Gold linked to lichen planus

DEAR DR. GOTT: You recently wrote about lichen planus and gold as a risk factor. I’ve had lichen planus for more than five years, and you are the only reference I’ve encountered that claims gold could be a problem. I have two gold bridges and two gold caps. Could these be contributing factors?

DEAR READER: This inflammatory condition can affect skin and mucous membranes. When on the skin, it resembles raised, flat bumps or lesions that are itchy and somewhat purple in color. They can crust or scab, resembling poison ivy or other forms of plant dermatitis. When mucus membranes of the mouth are affected, white patches that resemble lace can appear and be quite painful. Lichen planus occurs when the immune system attacks the cells of the skin or mucus membranes.
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Did med cause skin condition?

DEAR DR. GOTT: While in Vietnam, I was taking a dapsone pill daily, as the Army suggested. Unknown to me, I had an allergy to the pill and became methemoglobinemic. I stopped taking the pill, but still have lichen planus on my legs and buttocks that comes and goes. I can go weeks with no trouble, then I have a breakout that will last for up to a month before clearing. I read that the dapsone could be the cause of the onset of the lichen planus. Can you tell me if this is right or wrong? Where can I find more information?

DEAR READER: Dapsone is commonly prescribed to treat dermatitis, herpetiformis (a skin condition that commonly appears on the elbows and knees), acne, infection and more.
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Lichen planus diagnosis raises questions

DEAR DR. GOTT: I am an 80-year-old female diagnosed with lichen planus. Other than being told it is an autoimmune disease, the dentists and doctors I have visited have no idea what to do with me. I have a white coating in my mouth on the bottom gums and occasionally break out with water blisters on my legs.

I am writing to you as a last resort for help. I have read on the computer that it is short-lived, but may come back. I have had it for three years now, and while it doesn’t always cause pain, it is annoying. Can you offer any suggestions or aid?

I once sent away for pills that were supposed to rid me of it, but they did nothing to help and they were expensive — $65 for a 30-day supply. I think they were some kind of herb.
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Lichen planus treatable

DEAR DR. GOTT: I have lichen planus with white spots in my mouth and blisters on my legs. This has been occuring on and off for two or three years. Is there any cure for this autoimmune disease?

DEAR READER: The exact cause for this annoying condition is unknown, but it is thought to be related to allergies from exposure to antibiotics, other medications, hepatitis C, iodides, diuretics, chemical substances such as compounds in gold rings or bracelets, and more.

Mild symptoms may not require any treatment. More complex cases generally respond to antihistamines, topical or oral corticosteroids, ointments or creams, lidocaine mouthwashes and medications to suppress the immune system. Lichen planus may respond to treatment over time but may also wax and wane for years. Be sure to see your physician or dentist for regular exams, since long-standing mouth ulcers can develop into oral cancer.