Q. Would you please write something about Lichen Planus? I have been suffering for some time with this ailment. A biopsy confirms that’s what I have.
A. Lichen Planus is a skin frustrating disease for the person who has it and the doctor trying to treat it. It’s important, as you have done, to make sure that you’re not suffering from another similar disease called leukoplakia, which often leads to cancer.
Lichen Planus occurs almost anywhere on the body but most of the time it also will affect the lining of the mouth. On the body, the lesions are about an eighth of an inch across and violet in color. They often cause severe itching.
In the mouth, the lesions look more like white streaks–similar to the appearance of leukoplakia. Lichen Planus lesions in the mouth may progress to small ulcers. As with many long-standing ulcers in the mouth, there is an increased risk of progression to cancer.
The cause of Lichen Planus is not well known, but some medications that contain gold, bismuth or arsenic, as well as exposure to photographic developers, may cause very similar eruptions. The first step to treatment is removal of these materials.
Treatment with antihistamines and steroids can provide some relief, but the symptoms reappear when the medications are discontinued. Fortunately, Lichen Planus seems to go away by itself over time. Unfortunately, it may recur years later.
Q. Can you provide me with an 800 phone number for board-certified doctors?
A. Almost all medical specialties provide an evaluation process of a doctor to determine certification in that specialty. Basically, this process requires that doctors complete advanced training and pass a test in the specialty.
In addition, most specialties require that the doctor take continuing medical education courses to remain certified.
I presume that you are looking for one or more board-certified specialists in your area. If so, I’ve found that it is best to look to local resources for that information. Try this: Ask your primary-care practitioner/doctor for a referral. Call your county medical society, and if one doesn’t exist, try the state medical society. Almost all hospitals also will provide you with referrals.
Almost all medical specialists are either board certified or board eligible (meaning they have completed their training but have not yet passed the examination). Remember to check with your insurance company or health maintenance organization to determine if the medical specialist you choose is on their approved list.
I’d like to add a strong reminder. How well you and your doctor communicate will have as much impact on your medical care as the doctor’s medical expertise. So, in looking for a specialist, try to interview more than one to select the one with whom you can communicate best.
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Write to Dr. Douma in care of the Chicago Tribune, Room 400, 435 N. Michigan Ave., Chicago, Ill. 60611.
