Lichen Planus Diabetes Info

by MARBLE

Lichen Planus

Lichen Planus

CONCERN: Hi,


I have been taking Metformin for a long time, maybe 9 years. In 2007 I was diagnosed with oral lichen planus. It was OK for a while until I lost my job and had no insurance to go to the dentist or get the medications.

I thought I was OK and did not know exactly how this disease would show itself. It began with hair brittle hair then hair loss. They checked my thyroid and ran all kinds of tests. They could find nothing.

Then, all of a sudden my mouth became raw and red and was sensitive to things like salt and vinegar. I had a bad taste in my mouth that changed the taste of all my food. Even cigaretts became unbearable.

I search and searched. I get my care from a Veterans Hospital. I cannot get dental privileges.

My primary care knew nothing of this disease. I asked them to give me the prescriptions I was taking before. I am in the process of coordinating them with my former dentist.

Oh by the way along with the ton. I believe this is all related.

Thank you for this site. I might guess issues and cheek issues, I have had a sore throat for months. Without this site, I would never have known the possible causes of all these symptoms.

MARBLE


REPLY Hi MARBLE,

First, I wish you lots of strength to face this situation, hoping it will be over soon.

Now, with regards to your symptoms, I could guess it might be Lichen planus. However, there are other diseases with the same symptoms. Therefore, I should ask you some questions as following:

- You are saying that since 2007, you were diagnosed with Lichen planus. In other words, you are suffering from supposed Lichen planus symptoms for more than 5 years.

Usually, the symptoms of Lichen planus disappear within 18 to 24 months. Yours is elongated. I am wondering WHY?

- Have you been treated? What medications have you taken apart Metformin? This is to find the right culprit to your condition.

- Do you have problems only in your throat and mouth? Do you have the same problems at any other site of your body?

This is very important as I want to differentiate with any other mouth disease (such as those of malign type, cancers).

However, in this case, the biopsy can make the differentiation. I would suggest you to perform the biopsy because elongated Lichen planus is related to higher risk for oral cancers.

  • As there is not specific treatment for Lichen planus, I would suggest as following:

    - You are saying that cigarettes are unbearable; meaning you are smoking. Please gather all your strength and stop smoking.

    Together with alcohol, smoking can aggravate your situation, and increasing the risk for oral cancer.

    - Next, please avoid foods that irritate wounds in your mouth, such as:

  • citrus fruits (lemon, orange, grapefruit, etc.);

  • spicy foods,

  • coffee, cola, tea containing caffeine

  • tomato and related foods (sauces or salsa)

  • crispy snacks or those that have salt

    - Regularly brush your teeth twice daily and floss appropriately.

    - Perform the biopsy every six months or yearly.

    - Make regular checkups with your dentist.

    Hope it helped!

    Dr.Alba

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    Diabetes and itching skin

    QUESTION: I have heard that diabetics have itching skin problems. Both of my parents are diabetics, but until now they do not have any itching symptoms.

    But I wanted to know how to recognize these diabetes symptoms itching in time to alleviate my parents suffering. Is it something only related to skin or other parts are also involved? Thank you.


    ANSWER: Hi there,

    You have to know that people with diabetes are having a lot of problems with their skin. However, these problems are observed only when they are not controlling their blood sugar well.

    Under good control of blood sugar, I mean that the dose of insulin is not enough to cover their needs or the number of the insulin injections per day is low.

  • The most common skin problem, which is characterized by itching, is the skin infection. These infections are caused by bacteria, which are normally living on the skin.

    If the patient is healthy and he/she is not having problems with high blood glucose, these bactera are no leading to troubles.

    However, some metabolic changes in the organism are leading to an elevation of the certain substances, like glucose in this case, which is helping the bacteria to grow and the multiply faster and more often.

    As you probably know, when the blood glucose is not controlled well, there is an elevation in the blood glucose amount. This elevation is a general one, and in a few days, the elevated amount of glucose is going inside the cell, including the cell of the skin.

    When the bacteria, which are living on the skin, find that there is enough glucose for them to grow and multiply, they are causing infection.

    These infections can be caused by a lot of bacteria and they are characterized by erythema and itchy skin. Furthermore, an infection like this can be developed almost everywhere on the human body.

    But the most probable part is the legs. The explanation of this fact is related with the obstruction of the blood vessels of the legs, cause by the elevated amount of the blood glucose and cholesterol level.

    This obstruction is stopping the immune cells to go in the affected area and to kill the bacteria which are causing this problem.

    You have to know that these conditions are observed in the advanced stages of diabetes, especially in patients who are not managing their diabetes well.

    As I mentioned before, these infections are observed when there is a persistent elevation in the blood glucose level. This elevation is causing not only skin problems but others like kidney problems, problems with the eye and heart.

    If your parents are treating their diabetes well, by controlling the blood glucose level, they won’t develop condition like this.

    Although such infections can be treated easily with antibiotics, changes in the kidneys, eyes and heart are very dangerous.

    Hope it helped! All the best!

    Dr.Alba

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    Blood Sugar Level And Itching Pruritus

    QUESTION: How are high blood sugar level and itching pruritus related in diabetics?


    ANSWER: Hi,

    Generally, there are a lot of skin problems during diabetes. In this case, the itching pruritus is caused by infection. If you notice that your skin is red, there is edema and this particular place is warm, that indicates for an infection.

    This type of condition occurs in those diabetic patients who are not controlling their diabetes well. That means that the dose of your insulin or any other drugs you may take, needs adjustment.

    An infection like this may develop in every part of the body. The explanation of these infections is hidden in the glucose metabolism.

    As you may know, diabetes is condition characterized by elevation of the glucose level in plasma. This elevation is leading to an increased glucose level in the organs; in this case, the organ is the skin.

    There are many bacteria normally living on the skin surface. These bacteria are not causing infections, because the health organism is able to kill them or most or them are healthy, i.e do not cause infection to our organism; on contrary they are helpful in its metabolism.

    However, sometimes due to changes in the metabolism, infection is developed. The elevation of the glucose in the skin is creating good environment for the development of bacteria and infections.

    The organism is capable to kill those bacteria but sometimes, in the advanced stages of uncontrolled diabetes there is no such option.

    As you probably know, when someone is suffering from diabetes microangiopathy is developing as a consequence. That means that the small blood vessels in your body are not able to transport enough blood to a specific organ.

    Immune cells are transported by the blood. When there is a reduction of the blood flow, there is a reduction of the number of immune cells transported in a specific area. These immune cells are not enough to prevent the infection.

    Increased glucose amount in the skin in combination with reduced protection of the organism, is leading to the development of infections characterized by itching pruritus.

    In this case, the usage of antibiotics will remove this infection, but you have to consult your doctor, because he will prescribe you the best drug suitable for a diabetic patient.

    On the other hand, it is a must to control your blood sugar in order to accelerate the healing process of the skin and to prevent the future onset of other infections.

    Hope it helped!

    Dr.Alba

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