Hi,

Thanks for writing to Health care magic.

Lichen planus is a papulosquamous disorder .

It is characterised by itchy,red papules.

It invovles skin prominently,but in many cases mouth,genitals can also be invovled.

Treatment of lichen planus invovles oral and topical steroids mainly.Formild cases topical clobetasol cream is sufficient.In severe cases of lichen planus I ususally start at a dose of 40 mg of prednisolone and tapper off accordingly,depending on further response.Dapsone also works good in certain cases.

For oral and genital lichen planus i give steroid ointment (triamcinolone) in day time and tacrolimus ointment at night time.It gives good results.Injectable kenacort also has excellent results in some cases.

In certain cases lichen planus is secondary to some underlying conditions like fungal infections ,dental careis ,hepatitis.Treatment of these conditions is also important.

Lichen planus like eruptions can also be seen secondary to drug reaction.

In short I can tell you that lichen planus is easily curable and does not need to worry much.

The treatment profile which i mentioned is for normal pateints ,but since you have got multiple myloma,in your case treatment needs to be modified.

For lichen planus visiting a dermatologist is a best option.You can easily find out for dermatologist in las vegas from google.

Hope this will help you.In case you have any concerns I will be happy to help you.Take care.

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Hello,

Thanks for follow up query.

Oral lichen planus affects gums.It is known as desquamative gingvitis.

Best treatment for oral lichen planus is tacrolimus ointment .

It is used as 0.03%,and applied at night time.It produces a mild burning sensation.

Response is slow and it is advisable to add a steroid ointment preferably kenacort oral paste for 1 to 2 weeks.

You can apply kenacort oral paste at day time and tacrolimus at night time.Tacrolimus needs to be continued for 2 to 3 months even after adequate response is obtained.

Due to multiple myeloma your immunity is somewhat compromised ,so there is a chance that you may devolp secondary fungal infections.

For this you need to take oral fluconazole 150 mg once a week till your traetment continues.

You also need to use a good mouth wash like chlorhexidine gargles for preventing infections.

I will not advise you to go for intralesional steroid treatment.

Avoid hot and spicy foods as far as possible.

If you have any dentures you need to talk to your dentist about this.

I hope this will help you.In case of any concerns feel free to ask.Take care.

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