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Lichen Planus

Q: After being diagnosed with a urinary tract infection about four months ago, my doctor prescribed antibiotics to clear it up. It worked well, but I've now developed these patches of little white lines and dots on my tongue and the insides of my cheeks. What is it, and what can I do about it?

Dr. Donnica:
You are describing a condition called lichen planus, an uncommon disorder involving a recurrent, itchy, inflammatory rash with or without purplish bumps on the skin or in the mouth. While the exact cause is unknown, it is considered an autoimmune disorder. It may be triggered by certain antibiotics (most likely sulphonamides, commonly used to treat bladder infections), allergens, other medications (including iodides, chloroquine, quinacrine, quinidine, antimony, phenothiazines, and diuretics such as chlorothiazide), dyes, other chemical substances, stress, or viral infections. It usually affects adults in middle age. The initial attack may last for weeks to months, resolve, and then may not recur for 18 months to several years.

Recurrences should be monitored by a physician because this condition can be associated with hepatitis C as well as oral and genital cancers. Your physician may confirm the diagnosis with a biopsy of the affected skin. Treatment is based upon the severity of the symptoms. If symptoms are not bothersome, no treatment is necessary. Treatment options include antihistamines, liquid lidocaine mouthwashes, topical corticosteroids, oral corticosteroids, topical vitamin A cream, and ultraviolet light therapy. The good news is that lichen planus is not contagious.

Created: 3/4/2005  -  Donnica Moore, M.D.

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