Lichen Planopilaris is the specific name given to lichen planus on
the scalp that causes permanent scarring alopecia with inflammation
around affected hair follicles. It mostly affects middle-aged adults
as distinct patches of hair loss. Treatment includes oral steroids (to
get it under quick control) plus topical steroid liquids, and the oral
medications Accutane or Plaquenil."
http://www.aocd.org/skin/dermatologic_diseases/lichen_planus.html
This Texas A&M Health Science Center website offers a free newsletter
and online support groups:
http://www.tambcd.edu/lichen/
Soothing mouth sores:
"It is important to make sure that one of these applications occurs
just before bedtime in the evening. The medication probably stays in
place longer at that time because saliva flow diminishes when you are
asleep.
Whenever you can, it will help if you gently blot the mouth sores dry
just before you apply the medication. Don't rub them dry, just blot
using gauze. This also will help keep the medication in place for a
longer period of time.
When you apply the topical corticosteroid, try to avoid rubbing it in
place using a back-and-forth motion, because that motion may rub the
"skin" surface away. Instead "dab" the medication into place.
Remember that more is not better. All you need to do is apply a thin
coating of the medication. If you do this, it will stay in place
better, last longer, and will be safer to use.
RINSE
Use as often as directed for as long as directed. After use,
expectorate but don't ingest other liquids for thirty minutes.
SPRAY
Direct spray toward mouth sores as directed. After use, don't ingest
water or other liquids for thirty minutes.
http://www.tambcd.edu/lichen/olpfacts/topicals/topicals.html
Graphic pictures, along with further information
http://www.nlm.nih.gov/medlineplus/ency/article/000867.htm
I hope this helps out your girlfriend. If any part of my answer is
unclear, please request an Answer Clarification, before rating. I will
be happy to respond.
Sincerely, Crabcakes
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